Constipation in older people

Constipation is a condition in which bowel movements are difficult or infrequent, have hard stools, or the feeling that the rectum is not completely empty after a bowel movement (incomplete bowel movements). This is a common condition in many age groups from children, adults, to the elderly. Constipation can be acute or chronic. Acute constipation begins suddenly and is noticeable. Chronic constipation can begin gradually and last for months or years. If constipation persists, it will affect the health and quality of life of the sufferer.

What is the cause of constipation in older people?

The rectum enlarges as people age, and increased storage of stool in the rectum means that older people often need to have larger volumes of stool in their rectum in order to feel the urge to defecate. The increased rectal volume also allows hard stool to become impacted.

Other common factors in older people that lead to constipation include increased use of constipating drugs, a low-fiber diet, coexisting medical conditions (such as diabetes and an underactive thyroid), and reduced physical activity. Many older people also have misconceptions about normal bowel habits and use laxatives too often.

Here are some causes of constipation:

Diet 

Changes in diet such as decreased fluid intake, low-fiber diet, and/or constipating foods. Dietary causes of constipation are very common. Fruits, vegetables, cereals and other fiber-containing foods are considered natural laxatives of the digestive tract. Lack of fiber in the diet can lead to constipation because fiber helps hold water in the stool and increases its bulk, making it easier to pass. In addition, dehydration also causes constipation because the body tries to conserve water in the blood by removing additional water from the stool. If the stool contains less water, it is harder to pass.

Medications that slow down intestinal motility

The most common medications that can slow intestinal motility include opioids, iron salts, and drugs with anticholinergic effects (such as many antihistamines and tricyclic antidepressants). Some other medications, including aluminum hydroxide, bismuth subsalicylate, some antihypertensive medications, and many sedatives, can all cause constipation.

Disordered defecation

Disordered defecation (dyschezia) refers to a problem with the intestines not generating enough force to propel stool from the rectum and/or difficulty relaxing the muscle fibers around the rectum and the external anal sphincter during defecation. People with dyschezia sense the need to have a bowel movement but cannot. Even stool that is not hard may be difficult to pass.

Irritable bowel syndrome (IBS)

People with irritable bowel syndrome (IBS) may have loose stools, disordered defecation or constipation.

Laxative abuse

People who frequently use laxatives or enemas often lose the ability to move their bowels without such aids. At this time, the vicious circle of constipation will repeat over and over again. The more laxatives you use, the more likely you are to experience constipation.

There are also a number of less common causes of constipation include specific medical disorders, intestinal obstruction, metabolic disorders and neurological disorders. Constipation also can occur during any major illness that requires prolonged bed rest (because physical activity helps the intestines move stool along), with decreased food intake, with use of drugs that can cause constipation, and after a head or spinal cord injury. In many cases, however, the cause of constipation is unknown.

Effects of constipation

In people with constipation, certain symptoms and characteristics are cause for concern, include:

  • Distended, swollen abdomen
  • Vomiting
  • Blood in stool
  • Weight loss
  • Worsening severe constipation in older people

Treatment of constipation

Any underlying disorder causing constipation must be treated. When possible, drugs that cause constipation are stopped or changed. Constipation is best prevented with a combination of exercise, a high-fiber diet, and an adequate intake of fluids. When using a drug that can cause constipation, doctors often prescribe laxatives and advise increasing fiber and liquid foods.

Diet

People need to ingest enough fiber in their diet (typically 15 to 20 grams per day). Vegetables, fruits and bran are excellent sources of fiber. Besides supporting the digestive process more smoothly, many studies prove that fiber has the ability to reduce cholesterol in the blood extremely effectively. Thereby, people will limit problems related to cardiovascular health such as high blood pressure, diabetes, etc. In addition, increasing fiber into the daily diet can control the condition. weight. This nutrient helps you feel full for a long time, reduces cravings during the day, supports the weight loss process to go smoothly and achieve good results soon.

Laxatives

Some laxatives that are safe for long-term use and help treat and/or prevent constipation include: Stool softeners (such as docusate or mineral oil), Osmotic agents, Stimulant laxatives (phenolphthalein, bisacodyl, and anthraquinones),...

Enemas

This is a procedure to bring water from the anus into the colon to soften and loosen stools, often applied to people who have been constipated for a long time and cannot defecate. The intestinal wall expands and is stimulated to contract, helping to push stool out quickly.

Medical experts say it is best not to do colon enemas at home, if necessary, it must be guided and supervised by medical staff.

Source: https://www.msdmanuals.com/home/digestive-disorders/symptoms-of-digestive-disorders/constipation-in-adults