Constipation is a common problem among the adult population, particularly in the elderly and chronically ill. Constipation can become severe and acutely symptomatic, prompting evaluation for treatment in the acute care setting. For mild cases, first-line recommendations include dietary changes, bulk-forming laxatives, and non-bulk-forming laxatives. However, these treatments may take several days to take effect. For acutely symptomatic constipation, treatment options include suppositories, enemas, and manual disimpaction. There is very limited data comparing these treatments for severe constipation. There is data showing phosphate enemas place patients at higher risk of developing hypophosphatemia and phosphate nephropathy. Enema administration also carries a risk of colonic perforation. Special populations, including the elderly, warrant careful consideration of treatment options.
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