Constipation: What To Do Between a Rock and a Hard Place

This podcast addresses the increasing prevalence and significance of constipation in older adults, particularly in the emergency department. It highlights that constipation-related visits have surged, reaching over one million in 2021, necessitating that medical professionals discern between benign cases and more serious underlying issues. Diagnostic criteria include straining, hard stools, incomplete evacuation, and infrequent bowel movements. Predisposing factors in geriatric patients involve physiological changes, chronic medications like opioids and anticholinergics, dietary deficits in fiber and fluid, sedentary lifestyles, and prevalent conditions such as diabetes and hypothyroidism. The discussion covers differentiating simple constipation from conditions like bowel obstruction or stercoral colitis, emphasizing thorough history-taking and physical exams. Treatment strategies range from dietary adjustments and hydration to pharmacologic interventions, including fiber supplements, osmotic laxatives, and stimulant laxatives, with a focus on preventing chronic recurrence and improving patient quality of life.