GERIATRIC SYNDROMES: CONSTIPATION

CONSTIPATION is defined as having a bowel movement than 3 or fewer times per week. Constipation occurs when the colon absorbs too much water or if the colon's muscle contractions are slow. As a result stools can become hard, dry, painful, small in size or difficult to eliminate.

Almost everyone experiences constipation at some point in their life, but the constipation's prevalence increases with age, being more prevalent from 60 years. The 25% of the elderly experience constipation and that is mor commonly a problem for women. For this reason, it's a important topic of aging, for its complications and impact on the elderly's quality of life.

Constipation is a symptom, not a disease, so that it's important to know the causes of constipation:

• Lack of physical activity (especially in the elderly)
• low-fiber diet
• Drink little water (deydration).
• Changes in life such as pregnancy, aging, travel,etc
• Ignoring the urge to have a bowel movement
• Mechanical problems such as obstruction, neoplasias, herniations,etc.
• Functional problems such as hemorrhoids,diverticula, anal fissure, anal prolapse, irritable bowel syndrome, chronic idiopathic constipation,etc.
• Some conditions such as stroke (the most common).
• Specific diseases such as diabetes mellitus, uremia, hypokalemia, hypomagnesemia, hypocalcemia, hypothyroidism, neurological diseases (parkinson, dementia, depression...), etc.
• Drugs (opiates) or abuse of laxatives.

Nursing should be able to advise the population constipated about the best life habits, because in this way, they can prevent the appearance of constipation's complitations such as fecalomas.

Therefore, the mainstays of treatment for constipation are the following:

• DIET: increase intake of dietary fiber (eating more fruits, vegetables and grains) and an adequate fluid intake (2000ml/day)
• PHYSICAL ACTIVITY: Exercise must be individualized in each patient. Regular exercise helps your digestive system stay active and healthy, above all, exercises to strengthen the pressure abdominal and pelvic floor
• INTESTINAL EDUCACTION: Schedule or encourage toileting at times when the person's defectaion urge is strongest. It's recommended to be 10-15 minutes sitting in the WC after breakfast (gastrocolic reflex). If the patient can't defecate, he will repite the same process after lunch and dinner.
• POSITION  the person to facilite ease of elimination
• Provide PRIVACY for elimination.
• LAXATIVES, SUPPOSITORIES OR ENEMAS only if the other methods have not been effective.

Bibliografia

• NATIONAL DIGESTIVE DISEASES INFORMATION CLEARINGHOUSE (NDDIC)
• MEDLINEPLUS