Chronic constipation is one of the commonest lower gastrointestinal disorders affecting people in the western world.1 It is a major health concern for health providers, particularly for high-risk patients, such as older people, those who are less mobile, people with neurologically impairments and those with multiple healthcare needs. Constipation also has cost implications in terms of medications, containment equipment and nursing time.
Constipation is rarely a life-threatening symptom; however, the distress it causes leads to patient discomfort and diminished quality of life. Unfortunately, constipation may be regarded as less important than other conditions commonly seen in general practice because it does not fall within an agreed management target.2
Effective management of constipation could have an important positive impact on a patient's quality of life: international surveys have suggested that 20-50 per cent of elderly people living in the community have symptoms of constipation.3,4
Causes of constipation
Constipation is an unpleasant and often distressing symptom that can happen to anyone at anytime. It is characterised by a real or perceived change in normal bowel habit that is unsatisfactory because of the infrequent and difficult passage of hard stools or feelings of incomplete defaecation.