Characteristics associated with constipation in elderly persons

American Family Physician,  Nov 1, 1994  

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Constipation is the most common digestive complaint among outpatients in the United States, especially in elderly persons. Rates of constipation in persons over age 65 are as high as 34 percent among women and 30 percent among men. Complaints associated with constipation include decreased frequency of bowel movements, painful defecation, hard stools or a feeling of incomplete evacuation. Towers and colleagues compared characteristics of older persons with chronic constipation with characteristics of nonconstipated volunteers to define the pathophysiology of constipation and identify dietary, psychologic and physiologic characteristics of older persons with chronic constipation.

A total of 18 constipated elderly patients and 18 control subjects over age 60 were included in the study. All of the subjects were ambulatory, community-dwelling adults without dementia. The subjects who were constipated reported two or fewer bowel movements per week and/or regular use of laxatives, enemas or suppositories, and/or straining in more than 25 percent of bowel movements for a period of at least six months. A variety of measures were used to evaluate dietary habits and bowel function, including a thorough history and physical examination, a one-week food diary and colonic transit studies.

The one-week food diary showed that the group with constipation consumed fewer calories than did the control group. The two groups were similar with regard to number of snacks, fluid intake and crude or dietary fiber intake, activity level and body mass index. Abdominal radiographs taken at spaced intervals after the ingestion of high-fiber biscuits showed slower colonic transit time for constipated subjects. Slower transit times were associated with low caloric intake, number of meals, and four psychologic symptoms, including somatization, obsessive-compulsive disorder, depression and anxiety.

The authors conclude that constipation in the elderly may be related to caloric intake, rather than fiber and fluid consumption. In addition, psychologic distress may also affect colonic function. (Journal of the American Geriatrics Society, July 1994, vol. 42, p. 701.)

COPYRIGHT 1994 American Academy of Family Physicians
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