De Giorgio Roberto, Ruggeri Eugenio, Stanghellini Vincenzo, Eusebi Leonardo H, Bazzoli Franco, Chiarioni Giuseppe
Department of Medical and Surgical Sciences/Digestive system, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy.
Division of Gastroenterology of the University of Verona, AOUI Verona, Verona, Italy.
BMC Gastroenterol. 2015 Oct 14;15:130. doi: 10.1186/s12876-015-0366-3.
Constipation is a frequently reported bowel symptom in the elderly with considerable impact on quality of life and health expenses. Disease-related morbidity and even mortality have been reported in the affected frail elderly. Although constipation is not a physiologic consequence of normal aging, decreased mobility, medications, underlying diseases, and rectal sensory-motor dysfunction may all contribute to its increased prevalence in older adults. In the elderly there is usually more than one etiologic mechanism, requiring a multifactorial treatment approach. The majority of patients would respond to diet and lifestyle modifications reinforced by bowel training measures. In those not responding to conservative treatment, the approach needs to be tailored addressing all comorbid conditions. In the adult population, the management of constipation continues to evolve as well as the understanding of its complex etiology. However, the constipated elderly have been left behind while gastroenterology consultations for this common conditions are at a rise for the worldwide age increment. Aim of this review is to provide an update on epidemiology, quality of life burden, etiology, diagnosis, current approaches and limitations in the management of constipation in the older ones to ease the gastroenterologists' clinic workload.
便秘是老年人中经常报告的肠道症状，对生活质量和医疗费用有相当大的影响。在受影响的体弱老年人中，已报告了与疾病相关的发病率甚至死亡率。虽然便秘不是正常衰老的生理后果，但活动能力下降、药物治疗、基础疾病以及直肠感觉运动功能障碍都可能导致其在老年人中的患病率增加。在老年人中，通常存在多种病因机制，需要采取多因素治疗方法。大多数患者会对通过肠道训练措施强化的饮食和生活方式改变做出反应。对于那些对保守治疗无反应的患者，治疗方法需要针对所有合并症进行调整。在成人人群中，便秘的管理以及对其复杂病因的理解都在不断发展。然而，随着全球老龄化的加剧，因这种常见疾病进行胃肠病学咨询的人数不断增加，而便秘的老年人却被忽视了。本综述的目的是提供有关老年人便秘的流行病学、生活质量负担、病因、诊断、当前治疗方法及局限性的最新信息，以减轻胃肠病医生的临床工作量。
