title: Review of efficacy and safety of laxatives use in geriatrics.
abstract: OBJECTIVE
  To study the efficacy and safety of pharmacological treatment of constipation in geriatrics.
  
  
  METHODS
  PubMed, MEDLINE, google scholar, and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation, which were conducted between January 1990 and January 2013 using the specified keywords. Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included. Studies were excluded from this review if they were non-controlled trials, case series, or case reports.
  
  
  RESULTS
  Out of twenty three studies we initially retrieved in our search, only nine studies met the eligibility criteria of being controlled trials within geriatrics. The laxatives examined in the nine studies were senna, lactulose, sorbital, polyethylene glycol (PEG), lubiprostone, linaclotide, and prucalopride. In those studies, senna combinations had a higher efficacy than sorbitol or lactulose as well as, a very good adverse effect profile. PEG was also shown to be safe and effective in geriatric population. Furthermore, it has been shown that PEG is as safe in geriatrics as in general population. New agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrants further investigation.
  
  
  CONCLUSIONS
  Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation.
authors.affiliation: Manhal Izzy, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States.
authors.forename: Manhal
authors.initials: M
authors.lastname: Izzy
authors.affiliation: Manhal Izzy, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States.
authors.forename: Anju
authors.initials: A
authors.lastname: Malieckal
authors.affiliation: Manhal Izzy, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States.
authors.forename: Erin
authors.initials: E
authors.lastname: Little
authors.affiliation: Manhal Izzy, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States.
authors.forename: Sury
authors.initials: S
authors.lastname: Anand
keywords: Chronic constipation; Elderly; Laxatives; Linaclotide; Lubiprostone; Prucalopride