Constipation is one of the most common disorders in Western
societies, and its prevalence increases with age. Many of the factors that predispose older
adults to constipation are not a direct effect of normal aging, but are closely
related to it. Fortunately, there are therapies which can improve this
distressing condition.
Causes
A majority of people over 65 take one or more medications
that effect nerve conduction and smooth muscle function. Medications
such as opioids, NSAIDS, calcium supplements, and various others increase the
risk of constipation in older patients. Other
common risks include low-fiber diets,
limited fluid intake, impaired mobility, and cognitive disorders. Studies also show that there are distinct physiological changes which can affect
colonic motility in older people.
Treatment
Treatment should focus
on education. Informing patients
about diet, exercise and bowel
techniques, including evacuation timing, breathing, and the way they
position themselves on the toilet, can be incredibly effective.
Depending upon the type of constipation, a routine that
includes taking a fiber supplement mixed with 2 ounces of water every evening,
can be a proven therapy. Additionally, adding a morning routine which begins
with mild physical activity- just stretching in bed- a hot, preferably
caffeinated beverage and possibly a fiber cereal followed by another cup of a
hot beverage- all within 45 minutes of waking can increase the possibilities of
effective evacuation.
Having a routine and an organized plan will provide patients
with an improved quality of life. It offers more than the band-aide of taking a
laxative, as laxatives really do not provide a long term solution, nor do they promote
health.
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