الفهرس 
Introduction & RationaleOnly 14 pages are availabe for public view
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Abstract
Chronic constipation is one of the commonest gastrointestinal disorders in the elderly. However, its definitions vary widely. Thus, Rome III criteria were recommended to be used in defining constipation. In the elderly with chronic constipation, initial investigations should be performed. If the results are normal, an empiric therapy could be given. Patients who fail to respond to this approach are appropriate candidates for more specialized diagnostic testing. Nowadays, further advances in the management of constipation bring new hope to patients with refractory constipation.
In conclusion, constipation is a common, self-reported digestive symptom that affects up to 30 % of people in Western countries and has considerable impact on health expenses and quality of life. Older individuals are particularly prone to it with a reported prevalence of up to 50 % in community-dwelling elderly and up to 70 % in nursing-home residents. Loss of mobility, medications, associated comorbidities, and rectal sensory-motor dysfunction are as important as gut aging alterations in causing constipation. Digital rectal exam and clinical history may help on identifying causes of constipation, but more than one mechanism might be involved. Diet and lifestyle modifications are often ineffective to manage constipation in the elderly and a