Managing Constipation in the Older Adult
Published: 10 October 2019
Published: 10 October 2019
Constipation is defined as having fewer than three bowel movements a week (Mayo Clinic 2019). Constipation also encompasses the passing of hard, dry bowel motions (stools) that are infrequent, difficult to pass, or both (Better Health Channel 2014).
Constipation can usually be prevented and treated by maintaining a high fibre diet, increasing water intake and exercising regularly (Better Health Channel 2014).
Constipation is a medical issue to be taken seriously, particularly when present in the older adult. Older adults are considered to be a primary at-risk group for chronic constipation. It is estimated that older adults are five times more likely to develop constipated-related problems (Mandal 2019).
The process of digestion is as follows: when food is consumed, it breaks down in the stomach and passes through the intestine. The walls of the intestine then absorb nutrients from the food. The waste that remains is then passed through the colon and rectum. At times this process is disturbed, and waste becomes lodged in the colon, this is known as faecal impaction of the colon (Khan 2017).
(Better Health Channel 2014; Mayo Clinic 2019).
Constipation can be the result of more serious illnesses and events, including tumours and systemic diseases (Better Health Channel 2014).
There are many reasons why constipation affects older adults. One is as a side-effect of certain medications such as medications for pain, antidepressants, anticonvulsants, and antihistamines, or a result of medical conditions such as strictures, hypothyroidism, tumours or Parkinson’s disease. Prolonged bed rest, perhaps during illness, resulting in a decrease in movement (Daily Caring 2019; Mandal 2019)
Other reasons include:
(Daily Caring 2019; Mandal 2019)
(Mandal 2019)
Being older than 65 is a major risk factor for chronic constipation. Other risk factors include:
(Djordjevic 2018; Better Health Channel 2014)
(Mayo Clinic 2019; Better Health Channel 2014)
Diagnosis can involve a detailed medical history, a physical examination, questions relating to diet, exercise and lifestyle habits, a colonoscopy or a combination of these (Mandal 2019; Better Health Channel 2014).
From this examination, the cause of constipation – such as drug-induced constipation, constipation as a result of prolonged inactivity, and changes in diet and fluid intake – can be identified (Mandal 2019).
(Better Health Channel 2014; Mayo Clinic 2019)
(Mayo Clinic 2019; Better Health Channel 2014; Daily Caring 2019)
Drinking adequate amounts of water is a known strategy for preventing and aiding constipation. Water softens stools and stimulates the bowel (Daily Caring 2019).
If a person’s diet is lacking in fibre and they are reluctant to eat certain foods, consider advising the intake of a fibre supplement (Better Health Channel 2014).
Laxatives are a treatment option for constipation if diet and lifestyle modifications do not provide a solution. There are two primary types of laxatives: osmotic laxatives and bowel stimulants. Laxatives should be used appropriately to avoid adverse effects (Better Health Channel 2014; Mounsey et al. 2015).
Regular exercise is known to aid and regulate digestion. The minimum amount of exercise recommended is 30 minutes per day. In the case of an older person and/or where mobility issues are apparent, activity should be encouraged. Every small bit of exercise makes a difference (Better Health Channel 2014).
It has been shown that depression and mood disorders can trigger constipation. Yoga, meditation or other relaxation techniques may aid this (MedicineNet 2018).
Try to establish a regular bathroom time in which an older adult tries to empty their bowels each day. In addition to this routine, they should be encouraged to go as soon as they feel the urge (Daily Caring 2019).
(Mayo Clinic 2019; Better Health Channel 2014)
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Which of the following is recommended as a treatment of constipation?
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