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

About This Podcast

In 2021 constipation related visits to the ED reached over 1 million.4 The prevalence of constipation in elderly individuals in the community is between 15-30% and for those living in nursing homes or long-term care facilities it ranges between 50-75%.2 While constipation itself is not usually life-threatening, it can be indicative of life-threatening diseases or disorders and therefore a comprehensive history and physical assessment of patients is essential to avoid missing a critical diagnosis.

Dr. Sarah Lee is an emergency physician at the University of Maryland. In this episode she joins Dr. Christina Shenvi to discuss the presentation, risk factors, assessment and management of constipation in geriatric patients in the ED.

Play the Episode

https://youtu.be/XtXT-__feYo

Key Points

Constipation is clinically classified by 2 or more of the following: straining, hard stools, incomplete evacuation and/or fewer than 3 bowel movements per week. It may present as an acute or chronic complaint; it is considered chronic when symptoms are present for at least 12 weeks in a 1 year period.

Diet, physical inactivity, medications, chronic medical conditions and normal physiological changes contribute to an overall increased risk of constipation amongst elderly patients.

Assessment should involve a detailed history and an abdominal exam. Look out for red flag signs and symptoms that constipation may not be the only diagnosis. Further diagnostic imaging and testing can be helpful to determine the cause.

Multidimensional and individually tailored approach to management.

Addressing the underlying cause is key. Consider medications, lifestyle, and other medical conditions.

Variety of pharmacologic and non-pharmacologic interventions.

Next, listen to Revive and Survive: Pearls for Resuscitation of Older Adults in the ED with Dr. Cliff Reid.

Play Episode

View All Frailty Resources >

References

https://pubmed.ncbi.nlm.nih.gov/2910654/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920196/

https://www.emdocs.net/constipation-mimics-differential-diagnosis-and-approach-to-management/

https://www.cdc.gov/nchs/products/databriefs/db478.htm

https://www.tamingthesru.com/blog/diagnostics/the-kub

https://www.emdocs.net/constipation-mimics-differential-diagnosis-and-approach-to-management/