Getting to the bottom of chronic constipation and faecal incontinence in the elderly

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Chronic constipation and faecal incontinence are common complaints in the elderly. The initial management of constipation consists of medication review, and dietary changes with regular physical activity if practicable. Should constipation continue, a variety of agents belonging to different laxative classes are available. Faecal incontinence generally falls into three categories: overflow incontinence, treated initially with enemas and followed up with a bowel management programme; reservoir incontinence, potentially treated with anti-inflammatory and immunosuppressive agents supplemented with antidiarrhoeals; and rectosphincteric incontinence, treated with dietary, behavioural, pharmacological and surgical modalities.

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