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. |
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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). |
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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.
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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.
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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. |
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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. |
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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. |
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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. |
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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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