constipation is a common health problem for older persons, which not only affects daily life but can also cause many health hazards. This paper will provide a detailed account of knowledge of constipation in old age and help to better understand and respond to this problem.
I. Definition and hazard of constipation in old age
Old-age constipation refers to the reduction in the number of defecations, dryness and/or defecation difficulties that persist for some time. Specifically, the pre-diagnostic symptoms are at least six months, of which at least three months are symptomatic, and at least one quarter of the defecation cases meet two or more of the following: defecation excreta, dung or dung, defecation incontinence, anal rectum resistance and/or congestion, and even handmade assisted defecation less than three times a week. The dangers of constipation in old age cannot be minimized. It can lead to increased abdominal pressure, increased blood pressure and increased oxygen consumption of myocardial muscles, leading to cerebrovascular diseases such as cerebral haemorrhage, cardiac pain, myocardial infarction and endangering life. In addition, there may be complications such as “septical” intestine infarction, ulcers of the intestinal wall, intestinal perforation, vasectomy, hemorrhoid decomposition, colon cancer, abdominal abdominal gland, mastosis, ischaemic enteritis, psychopsychiatric disorders, urine larvae and urinary tract infections.
II. Causes of constipation in old age
Physiological factors: With age, older persons experience a gradual decline in their physical functioning and a reduction in their intestinal wrinkles, which slows the movement of faeces within their intestinal tracts and can easily lead to constipation.
(b) Inappropriate diet: inadequate intake of food fibre is one of the common causes of constipation in old age. If the diet of older persons lacks foods rich in dietary fibres such as vegetables, fruits and whole cereals, the intestinal excreta becomes dry and difficult to excrete.
Inadequate water intake: Water is essential to keep excrement soft and smooth. When older persons have too little water, less water in their intestinal tracts and defecation, increasing the risk of constipation.
Lack of exercise: Older persons tend to have relatively low activity, and chronic lack of exercise can cause intestinal muscles to go soft, with further decline in kinetic functions, thus triggering constipation.
Diseases of the intestinal tract, such as tumours, vasectomy, hemorrhoids, anal fractures, inflammatory enteria, abdominal abdominal tumours, intestinal tumours, rectal tumours, or other excretional diseases, previously inflammatory / traumatic / radioactive or surgical intestinal narrowness, history of pelvis or anal weeks, may affect the normal structure and functioning of the intestinal tract, leading to constitus.
Diseases of the nervous system: cerebrovascular diseases, multiple sclerosis, spinal lesions from Parkinson ‘ s disease, trauma or tumours, autoneurological disorders, cognitive disorders, dementia, etc., may interfere with the normal conduct of intestinal neurons, affect intestinal creeping and excretion, thereby triggering constipation.
Muscular diseases: Muscular diseases such as starch morbidity, sclerosis and systemic sclerosis affect the normal contraction and constriction of the intestinal muscles, reducing the capacity of the intestinal tract to promote faeces and leading to constipation. Endocrine and metabolic diseases: Endocrine and metabolic disorders such as diabetes mellitus, thyroid decomposition and thyroid hyperplasia may affect intestinal digestion and absorption or alter intestinal neuroregulation, which causes constipation.
Other diseases: Cardiac diseases such as diarrhea heart failure may also be associated with the occurrence of constipation in old age.
Drug factors: Older persons often suffer from multiple chronic diseases and require multi-drugs. Some drugs, such as opioid analgesics, tricyclic antidepressants, anticholines, antimonometamines, antishock palsy, neurostimulant retardants, inflammants, anti acids with calcium carbonate or aluminum hydroxide, americ acids, irons, calcium stressants, urea and some antibacterial drugs, may cause or aggravate constipation.
III. Prevention of constipation in old age
Adapting diets to increase dietary fibre intake: older persons are encouraged to eat more foods rich in food, such as vegetables (e.g. spinach, celery, broccoli, etc.), fruit (e.g. apples, bananas, pear, etc.), whole cereals (e.g. oats, rough rice, whole wheat bread, etc.), beans (e.g. black beans, red beans, green beans, etc.). Dietary fibres absorb moisture, increase excreta volume, promote intestinal creeping and make defecation smoother.
Adequate water intake is ensured: 1,500 – 1700 ml of water per day can be consumed in multiple doses of 50 – 100 ml each to keep the intestinal humid. Apart from free water, light tea is a good option, but excessive consumption of coffee and strong tea should be avoided, as it may have the effect of facilitating urine, leading to water loss.
Moderate exercise: Appropriate exercise enhances intestinal muscles and promotes intestinal creeping. Depending on their physical condition, older persons can choose the appropriate mode of sports, such as walking, Tai Chi, yoga, jogging, etc., at least three to five times a week for more than 30 minutes each. Even simple activities, such as indoor mobility, housework, etc., can help improve intestinal functions.
Good defecation habits are regular defecation: daily, fixed up at morning or two hours after meal, try defecation, even if it is not convenient, by sitting on a toilet for a little while to develop a reflection of defecation. Avoiding hard defecation: Do not over-exercise when defecating, so as not to increase abdominal pressure and cause cardiovascular accidents. If defecation is difficult, you can try to take a deep breath, relax, or use aids such as a seat.
Restraint: Undesired moods such as chronic anxiety and depression may affect intestinal neurological function and aggravate constipation symptoms. Older persons should be careful to remain happy, and can reduce stress and regulate emotions by communicating with family and friends, participating in social events, and developing hobby. Treatment of constipation in old age
In addition to diet, exercise and defecation habits in the above-mentioned preventive measures, attention should be paid to creating a good defecation environment that avoids outside interference and allows older persons to defecate in relaxed conditions.
Drug treatment
Permeable laxatives: Lactose and polyethanol are commonly permeable laxatives with an evidence level of I and a recommended level of A. They soften the faeces and ease their discharge by increasing intestinal moisture.
Accumulative laxatives: e.g., pre-European, wheat, methyl cellulose, polycarpofacin, etc., with evidence levels I (pre-European) or II (other) and recommended levels B (pre-European) or C (other). These drugs increase the volume of excreta and stimulate intestinal creeping.
Irritating laxatives: The evidence level of irritating laxatives, such as pisacoletium and tanaf, is level C, which can be used with caution when the volume laxatives or permeable laxatives are ineffective, but long-term applications should be avoided to avoid damage to intestinal nerves.
Softener: Sodium sulfon-butadiate dioctyl allows for softening of excreta to ease discharge, with an I level of evidence and a C level recommended. Promotive drug: Pupacili has a better therapeutic effect on slow-transmission constipation at I level of evidence and A level of recommendation.
Promoting drugs: Rubi-Pregenone, Linarozoe, etc., promote intestinal genre, soft excreta, evidence levels I (Ruby-Precodone) or II (Linalode) and recommended levels A (Ruby-Predone) or B (Linalode).
Drug treatment should be based on the following principles: lifestyle adjustment; gradients, in order of volume or permeable laxatives, degenerative and irritative laxatives, which can be combined, depending on the condition; mild and moderate chronic constipated patients, in particular elderly patients with high blood pressure, poor heart and kidney function, who should be careful to use permeable laxals such as magnesium, phosphate, sodium, potassium, etc., which may be suitable for mild and safe lactose sugars; and care to identify pseudodiarrhea from faeces.
3. Other treatments
Medical treatment in Chinese medicine: Chinese medicine may have some effect on old-age constipation by means of evidence-based treatment, such as Chinese medicine, acupuncture and administration. For example, acupuncture can promote intestinal creeping and improve constipation.
Psycho-psychiatric treatment: Strengthening psychological counselling is essential for older persons who are exposed to or aggravated by mental and psychological factors. Psychologists can improve constipation by communicating with patients to help them alleviate anxiety, depression and psychological stress.
Sound social support: family and social care support has a positive impact on the physical and mental health of older persons. Families should give older persons more support and care to encourage them to be active in the face of disease, while communities can organize activities that provide a platform for social and psychological support for older persons. Cognitive function training: Cognitive function training for older persons with cognitive impairments can help to improve their overall quality of life and may also have some effect on the reduction of constipation symptoms.
Cognitive training may include memory training, thought training, attention training, etc.
Biofeedback treatment: This is a method of rehab therapy that feeds intestinal activity information back to the patient through the instrument, helps the patient learn to control intestinal muscles autonomously, enhances defecation, applies to export barriers, etc.
Surgery treatment: In cases of recalcitrant defecation, after rigorous assessment, surgical treatment may be considered if other treatments are ineffective, but the risks and complications of the operation need to be carefully weighed. 5. In conclusion, constipation in old age is a health issue that requires attention and involves a variety of factors that have a greater impact on the quality of life and physical health of older persons. The incidence of constipation can be effectively reduced by understanding the causes, hazards and active preventive measures, such as diet adjustment, moderate exercise, good defecation habits and the maintenance of a comfortable mood.
In the case of older persons already suffering from constipation, access should be provided in a timely manner and appropriate treatments, including lifestyle adjustments, medication and other complementary treatments, should be selected on a case-by-case basis. In the course of treatment, medical advice is followed to rationalize the use of drugs and to avoid self-abuse of laxatives. At the same time, families and society should give older persons more care and support to help them improve their constipation symptoms, improve their quality of life and enjoy a healthy and happy old age. It was to be hoped that, through joint efforts, older persons would be able to live a healthier and better life, free from constipation.
