UNIT 4: COMMON DISORDERS IN THE AGING 4.6 GERIATRIC SYNDROMES: CONSTIPATION

Constipation is a symptom, not a disease. It can be defined as the decrease of the number of times depositional (<3 times per week) or evacuating dry feces too slim. It is associated with hard consistency of stool.

It represents a major geriatric syndrome because of its prevalence, its serious complications and their significant impact on the quality of life of elderly. It affects mostly females. Only 5% of the elderly have fewer than 3 bowel movements a week, though more than 1/4 of those over 60 years meet other criteria for constipation. Approximately 80% of the institutionalized elderly are constipated.

Causes of constipation in the elderly are multiple and, in many cases, several causes coexist simultaneously. This should be taken into account when considering a diagnosis and treatment. Although most people suffering from constipation due to unsuitable lifestyle habits such as:

• A sedentary lifestyle

• A diet low in fiber.

• Drugs that decrease or slow down bowel motility.

• Emotional disturbances.

Constipation can also be secondary to diseases such as: structural colon lesions, postsurgical changes, metabolic disorders, neurological disorders, etc.

The symptoms experienced by people who suffer constipation are:

- Bloating.

- Abdominal pain.

- Pain on defecation.

- Changes in behavior.

The Recommendations and advice that we give the patient are:

• Increase fluid intake (if not contraindicated).

• A diet rich in fiber, increase your intake of fruits, vegetables and whole grains. And reduce food consumption astringent food.

• Avoid a sedentary lifestyle and exercise appropriate to the patient.

• Avoid drugs that slow or slow peristalsis.
 • Encourage the person intimacy when defecation.

• Administer laxatives (by prescription).

• Establishment of schedules defecation, intestinal rehabilitation.

• Encourage the practice of exercises that promote or strengthen pelvic muscles, like Kegel exercises.

• Control the number and shape of stools, great importance in geriatric institutionalized people with dependence.

From the point of view is also recommended nursing identify drugs that cause constipation, such as calcium antagonists, tricyclic antidepressants, antimuscarinic bladder and opiates.

The easier and cheaper treatment will be to implement changes in individual lifestyles. So it is necessary make a proper health education and prevention to patients.

REFERENCES:

• Treaty of geriatrics for residents. Spanish Society of Geriatrics and Gerontology. [Home Site] [accessed May 18, 2013] Available at: http://www.segg.es/tratadogeriatria/main.html

• From the Key Benito J A. Horsemen Anes M. Management of constipation in older people. Bulletin of Nursing in Primary Care of Talavera de la Reina, 2008. Available at: http://gaptalavera.sescam.jccm.es/web1/gaptalavera/prof_enfermeria/boletines/boletin_enfermeria6_2008.pdf

• Clinical Practice Guideline: Assessment Comprehensive Geriatric Gerontological Ambulatory Elderly. Mexico: Ministry of Health, 2011. Available at: http://sgm.issste.gob.mx/medica/medica_documentacion/guias_autorizadas/Geriatr%C3%ADa/IMSS-491-11-valoraci%C3%B3n%20geronto-geriatrica/IMSS-491-11-GER%20Valoraci%C3%B3n%20geronto%20geriatrica.pdf