This review of evidence and policy across Europe uncovers a hidden burden of constipation affecting older people
Visit the Burden of Constipation website http://www.burdenofconstipation.com/
ILC-UK, supported by Norgine and working alongside a steering group of European experts, have conducted a European review of the evidence and policy on constipation in older people, particularly those living in residential care settings.
The burden of constipation in our ageing society: working towards better solutions aimed to draw on evidence available as to the extent of the impact of constipation, as an often misunderstood and misrepresented topic. Though highlighting the impact of constipation on those affected in terms of pain, quality of life and emotion wellbeing, the review seeks to improve knowledge and understanding of this issue. It also aims to highlight the impact of untreated or under-treated constipation on healthcare resources, and to identify and evaluate existing guidance and guidelines on diagnosis and management of constipation, and to highlight where gaps exist.
The key findings of the report are that constipation is under-recognised in terms of the impact it has on physical health and quality of life. Of particular importance in an older age group, constipation can exacerbate symptoms in patients with mental conditions such as dementia. If left untreated, constipation can have serious medical consequences, such as faecal impaction, which may require admission to hospital. As with all health conditions affecting older people, we will see a rise in this issue as the population ages unless action is taken. Constipation is often not managed effectively, with a lack of evidence-based guidance on the management of constipation in older adults across Europe.
The report highlights a number of areas where action can be taken to improve this situation:
- Functional constipation should not be underestimated or trivialised and should not simply be considered as an inevitable consequence of ageing or frailty
- Constipation should be classified and recognised as a condition in its own right, not just a set of symptoms associated with other disorders
- Recognition and awareness of the typical symptoms and causes of constipation, as well as understanding how to effectively prevent and treat it, should be a training priority across the whole multi-disciplinary team and for social care professionals working with older people
- Constipation needs to be better diagnosed so it can be promptly treated and managed more effectively in line with agreed best practice and recognised standards
- The taboo nature of constipation needs to be addressed amongst the general public such that older people start to feel more comfortable and less embarrassed about self-reporting suspected constipation, knowing that they will be taken seriously and always treated with respect
- Highlight the true cost of failing to effectively manage constipation in older people, in terms of economic and societal burden to health services, as well as the cost in terms of individual suffering and reduction in quality of life.