title: Chronic constipation in the elderly: a primer for the gastroenterologist.
abstract: Constipation is a frequently reported bowel symptom in the elderly with considerable impact on quality of life and health expenses. Disease-related morbidity and even mortality have been reported in the affected frail elderly. Although constipation is not a physiologic consequence of normal aging, decreased mobility, medications, underlying diseases, and rectal sensory-motor dysfunction may all contribute to its increased prevalence in older adults. In the elderly there is usually more than one etiologic mechanism, requiring a multifactorial treatment approach. The majority of patients would respond to diet and lifestyle modifications reinforced by bowel training measures. In those not responding to conservative treatment, the approach needs to be tailored addressing all comorbid conditions. In the adult population, the management of constipation continues to evolve as well as the understanding of its complex etiology. However, the constipated elderly have been left behind while gastroenterology consultations for this common conditions are at a rise for the worldwide age increment. Aim of this review is to provide an update on epidemiology, quality of life burden, etiology, diagnosis, current approaches and limitations in the management of constipation in the older ones to ease the gastroenterologists' clinic workload.
authors.affiliation: Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. deg@aosp.bo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: De Giorgio
authors.affiliation: Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. eugenio_ruggeri@hotmail.it.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Ruggeri
authors.affiliation: Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. v.stanghellini@unibo.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Stanghellini
authors.affiliation: Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. lheusebi@gmail.com.
authors.forename: Leonardo H
authors.initials: LH
authors.lastname: Eusebi
authors.affiliation: Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. franco.bazzoli@unibo.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Bazzoli
authors.affiliation: Division of Gastroenterology of the University of Verona, AOUI Verona, Verona, Italy. chiarioni@tin.it.|UNC Center for Functional GI & Motility Disorder, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. chiarioni@tin.it.|Division of Gastroenterology of the University of Verona, Ospedale Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134, Verona, Italy. chiarioni@tin.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Chiarioni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease; D003248:Constipation / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016330:Frail Elderly; D005762:Gastroenterology; D006801:Humans; D011788:Quality of Life