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Constipation in the older adult

Satish SC Rao, MD, PhD, FRCP
Section Editors
Nicholas J Talley, MD, PhD
Kenneth E Schmader, MD
Deputy Editor
Shilpa Grover, MD, MPH


Constipation is a common complaint in older adults. It has a major impact on healthcare costs in the United States because it results in several office visits, specialty referrals, hospital admissions, and surgical procedures. It also affects health-related quality of life [1,2].

This topic will review the clinical approach to the diagnosis and management of constipation in the older adult. The approach to diagnosis and management of constipation in children and adults in general are presented separately. (See "Constipation in infants and children: Evaluation" and "Chronic functional constipation and fecal incontinence in infants and children: Treatment" and "Etiology and evaluation of chronic constipation in adults" and "Management of chronic constipation in adults".)


The term constipation is variably defined by patients and physicians [3].

According to the Rome III criteria, functional constipation is defined as any two of the following features: straining, lumpy hard stools, sensation of incomplete evacuation, use of digital maneuvers, sensation of anorectal obstruction or blockage with 25 percent of bowel movements, and decrease in stool frequency (less than three bowel movements per week). The above criteria must be fulfilled for the last three months with symptom onset six months prior to diagnosis, loose stools should rarely be present without the use of laxatives, and there must be insufficient criteria for a diagnosis of irritable bowel syndrome.


The prevalence of constipation in the older adult has not been well defined. Studies have reported that the prevalence of constipation in the older adult ranges from 24 to 50 percent [4-12]. Laxatives are used daily by 10 and 18 percent of community dwelling older adults and 74 percent of nursing home residents [9,13-16].


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Literature review current through: Sep 2016. | This topic last updated: Mar 11, 2015.
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