Obstipation in the elderly
Authors:
M. Berková; Z. Berka; E. Topinková
Published in:
Geriatrie a Gerontologie 2016, 5, č. 4: 209-216
Category:
Review Article
Overview
Constipation affects up to 30% of the elderly population in the developed world. It can be a transient, benign condition, but it can also be a symptom of a serious disease. According to its duration, we classify constipation into chronic and acute, according to aetiology we classify it into primary and secondary. Constipation can be functional or organic. Chronic functional constipation is defined by the Rome criteria III (ROMA III). According to the type of the intestinal dysfunction, we differentiate among chronic functional obstipation: a) with normal passage, b) slowed passage, c) incomplete evacuation and d) combined symptoms. In seniors we commonly encounter chronic functional constipation lasting many years, which is made worse by lack of exercise, insufficient fibre and fluid intake, medication related issues and age-induced changes in the bowel and its innervation. It is important to rule out a serious organic disease, especially a malignancy, when presented with a new case of a senior with constipation issues. A rare complication of stool impaction is a stercoidal ulcer causing intestinal haemorrhage or perforation, especially in bedridden patients, immunocompromised patients and patients with ischemised large intestine wall. Three groups of laxatives are used to treat functional obstipation: volume, osmotic and contact. If their effects are insufficient, it is possible to try the prokinetic prucaloprid. Newer entries in the laxative category include chloride canal activators and guanylate cyclase receptor activators. In disorders with incomplete bowel evacuation, it is best to train the patient in a synergic response of the pelvic floor, assuming the patient is capable of cooperation. It is however true that in many polymorbid seniors with cognitive deficits, this method is not suitable.
KEYWORDS:
Constipation – obstipation – criteria Roma III - laxatives
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Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2016 Issue 4
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