Letter to the Editor: Review of Constipation.

The authors respond:
There appears to be no specific effect of aging on bowel function. It is more likely the cumulative result of decreased mobility, comorbid illness, and medication side effects that cause a higher incidence of constipation among older adults.1

While it is true that lactulose can be an effective osmotic laxative, the fact remains that it may also lead to painful abdominal cramping and flatus.2 For this reason, it is recommended as a second or third line laxative, usually in combination with other medications.

Hershl Berman, Shawna Silver, Laura Brooks


  1. Salles N. Basic mechanisms of the aging gastrointestinal tract. Dig Dis 2007;25:112-7.
  2. Hsieh C. Treatment of constipation in older adults. Am Fam Physician 2005;72:2277-85.