Constipation in frailty should be considered a clinically significant and potentially reversible contributor to acute deterioration, particularly in presentations characterised by delirium, falls, urinary retention and functional decline.
Clinical Context
Frailty is characterised by reduced physiological reserve and increased vulnerability to stressors, resulting in disproportionate responses to relatively minor insults. In this context, acute deterioration is frequently driven by interacting, multisystem processes rather than isolated disease entities.
Clinical Implications
- Include bowel assessment in CGA for all frailty presentations
- Recognise overflow diarrhoea as a potential sign of impaction
- Avoid diagnostic anchoring when infection appears likely
- Prioritise early treatment of reversible contributors
- Reassess dynamically following intervention
In frailty, deterioration is rarely explained by a single cause. Clinical reasoning should prioritise identification of interacting, reversible contributors.