[Diarrhea in the elderly].
The causes of acute and chronic diarrheal disorders and their underlying pathophysiologic mechanisms are common at all ages. The impact of diarrhea, however, may be more pronounced in the elderly due to various causes, such as age-related structural and functional intestinal changes, concomittant illnesses, consume of preventive and therapeutic drugs, impaired sense of hunger and thirst, compromised nutrition and hydration to withstand the effect of diarrhea, more frequent hospital admissions and courses of antibiotics, and more subtle clinical presentation than in younger patients. These aspects have to be considered when investigating and treating diarrhea of older patients. Diarrhea may have a devastating effect on quality of life in the elderly and above all, fecal incontinence is a common consequence. In elderly institutionalized persons, fecal impaction in the rectum with liquid stool leaking around the hard, dry fecal mass is often associated with fecal incontinence. In this article, general aspects of diarrhea in the elderly, clostridium difficile infection, ischemic colitis, microscopic colitis and incontinence due to fecal impaction are discussed.
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