LAXATIVES FOR THE ELDERLY

Systematic review of the effectiveness of laxatives in the elderly

Background

This systematic review was carried out to determine the effectiveness and cost of laxatives in the prevention and treatment of constipation in the elderly.

Findings

The review resulted in the following recommendations being made: laxatives may not be appropriate for all constipated elderly people. When possible, therefore, constipation should be managed by a 'stepped-care' approach, with the first step (after exclusion of co-morbidity) being advice about dietary improvement. If this fails, patients could then be prescribed the cheapest laxative treatment and, if this also fails, other laxative preparations could be given. There is no evidence that the expensive danthron laxatives are more effective than other laxative preparations, and they should not be used routinely in the treatment of constipation. Further research is required to determine the most effective ways of preventing and treating constipation in the elderly and to compare the different classes of laxatives.

Conducted by: Mark Petticrew1, Ian Watt1, Trevor Sheldon1

1. Centre for Reviews and Dissemination

Further details

Project page on HTA Programme website

Publications

Petticrew M, Watt I, Sheldon TA. Systematic review of the effectiveness of laxatives in the elderly. Health Technol Assess. 1997;1(13):1-53

Petticrew M. Treatment of constipation in older people. Nurs Times. 1997;93(48):55-6

Funding

Commissioned by the HTA Programme