Key points
Reports of constipation and the use of laxatives are very common in older people.
Stool frequency is no different in elders than younger people, with elders complaining most of straining and hard stools.
The use of medications and chronic medical illness correlate most closely with the development of constipation in elders.
Patients lacking worrisome symptoms may undergo an empirical therapeutic trial, with diagnostic testing reserved for those who fail to respond.
The best available evidence supports the use of psyllium, osmotic laxatives (especially PEG), and lubiprostone to treat constipation in elders.
Methylnaltrexone, available as an injection, is an important advance in the treatment of refractory opiate‐induced constipation.
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