• Fabio Salvi, Roberta Petrino, Simon P Conroy, Rosa Liperoti, Luca Paoletti, Alessia Beccacece, Giuseppina dell'Aquila, Massimiliano Fedecostante, and Antonio Cherubini.
• Department of Geriatrics and Emergency Care, IRCCS, Italian National Research Centres on Aging (I.N.R.C.A.), Via della Montagnola n. 81, 60127, Ancona, Italy. f.salvi@inrca.it.
• Intern Emerg Med. 2024 Oct 1; 19 (7): 197719861977-1986.

AbstractConstipation and fecal impaction are common issues with the potential for significant morbidity in older people presenting to the Emergency Department (ED). While many of these patients present with classical symptoms of constipation or fecal impaction, atypical presentations are also frequent. These atypical presentations may include paradoxical diarrhea, fecal incontinence, urinary retention or overflow incontinence, hyperactive or hypoactive delirium, anorexia/dysphagia, and syncope. In addition, various clinical conditions (such as dementia, Parkinson's disease, dehydration, and hypothyroidism) and medications (such as opiate analgesics, anticholinergics, diuretics, calcium channel blockers, anti-parkinsonian drugs, and oral iron supplements) are associated with constipation and should be considered during the diagnostic process in the ED. This narrative review specifically focuses on the prevalence, presentation, diagnoses, and management of constipation in older ED patients.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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