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Constipation 

 

Definition

A person who is constipated is unable to or finds it difficult to defecate, finds the process painful, or can only partially empty his or her bowels. Constipation is a common problem among older individuals. 

There are several possible contributing factors, such as the use of certain medications (some blood pressure drugs, antacids or sedatives, for example), lack of exercise, inadequate intake of water and fiber or other dietary changes. 

In addition, some diseases that are more common in the elderly, such as neurologic disorders (Parkinson’s disease, stroke), diabetes, hypothyroidism and other metabolic disorders, can predispose a person to constipation. 

A person is not necessarily constipated if he or she does not have a bowel movement every day. More important is whether the person’s bowel habits have changed from what is normal for them, and/or the degree of discomfort they may be feeling. 

A person who visits a physician because of constipation may be advised to try some of the simple preventive or treatment remedies mentioned below. Or, if after performing an examination the doctor believes there may be a more serious problem involved, he or she may send the person for blood tests or scans before deciding on an appropriate course of action. 

Treatment

In many people, constipation is easily prevented with a healthy diet that includes plenty of natural fiber (fruits, vegetables and whole grains) and water. Extra fiber can be provided with bran, psyllium or other bulking agents. Be cautious, though. Use small amounts at first so that your digestive system can become accustomed to the additional fiber. 

If you are thinking of trying psyllium, you should speak with your physician first because this agent can affect the absorption of iron, vitamin B-12, and various prescription medications including coumadin, digoxin, carbamazepine, and lithium.  

Here’s another hint.  Having a warm drink or meal upon getting up in the morning can be all it takes to promote the urge to “go” (in medical parlance, this is “the gastrocolonic response”.) 

There are many laxative agents available on the shelves of any pharmacy. Some soften the stool, usually by increasing its water content. Some directly stimulate contraction of the intestine to promote a bowel movement. 

While most of these stool softeners or laxatives are safe if used occasionally, it is important not to overuse them. Some contain large amounts of salt or other substances that can be dangerous for people with kidney disease or heart failure. Overuse of stimulant laxatives can cause the bowel to become “lazy”, compounding the constipation. Mineral oil is not usually recommended because it can cause lung problems if regurgitated. 

If these remedies for constipation are not effective, or if the constipation is caused by a specific problem in the digestive system or another disease, more complex treatments may be needed. In such cases, your doctor may refer you to a gastroenterologist for further evaluation.  

 

 

 

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