Constipation and Fecal Incontinence in the Elderly

Brototo Deb, David O. Prichard, Adil E. Bharucha

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: To review the epidemiology, pathogenesis, clinical features, and management of primary constipation and fecal incontinence in the elderly. Recent Findings: Among elderly people, 6.5%, 1.7%, and 1.1% have functional constipation, constipation-predominant IBS, and opioid-induced constipation. In elderly people, the number of colonic enteric neurons and smooth muscle functions is preserved; decreased cholinergic function with unopposed nitrergic relaxation may explain colonic motor dysfunction. Less physical activity or dietary fiber intake and postmenopausal hormonal therapy are risk factors for fecal incontinence in elderly people. Two thirds of patients with fecal incontinence respond to biofeedback therapy. Used in combination, loperamide and biofeedback therapy are more effective than placebo, education, and biofeedback therapy. Vaginal or anal insert devices are another option. Summary: In the elderly, constipation and fecal incontinence are common and often distressing symptoms that can often be managed by addressing bowel disturbances. Selected diagnostic tests, prescription medications, and, infrequently, surgical options should be considered when necessary.

Original languageEnglish (US)
Article number54
JournalCurrent gastroenterology reports
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2020

Keywords

  • Bowel leakage
  • Constipation
  • Defecatory disorder
  • Elderly
  • Fecal incontinence
  • Nursing home

ASJC Scopus subject areas

  • Gastroenterology

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