Bowel care in older people.

Bowel dysfunction not only causes considerable hardship for many older people and their carers, it is also financially costly to the health service and to the individuals affected. Despite the prevalence of constipation and faecal incontinence amongst, for example, older people in institutionalised settings, both conditions are often iatrogenic and entirely preventable. One reason why these conditions are generally not well managed is that the research base is poor: there are few robust data because of methodological weaknesses in existing studies, so clinicians and care staff are left to rely on anecdote and personal experience. Secondly, the costs to the NHS involved in providing proper bowel care for the elderly would be considerable, although recent government documents have set out a specific commitment to improve standards of care in this area. In order to address some of these issues, the College has recently published a book which gathers together and assesses research on faecal incontinence and constipation, and provides informed guidance on current best practice. The contents of the publication, including comments from older people suffering from bowel dysfunction, are outlined in this article.