Constipation is caused by many problems, including potentially dangerous medical conditions and medications you may be taking. If the initial investigations are normal, empiric therapy should be initiated. Josephson c onstipation encompasses many defecatory disorders and means different things to health care providers and patients. Constipation is common in the elderly because of agerelated physi. If you have not been to the elderly care bladder and bowel clinic and are not an inpatient, please call monica colorectal nurse specialist on 020 7188 4192. Jun 20, 2019 the elderly are five times more likely than younger adults to develop problems related to constipation. Primary constipation is also referred to as functional constipation. Constipation in people with disabilities clarissa kripke, md, faafp director, office of developmental primary care university of california, san francisco. Constipation and faecal impaction information sheet is41. The treatment of chronic constipation in elderly people.
Sep 20, 2016 constipation in elderly is becoming an increasingly common condition. We present an 82yearold female with long standing constipation presenting acutely with large bowel obstruction. Outpatient management of constipation in older adults. However, the constipated elderly have been left behind while gastroenterology consultations for this common conditions are at a rise for the. Chronic constipation is common in the elderly, and often no underlying pathology is found. She was treated with an enema, instructed to take 17 g of polyethylene glycol 3350 peg 3350 daily, and educated on lifestyle changes to reduce constipation. It is understandable that you are looking for the best treatment for constipation especially when you are suffering from cramps, lethargy, and even gas build up because of the blockage in your intestines. Chronic constipation in senior citizen occurrence of constipation is much common in elderly people. Gordon wilkins consultant geriatrician to the york hospitals causes most of the causes of constipation in younger age groups apply to the elderly and i will not attempt a systematic classification table 1. We aimed to study the prevalence of, and potential risk factors for, constipation in a representative elderly community, using symptombased diagnostic criteria. In these patients, constipation results from a combination of risk factors, such as reduced fibre and fluid intake, decreased physical activity resulting from chronic diseases and multiple medications. However, while undoubtedly common in the elderly, data on the prevalence of constipation in general and of its subtypes vary. Nov 17, 2012 the cause of constipation in elderly patients is often multifactorial and may include inactivity, inappropriate diet, depression and confusion, certain medications, and neuromuscular disorders. Aug 31, 2012 constipation is a common problem in elderly persons, with prevalence ranging from 15% to 20% in the communitydwelling elderly population and up to 50% in some studies of nursing home residents.
Take a laxative or another medication designed to treat constipation in adults, with your doctors permission. Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home res idents. How to treat constipation in adults healthy living. Archived pdf from the original on 7 september 2011. The photo depicts a primary culture of hippocampal neurons stained for dna blue. Among elderly people living in a care home the rate of constipation is 5075 percent. In clinical practice, constipation is gener ally defined as fewer than three bowel move ments per week. Management of elderly patients with chronic constipation. Constipation in the elderly infrequent bowel movements, hard stools there is no set definition for normal frequency of bowel movements but it is accepted that a person will pass stool anywhere between 3 times a day to 3 times a week. Subjects77 elderly patients with a history of chronic constipation in long term. Managing constipation in elderly orthopaedic patients using either. The epidemiology of chronic constipation in the elderly remains poorly defined. A number of prescription medications are available to treat chronic constipation.
Apr 23, 2020 in conclusion, constipation is a common, selfreported digestive symptom that affects up to 30 % of people in western countries and has considerable impact on health expenses and quality of life. Treatment of constipation in older adults qnotes for adult medicine. Constipation refers to bowel movements that are infrequent or hard to pass. The easiest way to deal with constipation in the elderly is to understand that constipation prevention needs to be your first step. Evaluating and managing constipation in the elderly society of. Elderly patients admitted to orthopaedic wards are partic ularly prone to. Constipation is a common complaint and challenge for older adults. Epidemiology and management of chronic constipation in elderly patients maria vazquez roque, ernest p bouras gastroenterology and hepatology department, mayo clinic, jacksonville, fl, usa abstract. Laxatives should be used for shortterm relief only. Constipation is a common functional gastrointestinal disorder, with prevalence in the general population of approximately 20%. Constipation is a frequently reported bowel symptom in the elderly with considerable impact on quality of life and health expenses. Prevention of constipation in the older adult population rnao. Constipation refers to how easily stool passes out of your body and how often. Similarly to most fgid, chronic constipation is more commonly diagnosed in female patients mf ratio.
There are many other precautions on the labels of laxatives that you should read and understand before use. Evaluating and managing constipation in the elderly. The management of chronic constipation in the elderly should include a detailed medical history and physical examination to exclude secondary causes for constipation. Primary constipation is amenable to dietary adjustments, edu. Diseaserelated morbidity and even mortality have been reported in the affected frail elderly. Constipation, pear juice, fibre, orthopaedic, fluids, elderly diet. Laboratory evaluation should be performed in the initial assessment of the patient. If overthecounter medications dont help your chronic constipation, your doctor may recommend a prescription medication, especially if you have irritable bowel syndrome. When bowels have not acted for some days after illness relatives will say but shehasnt eaten anything.
In susceptible older people who are frail, excessive straining can trigger a. May 31, 2019 please use one of the following formats to cite this article in your essay, paper or report. You can usually treat it at home with simple changes to your diet and lifestyle. As we age, our body undergoes various changes, and decreasing efficiency of digestive system is one of them. Constipation prevalence in an elderly community setting was 40. Constipation is a common problem in the elderly, negatively affecting patients social and professional lives. Jul, 2017 a doctor can test to see if the problem is medical. Up to 28% of individuals over age 65 experience constipation, and it is the reason for more than 2. Jan 01, 2020 more than 4 million americans feel constipated frequently, according to a national institutes of health survey. In individuals 65 years of age or older in the community, the prevalence is 26% for women and 16% for men.
Chronic constipation in long stay elderly patients. Constipation is a very common problem and affects people of all ages. Constipation is a problem for less than 2 percent of people who arent elderly, but the rate is considerably higher in people over age 65. However, while undoubtedly common in the elderly, data on the prevalence of constipation in general and of its subtypes vary considerably, depending on the nature of the study population and their location. Secondary constipation is associated with chronic disease processes, medication use, and psychosocial issues. Straining is often the predominant symptom in the elderly. Jan 31, 2018 our choice for the best constipation treatment for the elderly. Constipation is a significant healthcare problem in the elderly. A full version of the document in pdf format is also available at the rnao website.
Causes of constipation include colon disease, metabolic disturbances, neurologic disorders, pharma. Constipation prevention in the elderly elder home care. Objectivesto compare the efficacy and cost effectiveness of a sennafibre combination and lactulose in treating constipation in long stay elderly patients. If you have any questions or concerns about constipation, and have been to the elderly or have been an inpatient at the hospital, please contact continence nurse specialist on 020 7188 2083. Treatment of constipation in older adults christine hsieh, m. Constipation is common and it affects people of all ages. For this reason, you should not selftreat constipation for more than 7 days.
Constipation is described as incomplete and irregular bowel movements that results in straining while expelling stools. It occurs in up to 65% of communitybased individuals older than 65 years of age, and hard stools are reported in approximately 40% of these individuals. Constipation is a common complaint in older adults. Its prevalence increases with age and is more frequently reported in female patients. Aug 04, 2014 reading resource for unit 3 of english for carers constipation and the elderly. Other important signs of constipation include extremely hard stools, abdominal muscle cramps and unproductive urges. Constipation in the elderly infrequent bowel movements, hard. Settingfour hospitals in northern ireland, one hospital in england, and two nursing homes in england.
The treatment of chronic constipation should be based on the nature of the complaint and the presumed pathophysiological mechanisms at work in each patient. Longterm use of laxatives can result in dehydration and other health complications, and may make constipation worse over time, according to the american academy of family physicians. Primary colonic dysmotility has been described in children but is rare in the elderly. Although constipation is common in all age groups, people over age 65 suffer from it the most. The august ce provides excellent information on fecal impaction and the added challenge of dementia, ways to avoid colon perforation, and the nurses role in managing constipation in the elderly. The prevalence of constipation increases with age and differs among settings. N2 chronic constipation is a common problem in the elderly, with a variety of causes, including pelvic floor dysfunction, medication effects, and numerous agespecific conditions. Chronic constipation has been associated with considerable impairment in quality of life. Ibs is a common disorder of the intestines that involves pain, bloating, and constipation or diarrhea. Pdf management of chronic constipation in the elderly. The prevalence of constipation rises dramatically with age, with some. Constipation is more frequent among elderly patients forced to periods of longterm care in hospital or nursing homes. Constipation is a prevalent disorders in western countries that may affect up to 30 % of the general population subject to the caveats that definitions of constipation vary across studies 2.
Rare or infrequent episodes of constipation are usually nothing to worry about but constipation can be a symptom of a number of different conditions, so it is important to seek advice from your doctor if you start to get. Another condition related to constipation is called irritable bowel syndrome. Evaluating and managing constipation in the elderly david a. Outpatient management of constipation in older adults darlene moyer, md and amy tierney, md, scottsdale healthcare, scottsdale, az constipation is common in older adults.
Constipation in the elderly, like in the young, can be caused by a diet lacking in fibre, or a low fluid intake, lack of exercise, and sometimes by emotional stress. Although constipation is not a physiologic consequence of normal aging, decreased mobility, medications, underlying diseases, and rectal sensorymotor dysfunction may. Constipation is one of the most frequent gastrointestinal disorders encountered in clinical practice in western societies. Whats the best constipation treatment for the elderly. Epidemiology and management of chronic constipation in. It has a major impact on healthcare costs in the united states because it results in several. A stepwise diagnostic and therapeutic approach to patients with chronic constipation based on historical and physical examination features is recommended. Some of the reasons for this propensity include poor. Oct 14, 2015 constipation is a frequently reported bowel symptom in the elderly with considerable impact on quality of life and health expenses. The keys to preventing constipation are simple enough.