A cure for constipation opens the door to convenience for the elderly

Author: Zeng Lu, The First Affiliated Hospital of Nanchang University

Reviewer: Zhu Jiaojiao, deputy chief nurse, the First Affiliated Hospital of Nanchang University

Constipation refers to a decrease in the frequency of bowel movements, accompanied by difficulty in defecation and/or hard stools. Normal people defecate 1 to 2 times a day or once every 2 to 3 days, while constipated patients defecate less than 3 times a week. Constipation is a common symptom among the elderly. According to relevant research[1], 28% to 50% of the elderly over 60 years old often suffer from constipation.

1. Causes of constipation in the elderly

1. Physiological factors: The incidence of constipation in the elderly is significantly higher than that in young and middle-aged people. This is mainly because as they age, their food intake and physical activity decrease significantly, the energy required decreases, and the amount of feces decreases accordingly. On the other hand, as the elderly age, their body functions and organ functions gradually decline, such as weakened anal sphincter muscle strength and weakened gastrointestinal motility, which can cause food to stay in the intestines for too long and excessive water absorption, causing constipation.

2. Dietary factors: As the elderly often suffer from tooth loss, they prefer simple food with less residue. Reduced intake of crude fiber increases the viscosity of stool and slows the movement of stool in the intestine, which leads to excessive absorption of water and constipation.

3. Bowel habits: Some elderly people do not develop the habit of regular bowel movements and often ignore the urge to defecate, which results in the suppression of the defecation reflex and causes constipation.

4. Reduced activity: Some elderly people have greatly reduced activity due to physical reasons, especially those who are bedridden or in wheelchairs due to illness. They are often prone to constipation due to the lack of exercise stimulation to promote the movement of feces.

Figure 1 Copyright image, no permission to reprint

5. Intestinal lesions: Some elderly people suffer from intestinal diseases such as inflammatory bowel disease, tumors, hernias, rectal prolapse, etc., which can lead to functional outlet obstruction and cause defecation problems.

6. Drug factors: Most elderly people suffer from chronic diseases. Acid suppressants, antihypertensive drugs, hypnotics, etc. all have the effect of inhibiting central nervous system activity, which can reduce intestinal motility and ultimately lead to constipation.

7. Mental and psychological factors: Elderly people with mental and psychological disorders such as depression, anxiety, and obsessive-compulsive disorder are also prone to constipation.

2. The harm of constipation in the elderly

The harm caused by chronic constipation is often very serious. Chronic constipation can be manifested clinically as difficulty in defecation and reduced frequency of defecation. When elderly people with chronic constipation exert too much force, they are prone to transient ischemic attacks or syncope during defecation, and even myocardial infarction and cerebrovascular disease on the basis of existing diseases. Long-term constipation can also increase the risk of colon cancer. Therefore, preventing and treating chronic constipation in the elderly is an effective way to improve their quality of life.

Figure 2 Copyright image, no permission to reprint

3. How to correctly deal with constipation in the elderly?

1. Develop good bowel habits: The elderly should have regular bowel movements and should not delay when they feel like defecating, otherwise the defecation reflex will be weakened, which will cause constipation in the long run. In addition, you should develop the habit of having a bowel movement once a day, and the time may vary from person to person; do not look at your phone or read newspapers when defecating, and try to shorten the bowel movement time, but make sure that the bowel movement is complete. At the same time, when the elderly have a bowel movement, they should create a quiet and comfortable environment and try to choose a sit-down toilet.

Figure 3 Copyright image, no permission to reprint

2. Appropriate exercise: The elderly should exercise appropriately, such as walking, practicing Tai Chi, etc., with the principle of safety, not falling, and not feeling tired. In addition, the elderly should avoid sitting for a long time. For bedridden elderly patients, even sitting up, standing or walking around the bed is beneficial for defecation.

3. Reasonable diet: The elderly should eat more staple foods, vegetables, fruits, beans, etc. that are rich in crude fiber. Drink more water, generally at least 1500 ml of water per day, especially a cup of warm water every morning or before meals, which can effectively prevent constipation. In addition, if there are no taboos, you can eat some foods that have a laxative effect, such as black sesame, honey, bananas, etc.

4. Supplement probiotics in the intestines: Poor intestinal health often indicates an imbalance in the intestinal flora. The elderly can directly supplement probiotics to stimulate the reproduction of probiotics in the intestines and inhibit the growth of harmful bacteria.

Figure 4 Copyright image, no permission to reprint

5. Auxiliary exercises: (1) While lying flat and relaxed, start from the right lower abdomen, go up, left, and then down, and massage the abdomen in a clockwise direction, that is, follow the order of ascending colon-transverse colon-descending colon-sigmoid colon, 20 to 30 minutes each time. (2) Lie flat and do abdominal contraction-abdomen bulging exercises, take a deep breath to bulge the abdomen, and contract the abdomen while exhaling, and repeat for 10 minutes. (3) Perform levator ani exercises while lying flat or sitting, that is, contract the anus exercises to exercise the contraction ability of the levator ani muscles.

6. Others: The elderly should try to avoid using drugs that may cause constipation and not abuse laxatives; actively treat systemic and perianal diseases; adjust their mental state, as a good mental state helps to develop good bowel habits.

In short, constipation is by no means a trivial matter and should not be taken lightly, especially for some elderly people who have underlying diseases. Seemingly "minor" constipation may threaten their lives and health. When elderly people experience constipation symptoms in their lives, they should pay attention to it, seek medical treatment in time, and follow the doctor's advice for treatment.

References:

[1] Ren Kai, Yang Linfang, Zhao Wenjing. Current status of constipation in self-care elderly people in nursing homes and analysis of influencing factors[J]. Evidence-Based Nursing, 2019, 5(8): 3.