Constipation is very common in the elderly and is classified as producing stools less than 3 times a week.
The risk factors of constipation are worse in
. Elderly
. Females
. Poor socio economic status
. Not enough Exercise
. Low calorie intake
Diet
It is not totally clear how diet and constipation are related but certainly less calories being consumed and dehydration play a part.
Fibre in the diet is also very important as well as maintaining adequate hydration.
Foods such as Bran, beans, peas, raspberries and broccoli are all high in fibre
-Eating breakfast is the best way of getting your fibre fix.
-Opt for plain whole-wheat cereals or go for some porridge oats if you want something warm.
-When it comes to bread go for wholemeal or granary options.
-Choose whole-wheat pasta and rice or bulgur wheat.
-Make sure your potatoes have the skins on – that’s where all the fibre is.
-Snack on nuts or some fruit – these are two very good sources of fibre.
Causes
Constipation is a symptom of many diseases.
Causes can be:
Decreased food intake
Thyroid problems
Depression
Dehydration
Parkinsons
Stroke
Diabetes
Bed bound patients
Certain tablets and painkillers especially things contained codeine
Colon cancer can also cause a change in bowel habits and should be investigated to rule it out.
Treatment
Acute cases
Admission to a nursing home where they can be given a nonstimulative laxative such as Sorbitol , water, fleet enemas or polyethylene glycol to clear the bowels.
Chronic
Daily Bowel movements are not necessary for health. People should train themselves to have regular habits, especially after breakfast, when they can take advantage of the body’s natural gastro-colic reflex.
Regular exercise, a diet including prune juice and good hydration are important
Laxatives should only be used when all these things fail.
Laxatives
If you use laxatives too often, your body forgets how to work on its own.
There are 4 main types of laxatives
. Bulk forming
. Surfactant
. Stimulant
. Osmotic such as Sorbitol
Treatment of choice is Sorbitol at night. Or Lactulose will have the same effect. These are both safe choices but the patient must also drink plenty of fluids
Bulk forming products attract water and increase stool mass and should not be used if there is any mechanical obstruction of the gut.
Stimulant laxatives should only ever be used intermittently and are never the first treatment of choice.
To summarize
Treat with fluids, good diet including lots of fruit and vegetables, adding bran in to the diet and prune juice.
If necessary use Sorbitol.
