Medical Management of Constipation in Elderly Patients : Systematic Review
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of neurogastroenterology and motility - 27(2021), 4 vom: 30. Okt., Seite 495-512 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kang, Seung Joo [VerfasserIn] |
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| Links: |
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| Themen: |
Aged |
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| Anmerkungen: |
Date Revised 27.04.2022 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5056/jnm20210 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM33183071X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
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| 100 | 1 | |a Kang, Seung Joo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Medical Management of Constipation in Elderly Patients |b Systematic Review |
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| 500 | |a Date Revised 27.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Aged | |
| 650 | 4 | |a Constipation | |
| 650 | 4 | |a Laxatives | |
| 650 | 4 | |a Systematic review | |
| 700 | 1 | |a Cho, Young Sin |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Tae Hee |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Seong-Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Ryu, Han Seung |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jung-Wook |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Seon-Young |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Yoo Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Jeong Eun |e verfasserin |4 aut | |
| 700 | 0 | |a Constipation Research Group of the Korean Society of Neurogastroenterology and Motility |e verfasserin |4 aut | |
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