Constipation disproportionately affects older adults with a, prevalences of 50% in community-dwelling elderly and 74% in. Nursing-home residents. Loss of mobility medications underlying diseases,,,, impaired anorectal sensation and ignoring calls. To defecate are as important as Dyssynergic defecation or irritable bowel syndrome in causing constipation.Detailed medical history on medications and co-morbid problems and meticulous, digital rectal examination may help identify. Causes of constipation. Likewise blood tests, and colonoscopy may identify organic causes such as colon cancer. Physiological. Tests such as colonic transit study with radio-opaque markers or wireless motility capsule anorectal manometry,,And balloon expulsion tests can identify disorders of colonic and anorectal function. However in the, elderly there is,, Usually more than, one mechanism requiring an individualized but multifactorial treatment approach. The management of constipation. Continues to evolve. Although osmotic laxatives such as polyethylene glycol, remain mainstaySeveral new agents that target different mechanisms appear promising such as chloride-channel activator (lubiprostone),. Guanylate cyclase agonist (linaclotide), 5HT4 agonist (prucalopride), and peripherally acting thermal - opioid receptor antagonists. (alvimopan and methylnaltrexone) for opioid-induced constipation.Biofeedback therapy is efficacious for treating Dyssynergic defecation and fecal impaction with soiling. However data,, On efficacy and safety of drugs in elderly are limited and urgently needed
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