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Medical Management of Constipation in Elderly Patients: Systematic Review

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Author(s)
Seung Joo KangYoung Sin ChoTae Hee LeeSeong-Eun KimHan Seung RyuJung-Wook KimSeon-Young ParkYoo Jin LeeJeong Eun Shin
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Neurogastroenterol Motil
Issued Date
2021
Volume
27
Issue
4
Keyword
AgedConstipationLaxativesSystematic review
Abstract
Background/Aims:
Constipation is a common gastrointestinal problem in the elderly. Because of the limitations of life style modifications and the comorbidity, laxative use is also very common. Therefore, this study reviews the latest literature on the effect and safety of laxative in the elderly.

Methods:
A systematic review of randomized controlled trials investigating the effectiveness and safety of laxatives for constipation in elderly patients over 65 years old were performed using the following databases: PubMed, EMBASE, and the Cochrane Library.

Results:
Twenty-three randomized controlled trials were included in this review. Among the selected studies, 9 studies compared laxative with placebo and 5 studies compared laxatives of the same type. Four studies compared different types of laxatives or compared combination agents. Five studies compared novel medications such as prucalopride, lubiprostone, and elobixibat with placebo. Psyllium, calcium polycarbophil, lactulose syrup, lactitol, polyethylene glycol, magnesium hydroxide, stimulant laxative with or without fiber, and other medications were more effective than placebo in elderly constipation patients in short-term. Generally, the frequency and severity of adverse effects of laxative were similar between the arms of studies.

Conclusions:
Bulk laxative, osmotic laxative, stimulant laxative with or without fiber, and other medications can be used in elderly patients in short-term within 3 months with reasonable safety. However, the quality of included studies was not high and most of studies was conducted in a small number of patients. Among these laxatives, polyethylene glycol seems to be safe and effective in long-term use of about 6 months in elderly patients.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine (의과대학)
Citation
Seung Joo Kang et al. (2021). Medical Management of Constipation in Elderly Patients: Systematic Review. J Neurogastroenterol Motil, 27(4), 495–512. doi: 10.5056/jnm20210
Type
Article
ISSN
2093-0887
Source
https://www.jnmjournal.org/journal/view.html?volume=27&number=4&spage=495
DOI
10.5056/jnm20210
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43863
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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