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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 7, 2008; 14(17): 2631-2638
Published online May 7, 2008. doi: 10.3748/wjg.14.2631
Pathophysiology of constipation in the older adult
G Lindsay McCrea, Christine Miaskowski, Nancy A Stotts, Liz Macera, Madhulika G Varma
G Lindsay McCrea, Christine Miaskowski, Nancy A Stotts, Liz Macera, Departments of Physiological Nursing, University of California, San Francisco 94143, United States
Madhulika G Varma, Department of Surgery, University of California, San Francisco 94143, United States
Author contributions: The literature review was completed and the paper was written by Ms. McCrea GL; Miaskowski C, Stotts NA, Macera L, and Varma MG contributed equally to the conceptualization and editing of the manuscript.
Correspondence to: G Lindsay McCrea, RN, MS, Doctoral Student, Department of Physiological Nursing, University of California, 2 Koret Way-0610, San Francisco 94143, United States. lindsay.mccrea@ucsf.edu
Telephone: +1-925-4511858
Fax: +1-415-4768899
Received: December 19, 2007
Revised: February 17, 2008
Published online: May 7, 2008
Abstract

This review provides information on the definition of constipation, normal continence and defecation and a description of the pathophysiologic mechanisms of constipation. In addition, changes in the anatomy and physiology of the lower gastrointestinal tract associated with aging that may contribute to constipation are described. MEDLINE (1966-2007) and CINAHL (1980-2007) were searched. The following MeSH terms were used: constipation/etiology OR constipation/physiology OR constipation/physiopathology) AND (age factors OR aged OR older OR 80 and over OR middle age). Constipation is not well defined in the literature. While self-reported constipation increases with age, findings from a limited number of clinical studies that utilized objective measures do not support this association. Dysmotility and pelvic floor dysfunction are important mechanisms associated with constipation. Changes in GI function associated with aging appear to be relatively subtle based on a limited amount of conflicting data. Additional research is warranted on the effects of aging on GI function, as well as on the timing of these changes.

Keywords: Constipation, Mechanisms, Functional consti-pation, Dysmotility, Older adults, Pelvic floor dysfunction, Gastrointestinal tract