Constipation in elderly: Open the gut to open the mind

Abstract

Constipation is a commonly reported bowel associated symptom in the elderly with a huge impact seen on the quality associated with life as well as expenditure on healthcare.1 Patients of the elderly age group with constipation are associated with higher psychological distress and anxiety issues. A higher prevalence of paranoid ideation, hostility and obsessive compulsive disorder is seen in the elderly who are dealing with constipation.2 Social as well a Work life are deeply affected negatively by constipation leading to a significant effect on quality of life. Constipation can often be associated with wide range of symptoms that negatively influence the daily life of a elderly. Many patients reported to having to make effort during defecation and eliminating hard stools and feeling of incomplete evacuation or difficult stool passage and these symptoms had a huge impact on their life leading to great mental distress.3 Although, it is not a physiologic condition associated with ageing, decreased mobility in old age, rectal sensory motor dysfunction, various co morbid conditions and drug intake might be contributing to development of constipation in the elderly. From a pathologic point of view constipation may itself present as a disease or may present clubbed as a complex clinical picture in secondary forms. Primary form may be a slow transit constipation or outlet obstruction or constipation associated with IBS.