Elderly Patients with Severe Constipation and Effective Treatment Options

Constipation in older adults is often linked to a sedentary lifestyle and the long-term use of multiple medications. Therefore, understanding the underlying causes is essential for effective management. A lack of physical activity can contribute significantly to bowel issues, and in such cases, improving dietary habits and incorporating light exercise into daily routines may help regulate digestion and relieve symptoms.

When medication use is involved, it's crucial to review all current prescriptions with a healthcare provider. Some drugs can worsen constipation, so determining whether dosages can be reduced or alternative treatments prescribed is an important step in managing this condition.

In cases where lifestyle changes and medication adjustments are not sufficient, first-line treatment options include osmotic and bulk-forming laxatives. Examples include polyethylene glycol and lactulose (such as Duphalac), which are considered safe and are internationally recommended as Class IA therapies. These medications work by drawing water into the intestines or increasing stool bulk, promoting natural bowel movements without significant side effects.

If initial treatments fail to provide relief, adding a prokinetic agent may be considered. Drugs like mosapride or prucalopride can enhance gastrointestinal motility and improve bowel transit time, offering additional support for elderly patients struggling with chronic constipation. However, manual manipulation or the use of enemas is generally not advised for older adults due to potential complications and discomfort.

In instances of sudden symptom flare-ups, short-term use of laxatives may be appropriate under medical supervision to provide immediate relief. It's important to always consult a healthcare professional before starting or changing any treatment plan, especially for elderly individuals who may have other underlying health conditions.