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of Medical Care
Constipation refers to 2 or fewer bowel movements per week, which may be accompanied by dry stools, low volume, and difficult and laborious bowel movements. Constipation is a common symptom of the elderly, and it is extremely harmful to the elderly. In addition to seriously affecting the quality of life, there are also risks of increased blood pressure, cerebral vascular rupture, myocardial infarction, and even sudden death, especially those with hypertension and vascular sclerosis. , heart disease, etc., so the elderly should pay special attention to constipation.
Common causes of constipation in older adults
1. Psychological factors
10% of the elderly have significant depressive symptoms, and depression and tension affect the defecation reflex, thereby promoting constipation. The organ function and psychology of the elderly will change accordingly with age, and anxiety may occur when they cannot adapt. On the one hand, depression and tension are related to the formation of constipation; on the other hand, long-term constipation promotes inability to concentrate, restlessness, and even insomnia, anxiety, and depression in the elderly, forming a vicious circle.
2. Unreasonable dietary structure
Fruits, vegetables, grains, and other fiber-containing foods are natural scavengers of the digestive tract, and fiber helps the stool retain water and bulk, making it easier to pass. The diet is too refined and the meat is relatively large, lacks sufficient dietary fiber, and there are few food residues in the intestines, and insufficient stimulation of the intestinal mucosa will lead to weakened peristalsis and constipation. Constipation due to dehydration occurs because the body has to absorb more water from the stool, resulting in reduced stool volume and dry stools. In addition, some elderly people drink less water is also an important cause of constipation.
3. Lack of exercise
Physical activity is good for bowel movement, but in the elderly, physical activity is reduced, gastrointestinal reflexes are weakened, food stays in the bowel for too long, and excessive water absorption can cause constipation.
Common drugs include anticholinergics (antipsychotics, antiparkinsonian drugs, anticonvulsants), opioid analgesics, calcium, iron, etc. The elderly often have chronic diseases such as cardiovascular disease, tumor, and insomnia. Therefore, drugs are also common factors that cause constipation in the elderly.
5. Abuse of laxatives
Older people have poor constitution, weakness, and weakened abdominal and pelvic muscle tension, making it difficult to expel feces from the body. Patients who regularly use laxatives and/or enemas often lose bowel function without these aids. Constipation leads to more laxative use, and laxative use leads to more constipation, creating a vicious circle.
6. Comorbid diseases
With age, the incidence of organic diseases in the elderly increases, especially colorectal tumors. Pay attention to alarm signs: including blood in the stool, abdominal pain, abdominal mass, anemia, appetite, changes in bowel habits, etc. Certain metabolic diseases (such as diabetes, hypothyroidism, uremia, etc.) and neurological diseases (Parkinson’s disease, stroke, spinal cord injury, etc.) can cause constipation by altering the structural and functional integrity of the gastrointestinal tract.
1. Behavioural therapy
Cultivate the regularity of regular meals and regular bowel movements. Generally, it is better to defecate in the morning exercise or after meals in the gastrocolic reflex time. Rely on conditioned reflexes to rebuild defecation habits, and focus on defecation. Power, reduce the interference of external factors, do not read newspapers, do not use mobile phones.
2. Diet adjustment
In the diet, more coarse grains, vegetables and fruits rich in dietary fiber should often be arranged. It is recommended to consume 25-35g of dietary fiber per day, and drink at least 1.5L of water every day. Immediately after getting up Drinking a glass of warm water can often trigger the urge to defecate and stimulate defecation. For patients with heart and kidney disease, attention should be paid to monitoring the effect of fluids on the disease.
3. Exercise properly
The elderly should exercise according to their ability, preferably walking, Taijiquan, etc., in order to enhance the strength of abdominal muscles, promote bowel movements, and improve defecation ability. For the elderly who are bedridden for a long time due to illness, family members can give them abdominal massage, gently pushing from the right upper abdomen to the left lower abdomen to promote their intestinal peristalsis.
4. Psychological adjustment
Children should give more care and care to their elders. While busy going out to make a living, they should pay attention to the mental and physical health of their elders, and visit home more often at appropriate times to relieve their depression and anxiety. , obsessive-compulsive symptoms, etc. The elderly should learn to self-adjust, maintain a positive and optimistic attitude, learn to relieve life pressure, and eliminate negative emotions in time.
: Actively treat intestinal and systemic diseases, and avoid the use of drugs that inhibit defecation reflex and bowel movement. The etiology and influencing factors of constipation in the elderlyThe factors are complex and require timely medical treatment, comprehensive evaluation, and individualized treatment.
Constipation has become a problem that cannot be ignored that affects the quality of life of the elderly. The causes, types and severity of constipation are different, and the treatment required is also different. Therefore, it is recommended that elderly patients have constipation symptoms , Do not listen to advertisements and the experience of relatives and friends to self-medicate, get out of the misunderstanding of constipation treatment as soon as possible, and go to the professional outpatient clinic of the regular hospital for medical consultation in time.
Author: Department of Geriatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine
An Ye Attending Physician