title: Constipation in older people: A consensus statement.
abstract: OBJECTIVE
  Chronic constipation is a serious medical condition that affects 30%-40% of people over 60 years old. Although not normally life threatening, constipation reduces quality of life by the same extent as diabetes and osteoarthritis. There are currently no Europe-wide guidelines for treating constipation in older people, although there is some country-level guidance for the general population. We have evaluated the existing guidance and best clinical practice to improve the care of older people with constipation.
  
  
  METHODS
  European healthcare professionals working in gastroenterology, geriatrics, nursing and pharmacology discussed the treatment of constipation in older people and reviewed existing guidance on the treatment of constipation in the general population. This manuscript represents the consensus of all authors.
  
  
  CONCLUSIONS
  Most general guidance for constipation treatment recommends increased dietary fibre, fluid intake and exercise; however, this is not always possible in older patients. Although a common first-line treatment, bulk-forming laxatives are unsuitable for older people because of an associated need to increase fluid intake, osmotic laxatives are likely to be the most suitable laxative type for older patients. Treatment is often hampered by reluctance to talk about bowel problems so healthcare providers should proactively identify older constipated patients who are self-medicating or not receiving treatment.
  
  
  CONCLUSIONS
  With certain modifications, general treatment guidelines can be applied to older people with constipation, although specific guidelines are still required for this age group. Awareness of constipation, its complications and treatment options need to be increased among healthcare providers, patients and carers.
authors.affiliation: GI Physiology Unit, University College London, London, UK.
authors.forename: Anton
authors.initials: A
authors.lastname: Emmanuel
authors.affiliation: Department of Geriatric Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mattace-Raso
authors.affiliation: Istituto Geriatrico "Pio Albergo Trivulzio", Milan, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Neri
authors.affiliation: Faculty of Medicine, RWTH Aachen, Aachen, Germany.
authors.forename: Karl-Uwe
authors.initials: KU
authors.lastname: Petersen
authors.affiliation: Division of Digestive Diseases, Department of Medicine, Instituo de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rey
authors.affiliation: PromoCon, Disabled Living, Manchester, UK.
authors.forename: June
authors.initials: J
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D032921:Consensus; D003248:Constipation / Q000175:diagnosis / Q000628:therapy*; D004043:Dietary Fiber / Q000008:administration & dosage; D005060:Europe; D006801:Humans; D054368:Laxatives / Q000145:classification / Q000627:therapeutic use*; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D004043:Dietary Fiber; D054368:Laxatives