Physiologic and psychologic characteristics of an elderly population with chronic constipation.
OBJECTIVE
To characterize colorectal physiologic parameters and psychological profiles in subjects > or = 60 yr with chronic constipation who have not sought medical advice.


METHODS
Colorectal physiologic studies and psychologic profiles were obtained in 18 self-identified constipated subjects and 17 nonconstipated control subjects. Constipation was defined as two or fewer bowel movements/week and/or defecatory difficulty for at least 6 months. All subjects underwent colonic transit with radiopaque markers, anorectal manometry and completed a self rated inventory assessing psychological distress (SCL-90-R).


RESULTS
Slow colonic transit occurred in five constipated subjects. Pelvic floor dyssynergia and/or increased rectal compliance were found in nine subjects versus only two controls. One-third of constipated subjects scored in the top 10th percentile for global psychologic distress with higher scores for somatization, depression, and anxiety than control subjects. Neither physiologic nor psychologic abnormalities were predictable on the basis of patterns of bowel complaints.


CONCLUSIONS
Colorectal physiologic and psychologic dysfunctions are common in elderly constipated subjects who do not seek medical attention for bowel dysfunction.
Merkel
I S
IS
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
Locher
J
J
Burgio
K
K
Towers
A
A
Wald
A
A
D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology; D001294:Attitude to Health; D002908:Chronic Disease; D015331:Cohort Studies; D003106:Colon / Q000503:physiopathology; D003248:Constipation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology