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Is Constipation a serious problem in the elderly?
Senior citizens are always obsessed with the regular or irregular movement of their bowels and even take laxatives unnecessarily. Their anxiety causes headache, exhaustion and loss of appetite.
What are the types of constipation?
1. The elderly may pass stools daily but they may have difficulty or the stools maybe hard.
2. The stools may not be hard but the movement of bowels maybe irregular (Once in 2 -3 days).
What are the causes of constipation?
  • Lack of adequate fibrous matter in the food.
  • Drinking less water which may sometimes be due to the fear of passing urine frequently.
  • Drugs such as iron tonics, antacids, painkillers, diureutics, anti-depressants, anti-hypertensive agents and sleeping tablets.
  • Intestinal obstruction due to various diseases, piles, inadequate secretion of thyroid glands, excess calcium in the body, lack of potassium and mental depression
  • Lack of adequate exercise.
  • Old people avoid visiting the toilet frequently due to unsanitory conditions in the lavatory.
  • Restricted mobililty due to arthiritis or stroke.
What are the complications of constipation?
The elderly should not become anxious if they do not pass stools for a day or two, but chronic constipation should be attended to immediately to avoid further complications.
  • They may strain while passing motion and this could trigger an attack of chest pain. The straining may also cause a fainting attack due to transient reduction of blood supply to the brain.
  • Chronic constipation increases intra-abdominal pressure and straining could lead to hernia or varicose veins.
  • Hard stools may cause fissures in the anal canal and result in bleeding.
  • A distended rectum could also cause obstruction of the urinary passage.
  • Stagnation of stools could cause intestinal obstruction.
  • Taking laxatives for a long time could become habit-forming and produce a dilated colon (mega colon).
  • Irregular movement could cause anxiety and needless worries.
  • Patients may begin to take purgatives in large doses which may result in diarrhoea. Irreversable damage may cause the bowel to become an inert tube. Excess fluid and potassium loss could lead to ill-health, apathy and weakness.
How do we manage constipation?
If there is a specific underlying cause, such as hypothyroidism, drugs, or dehydration then the physician will treat the patient accordingly. But, the most important factors that the elderly should remember are:
1. Take adequate fluids everyday (2 - 2.5 litres per day) unless their fluid intake has to be restricted due to some medical reason.
2. Adequate physical activity and exercise like walking. Even the bed-ridden should be assisted to do their exercises on the bed. Abdominal massage and pelvic floor exercises have shown to prevent constipation.
3. Adequate intake of dietary fibre Dietary fibre is undigestible carbohydrates present in food. This can absorb and hold water and help to add to the bulk.
4. Laxatives can be used as a last resort. These maybe lubricants or stool softeners (liquid paraffin), bulk agents (fibre supplements), Osmotic agents (sodium, potassium, magnesium salts and lactulose), chemicals (senna, castor oil) and pro-kinetics. 
One must consult the physician while taking laxatives.
What is the amount of dietary fibre that should be taken everyday?
40 Gms of dietary fibre per day should be included in the diet for the elderly.
What are the foods rich in dietary fibre?
Wheat, Ragi, horsegram, rice bran and millets are rich in fibre. There is also plenty of roughage in greens, cabbage, cauliflower, drumstick, bittergourd, guava and plaintain stem. You maybe surprised to know that even pepper, coriander, dried chilles, omum and fenugreek are rich in fibre.
Does plantain contain roughage?
It is commonly believed that bananas are good for constipated patients. But, it is more the starch in the bananas that loosens and softens the stools than the roughage which is insignificant.
What is an Enema?
An enema is instillation of a solution into the rectum and sigmoid colon to break up the fecal mass, stretch the rectal wall and initiate the reflex to pass motion. This is used to manage constipation when all other measures fail. Suppositories (enema pellets) are also used to relieve constipation.





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A diet rich in natural fibre
(Fruits and Vegetables) can help relieve constipation

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Physical Exercise can go a long way in correcting constipation

A Web-site giving more info on constipation


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