From the Research
Hyperinnervated colon, also known as hyperganglionosis, in elderly patients is a condition that requires a comprehensive management approach to alleviate symptoms and improve quality of life, focusing on dietary modifications, physical activity, and medications to regulate bowel function, as there is limited direct evidence on this specific condition. The condition typically presents with chronic constipation, abdominal pain, bloating, and sometimes paradoxical diarrhea. Management includes a combination of:
- Dietary modifications, such as increased fiber intake of 25-30g daily and adequate hydration of at least 2 liters per day
- Regular physical activity
- Medications such as osmotic laxatives (polyethylene glycol 17g daily) or prokinetic agents (prucalopride 1-2mg daily) For severe cases, neuromodulators like low-dose tricyclic antidepressants (amitriptyline 10-25mg at bedtime) may help regulate bowel function. The condition results from age-related changes in the enteric nervous system, including neuronal loss in some areas and compensatory hyperinnervation in others, disrupting normal peristalsis, as suggested by studies on colorectal cancer and elderly patients 1, 2. Elderly patients often have comorbidities and take multiple medications that can exacerbate symptoms, so a comprehensive approach addressing these factors is essential for effective management. While studies like 3 and 4 provide insights into the management of colon cancer and obstructive colon cancer in elderly patients, they do not directly address hyperinnervated colon. However, the principles of managing age-related changes and comorbidities can be applied to the care of patients with hyperinnervated colon, prioritizing their morbidity, mortality, and quality of life. Given the lack of direct evidence on hyperinnervated colon, the most recent and highest quality studies on related topics, such as 1 and 2, guide the approach to managing this condition in elderly patients.