CONSTIPATION IN ELDERLY PATIENTS
Constipation is common in elderly patients above 80 years who are at bed rest.
These geriatric patients tend to be at risk for tight motion or constipation due to insufficient intake of dietary fiber, fluids, failure to establish a regular bowel habit, and excessive use of inappropriate laxatives such as stimulant or osmotic laxatives which results in loss of bowel smooth muscle tone.
Laxative Abuse often happens in elderly patients and young women when they chronically use stimulant laxatives or osmotic laxatives in order to promote bowel movements and to shed their excess weight.
In some medical practices, the elderly patients with anorexia nervosa or bulimia(an obsessive desire to lose weight) are often advised to take high doses of stimulant laxatives several times per day which may result in serious laxative abuses with unwanted consequences such as loss of bowel tone, and bowel perforation, etc.
Elderly patients should be thoroughly examined for such drug abuse including uses of opiates, and anticholinergics along with their medical history for other underlying diseases such as Hypothyroidism.
Cough suppressants and some pain killers commonly contain opiates such as codeine, meperidine, and dextromethorphan, etc. Anticholinergics are commonly used in anti-allergic medications such as all antihistamines preparations, belladonna extract(for diarrhea), and hyoscyamus and stramonium plant products(for stomach pain). Hence care should be taken when elderly patients with constipation are to take the above medication.
A major concern with geriatric patients is the possible loss of digestive fluids if they take stimulant and saline laxatives on a long time basis. Enemas should be given on doctor's supervision only. Magnesium containing laxatives such as Epsom Salt should not be used for those who have kidney problems.
Geriatric patients can be treated for acute constipation at home by Glycerine Suppositories with Bulk Laxatives. For chronic constipation Lactulose, a prescription drug can be used under a doctor's advice.
