show age related loss of function in elderly population.1
Although constipation is not considered as direct consequence of ageing, it is more common in elderly as compared to young population.2,3 Constipation may affect up to 60% individuals late in life.1 Limited mobility, medications, underlying diseases, and rectal sensory motor dysfunction may be contributing factors in increased prevalence of constipation in older adults.2,4
Prevalence of chronic constipation is 20% in general population with significant negative impact over quality of life.3,5,6 General health, mental health, and social functioning are significantly impaired as compared to healthy individual. This impairment is comparable to other medical conditions like osteoarthritis, rheumatoid arthritis,
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Primary constipation has been sub classified into normal transit constipation, slow transitconstipation, and defecatory disorder.7,9 Normal transit constipation (functional constipation) is most common type of constipation. In normal transit constipation stool traverse at normal rate through colon and stool frequency is normal but patient complaints constipation. There may be hard stool, bloating, abdominal pain, and discomfort. Slow transit constipation is more common in young women. It has significant impairment in propulsive colonic motor activity.7,10 Defecatory disorders are most commonly caused by pelvic floor or anal sphincter dysfunction and they have problem in expelling stool out of rectum.10 Secondary constipation may be caused by organic diseases (colorectal cancer), endocrine diseases
(diabetes mellitus), neurological diseases (hirschsprung disease), drugs (antihypertensive medications), anorectal diseases (anal fissure), diet or lifestyle (inactive lifestyle).11 Secondary