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Many causes can cause constipation, for the elderly, factors such as sedentary activity, reduced bowel movements, improper nutrition and drinking less water are common. In particular, the elderly often have chronic diseases, so long-term drug use is a risk factor for severe constipation. However, in the process of using laxatives for the elderly, there are some caveats.
1. Causes of constipation in the elderly
Daily diet low in fiber; Elderly people do not have enough water supply on a daily basis; Undesirable effects of some pharmaceutical products (codeine-containing pain relievers, aluminum-containing acid neutralizers, amitriptyline antidepressants, iron tablets...). Associated with some diseases such as hypothyroidism, irritable bowel syndrome with constipation or other diseases. Women who are in pregnancy (caused by hormonal changes and mechanical compression of the fetus, which reduces intestinal motility). Abstain from going out due to busy work. In addition, there are some cases where constipation in the elderly has no identifiable cause and is classified as functional constipation with a predominance of female prevalence. In most cases, people can buy themselves oral laxatives to treat.
People with constipation are recommended to see a doctor so that a gastroenterologist can assign tests (fecal test, flexible colonoscopy, ...) to help evaluate and determine the cause. in the following situations:
New constipation occurs within 6 weeks despite the elderly following a correct lifestyle (regular exercise, drinking plenty of water, eating a lot of fiber,...). Severe constipation unresponsive to various laxatives. Having a bowel movement accompanied by nasal mucus, blood, weight loss, family history of diseases such as colon cancer or chronic inflammatory bowel disease (crohn's disease, ulcerative colitis). Another cause that should be noted is that the elderly often abuse drugs containing tannins, drugs for depression, and drugs that cover the stomach lining with aluminum-containing ingredients. At the same time, some people also have a bad habit of abusing some drugs with laxative effect, because too much use of drugs does not have the desired laxative effect. Therefore, constipation in the elderly is often prolonged and the treatment becomes difficult.
2. Laxatives for the elderly
Laxatives for the elderly have 3 main groups:
Groups that help increase stool volume are drugs that provide fiber and fibers such as Psyllium, Methylcellulose, calcium Polycarbophil, wheat dextrin. When using laxatives for the elderly, drink plenty of water (1-2 liters). Laxatives of this class, which increase stool volume and absorb water, are used to treat idiopathic constipation. Long-term use of the drug often causes gas and bloating. Contraindicated in cases of suspected mechanical intestinal obstruction, duodenal ulcer, gastrectomy. The group with stimulant effects (including: bisacodyl, doccusate, dantron, glycerol, senna and sodium picosulfate), drugs that stimulate intestinal motility, increase the expulsion of stool in the colon. Undesirable effects can cause abdominal pain and laxative dependence in the elderly with prolonged treatment. However, laxatives for the elderly in this group will lose their effectiveness if antibiotics kill bacteria in the intestines. The group of drugs that create osmotic force: Macrogol is a popular choice because of its safety effect and does not cause bloating, indigestion, and defecation. Lactulose can cause bloating and gas. The drug works by drawing water into the intestinal lumen, softening the stool. Some types of magnesium salts such as magnesium hydroxide, magnesium citrate (acting by increasing osmotic pressure) have strong laxative properties, often used before surgery. Osmotic laxatives have the effect of increasing the osmotic pressure in the intestinal lumen, helping to excrete and expel stool. Laxatives for the elderly in the osmotic group are contraindicated in patients with ulcerative colitis, intestinal obstruction, rectal cancer, dehydration, heart failure. In addition, laxatives for the elderly can also be used with enemas with mucus or micro-enemas, often used to prepare for colonoscopy or for cases of constipation when lying down for a long time. stool softener, however, should not be used for prolonged periods.
3. Adverse effects of laxatives
The undesirable effects that may be encountered when taking laxatives for the elderly are:
Cramping abdominal pain; Chronic diarrhea ; Flatulence, nausea; Loss of fluid retention, causing dehydration, vomiting, or rectal bleeding. Regular, long-term use of laxatives leads to irreversible damage to the gastrointestinal tract. Users tend to be dependent on the drug, if not using the drug will suffer from severe chronic constipation and pain for a long time. Using these laxatives at higher than prescribed doses, even if only a single higher dose or more than one dose per day can lead to severe and possibly life-threatening dehydration.
4. How to use laxatives for the elderly
Depending on the medical condition of each specific person or as prescribed by the treating doctor.
General principles when using laxatives:
Should use laxatives for the elderly to increase the amount of stool first. If not effective, the use of laxatives for the elderly with increased osmotic pressure can be combined with drugs to increase stool volume. When using the above-mentioned drugs, but still feeling difficult to digest, it is impossible to use the stimulant laxative group. Laxatives for the elderly should only be used for a short time, as soon as normal bowel movements are restored, you need to take other measures to prevent constipation. There is currently no evidence that long-term use of these laxatives causes colon cancer or damage. It should be noted that the use of laxatives for the elderly must be adjusted according to each specific person so that defecation is easy but does not cause diarrhea (dehydration, electrolyte disturbances, potassium loss.. .)
5. Natural laxatives
Some of the foods listed below act as natural laxatives:
Water: Drinking enough filtered water is one of the best methods for softening stools and making them easier to pass. You should try to drink at least eight glasses of water a day. Coconut water: If filtered water is too bland, you can try sipping coconut water. Coconut water works to help cleanse your digestive system. Apples or apple cider vinegar: The pectin in apples can have a stimulating effect on the intestines. Add a teaspoon of apple cider vinegar to a cup of water for anti-constipation benefits. Eating apples also adds fiber to prevent constipation. Aloe vera: Aloe vera contains compounds called anthraquinones that act as natural laxatives. You can add a few drops of aloe vera gel to your drinking water or use aloe vera juice to combat constipation. Flaxseed: Flaxseed contains fiber that can help with better digestion. This is a type of "natural laxative" that is often used by many people. Drink plenty of water when using flaxseed to help combat constipation effectively. Green leafy vegetables: Green leafy vegetables like kale and spinach contain collards and magnesium, minerals that can naturally soften stools. Lemon: The citric acid in lemon juice has the effect of stimulating the intestines and cleansing the intestines. You can add a few teaspoons of lemon to a glass of water to get results. In summary, in order to limit constipation, elderly people need to have a healthy diet, add more types of fiber, drink enough water, create a habit of gentle exercise every day, create a habit of If you have a bowel movement at a certain time, consult your doctor about any medication you are taking if you suspect it is the cause of your constipation. If these measures do not bring results, it is necessary to use laxatives for the elderly to treat.
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