PHYSIOLOGICAL AND PSYCHOLOGIC CHARACTERISTICS OF AN ELDERLY POPULATION WITH CHRONIC CONSTIPATION

Objectives: To characterize colorectal physiologic parameters and psyc hological profiles in subjects greater-than-or-equal-to 60 yr with chr onic constipation who have not sought medical advice. Methods: Colorec tal physiologic studies and psychologic profiles were obtained in 18 s elf-identified constipated subjects and 17 nonconstipated control subj ects. Constipation was defined as two or fewer bowel movements/week an d/or defecatory difficulty for at least 6 months. All subjects underwe nt colonic transit with radiopaque markers, anorectal manometry and co mpleted a self rated inventory assessing psychological distress (SCL-9 0-R). Results: Slow colonic transit occurred in five constipated subje cts. Pelvic floor dyssynergia and/or increased rectal compliance were found in nine subjects versus only two controls. One-third of constipa ted subjects scored in the top 10th percentile for global psychologic distress with higher scores for somatization, depression, and anxiety than control subjects. Neither physiologic nor psychologic abnormaliti es were predictable on the basis of patterns of bowel complaints. Conc lusions: Colorectal physiologic and psychologic dysfunctions are commo n in elderly constipated subjects who do not seek medical attention fo r bowel dysfunction.