Clinical case · Constipation
Diarrhoea that isn't
Care home staff report four days of diarrhoea in an 86-year-old woman with dementia. Examine her, find the real problem and the medicines behind it, and plan treatment that is safe for her kidneys.
Intermediate 12 minNeeds clinical review
You will learn to
- Recognise overflow from faecal impaction presenting as diarrhoea
- Identify constipating medicines and act on them
- Choose laxatives safely in frailty and kidney disease
Presentation
Step 1 of 10You are asked to see an 86-year-old care home resident. For four days she has had small amounts of loose stool several times a day, soiling her pads. She is eating less and staff say she is "more muddled than usual".
References
- Zheng S, Yao J, et al. Expert consensus on the assessment and treatment of chronic constipation in the elderly. Aging Med (Milton). 2018;1(1):8–17. doi:10.1002/agm2.12013 · PubMed 31942474
- Chang L, Chey WD, Imdad A, et al. American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. Gastroenterology. 2023;164(7):1086–1106. doi:10.1053/j.gastro.2023.03.214 · PubMed 37211380
Last updated 2026-10-24.
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