Constipation in Older People Pharmacological Management Issues

Constipation is a common complaint amongst older people although they are often concerned about features of constipation other than bowel action frequency. A careful assessment should be made, including a history, examination and appropriate investigations. Non‐pharmacological management often avoids the use of laxatives and includes adequate fibre, fluid and exercise. The laxatives most appropriate for older people include stimulants such as senna, bulking agents and osmotic agents such as polyethylene glycol plus electrolytes or sorbitol. Short‐term use is nearly always sufficient. Faecal impaction should be sought and managed before giving oral agents. Enemas and suppositories are usually appropriate for impaction and for excessive straining. Management of constipation with these measures will avoid long‐term use and abuse of laxatives.