As the elderly grow older, the function of the intestinal tract will become worse and worse, and the incidence of constipation will become higher and higher. Many elderly people feel that constipation is not a big deal, and they do not receive active and standardized treatment if they have constipation. As everyone knows, although constipation is a benign disease, the danger caused by constipation is very serious. So what should the elderly with constipation pay attention to? Avoid the abuse of stimulant laxatives: Most elderly people have constipation and rely on various laxatives such as rhubarb and Guodao for a long time to cause drug-induced constipation. Long-term use will cause colonic ganglion cells to decrease, colonic mucosal secretory function and sensitivity, intestinal microecological disorders, and decreased intestinal motility. Elderly constipation is best improved from diet: 1. Eat more whole grains, oatmeal, corn, sweet potatoes, etc. 2. Eat more fiber-rich foods. Such as fruits with skins, vegetables with large leaves. Some foods, such as radishes, raw onions, garlic, sweet potatoes, etc., can increase intestinal peristalsis and play a laxative effect. 3. When cooking, add more fat or vegetable oil appropriately. After fat is decomposed, fatty acids can be produced, and it can also stimulate intestinal peristalsis. You can put more sesame oil in cold dishes. 4. Eat foods that moisturize the intestines every day, such as honey, sesame, and walnuts. 5. Drink some warm water, light salt water, and fruit juice every morning to keep the moisture in the stool, make the stool soft and moisturize, and promote colon peristalsis. 6. Elderly people with severe constipation should maintain a certain amount of exercise every day. It is advisable to take a walk or dance square dancing. If the activities are not convenient, you can do exercises such as rubbing the belly button or levator anus. The hard work of the elderly with constipation and increasing abdominal pressure can rupture the originally fragile cerebrovascular, which can aggravate the coronary heart disease that was originally suffering from, and cause cardiovascular accidents, leading to death of the patient. Therefore, constipation in the elderly must be taken seriously to prevent accidents.
Tip: Bananas have low cellulose content. In fact, the laxative effect of bananas is often not good. Raw bananas contain more tannic acid, so it is not recommended, especially for children to eat bananas to relieve constipation. Constipation is an annoying thing in daily life. One day does not defecate. For many people, this day is an unresolved worry, and one day will not be pleasant. Adjusting treatment for constipation often starts with dietary adjustments, usually increasing fiber and fluid intake. If it can be tolerated, the total daily fiber intake should be 30g or more. Cellulose combined with a small amount of water can also treat diarrhea. Cellulose and plenty of water to treat constipation. The attached table lists common high-fiber foods. Secondly, the combination of drugs of different intensities can soften stools and enhance intestinal motility and increase the frequency of bowel movements. Such as-1. Volumetric laxatives. Such as psyllium husk, wheat fiber particles, polycarbophil calcium, sycamore gum. 2. Stool softener. Such as docusate sodium. Inhibits the absorption of water by the colon, softens stools, does not promote bowel movements, and takes effect for 1-3 days. 3. Osmotic and salt laxatives. Such as polyethylene glycol electrolyte powder (Fu Song), phosphate, or polysaccharides lactulose. 4. Irritant laxative. Such as Chinese herbal medicine rhubarb, aloe vera, senna, cassia seed, buckthorn skin (long-term use will cause intestinal melanosis). Western medicine bisacodyl (small powder pills in Japan contain such ingredients), phenolphthalein and so on. 5. Promoting drugs. Such as metoclopramide, cisapride, and mosapride. 6. Calcium channel agonist. Such as lubiprostone. Stimulate chloride channels in the intestine to promote fluid secretion and increase intestinal motility. 7. Chinese herbal medicine for laxative. Such as Ma Ren, Almond, Yu Li Ren, etc. Long-term use of intestinal stimulants and laxatives may cause water and electrolyte disorders, and laxative colonic weakness may also occur. The principle of using laxatives is to start from the lowest effective dose, not recommended for long-term use. Most patients can achieve 3-7 defecations per week by increasing dietary fiber and water intake and intermittent use of laxatives.
It’s time to share the case again. Today, I am sharing with you on May 14, 2020, a 59-year-old Ms. Guo who was consulted by Director Jia. Her problem is that in the past ten years, there has been no inconvenience and difficulty in bowel movements. In the past six months, it has obviously increased. For many years, I have been relying on various laxatives to live my life. I can’t pull them out without laxatives. I often take Xiangdanqing, Maren Runchang pills, aloe capsules, etc. It was effective at first, and then the effect became worse. I had to increase the laxative dose again and again. You can have a bowel movement once every three or four days. The stool is mushy, with less bowel movements, accompanied by abdominal distension, and poor sleep quality. Director Jia looked, smelled, asked, cut, and learned that the tongue was dark, with slight dents on the tongue, slightly dry fur, white color, lack of body fluid, thin pulse, and constipation of Qi and Yin deficiency in the four clinics. For Ms. Guo, she developed a treatment plan for nourishing qi and nourishing yin, raising yang and lowering qi, laxative and laxative. The experience of oral administration of Jia Director Fang Changzhou Laxative Recipe plus or minus decoction, one dose per day, two servings per day I took the initiative to defecate in the morning and did sibe to assist in regular defecation on time. In addition, I was instructed to adjust the cellulose-rich diet. The picture shows that when Ms. Guo revisited, Ms. Guo’s tongue revisited after two consecutive courses of treatment, and her condition improved unprecedentedly. The picture below shows Ms. Guo’s medical record at the time of her return visit. The important changes are: there was no inconvenience, but now there are occasional inconveniences, which was not there before; it used to be difficult to have stool twice a week, now almost every day, and sometimes There is quite a lot of stool; I didn’t take laxatives, but I haven’t used laxatives since I started taking traditional Chinese medicine. My abdominal distension was uncomfortable, and now my abdominal distension has completely disappeared. It’s especially gratifying that my mental state and sleep are better than before treatment. A lot! Case of Ms. Guo’s follow-up visit. Ms. Guo passed her two courses of treatment, and her stubborn constipation, which has tortured her for more than a decade, finally lowered her head. Ms. Guo felt relaxed and happy after a long absence, and her complexion was much better. After listening to Ms. Guo’s experience of her recovery, we are all happy for her. Let us wish this lucky Ms. Guo, and wish her a speedy recovery! The sharing case is hoped that more patients with constipation will understand that even stubborn constipation is not invincible. As long as the method is right and treatment is adhered to, you can see the dawn of victory! To deal with constipation, you must have confidence and patience, and you should never use laxatives. We treat constipation, focus on norms, focus on safety, focus on integration, focus on personalization, decoction plus Xibei to assist in defecation, plus diet, lifestyle habits guidance and correction to achieve the best effect. We will regularly share with you the cases of constipation encountered in the clinic, hoping to help more patients with constipation, overcome constipation, get rid of the constipation trouble, move towards victory, and find a healthy and happy life. Remarks: The content is from Jia Xiaoqiang Famous Medical Studio, please do not reprint.
How to treat the elderly with constipation? Many elderly people feel that this problem is very simple when they encounter constipation. Since they are constipated, they take laxatives. The abuse of laxatives is very common. Is this really the case? Actually it is completely wrong. Because constipation of the elderly is mostly related to aging, it is caused by weak constitution, weak organs, weak blood and yin and yang. If it is not solved fundamentally, just taking laxatives will cause the constitution to become weaker and constipation. Will get heavier. So the correct way is to go to a regular hospital to find an experienced doctor to take medication according to your situation. Can the elderly have an enema? The question of course depends on the specific situation. If the elderly suffer from constipation, they will not be able to defecate normally for a long time, and cause great pain, and other methods still cannot solve the problem of defecating. At this time, the enema method is a relatively quick and effective method. However, if this method of enema is used too often for too long, it will have a great impact on the physiological activities of defecation and will cause some side effects. Therefore, the enema can be used, but do not abuse it. It must be used under the guidance of a doctor. Use it when it should be used, and try not to use it when you can usually use it.
The treatment of chronic constipation first has the easy-to-understand purpose of “patient’s painful symptoms”. Furthermore, there are reports that chronic constipation can not only reduce the quality of life, but also increase the risk of colon cancer by about 1.4 times and the mortality rate by about 1.2 times, which is also a risk factor for colonic diverticulitis. In addition, laxative users more than twice a week have a risk of colorectal cancer of approximately 2.8 times compared with those who do not use laxatives1). Up to now, the treatment of constipation has been carried out with reference to the experience of ancestors. In recent years, after a lapse of about 30 years, new mechanisms of constipation treatment drugs have gradually appeared. Diagnosis and treatment guidelines “3). Knowledge about diagnosis and treatment of constipation requires update. FAQ1 If I encounter patients with constipation, how should I make a differential diagnosis? Although this can be said for any symptom or symptom, the first reason is to diagnose the cause. The treatment of causes and diseases is directly related to the treatment of constipation. The most important thing in the identification of constipation is the elimination of organic diseases. “There was no constipation before, but constipation recently”, which strongly suggests that the organic abnormality is the cause. Physically narrowing and occluding the rectum and colon is particularly important for the presence of neoplastic lesions. In addition, the existence of neurological diseases such as Parkinson’s disease and autonomic nerve disorders should also be taken into consideration. In Parkinson’s disease, from the beginning of the disease when the neurological symptoms are not obvious, only constipation often occurs. At this time, anti-Parkinson’s disease is mostly used for the treatment of constipation. Constipation itself may hinder the absorption of anti-Parkinson’s drugs, and improvement of constipation in disease management is also very important. Furthermore, constipation often occurs in metabolic endocrine diseases such as diabetes and hypothyroidism. Since it is speculated that the decline of intestinal motility due to the autonomic nerve disorder caused by the continuous development of diabetes history is the cause of constipation, it cannot be said that “the cause of constipation is diabetes” for all cases of diabetes and constipation. However, since high blood sugar itself will also affect the autonomic nerve function, it is believed that blood glucose control is an important treatment. Taking medicine internally can sometimes cause constipation. Especially in the case of prescribing chronic psychotropic drugs, you need to work hard on prescription. In addition, when there have been great environmental changes recently (from home life to hospitalization, etc.), due to changes in life, temporary constipation is also very likely. When there is constipation, denial of organic diseases, when there is no corresponding history of pharmacy, it is considered to be functional constipation. Answer … From the frequency point of view, there are more functional constipation, but also consider the possibility of organic diseases of the large intestine, neurological diseases, metabolic endocrine diseases, and medicinal properties. FAQ2 How to treat patients with functional chronic constipation? There are treatments based on empirical judgment for constipation treatment. In our country, magnesium oxide and irritant laxatives (senna etc.), which are osmotic laxatives, are mainly used, and now it is the same. On the other hand, in the paper 4) showing the level of evidence and recommendation of constipation medicines in Europe and the United States, the evidence level of stimulant laxatives frequently used in daily diagnosis and treatment in China is very low, and it is not listed in magnesium oxide. When using magnesium oxide, for elderly patients with renal insufficiency, it is necessary to regularly measure serum magnesium value, pay attention to hypermagnesemia. In addition, the mechanism of action of anthraquinone laxatives, such as the stimulant laxative senna, is considered to strongly stimulate the muscularis plexus in the intestine, but the details are not clear. Because of its strong effect, there are problems such as drug resistance, spiritual dependence, and habit. Therefore, we believe that it should not be used continuously every day, but should be used as needed (for temporary use) when necessary. In recent years, new constipation drugs have appeared, and in 2017, “Guidelines for the Diagnosis and Treatment of Chronic Constipation” was published. Focusing on the evidence of the latest constipation treatment drugs, reconsider future constipation treatment. The treatment-related items in this guide are shown in the table. Irritation laxatives are not highly recommended, and osmotic laxatives and epithelial dysfunction drugs are highly recommended and have a high level of evidence. Although the evidence is not complete, it is necessary to reconsider the medical treatment of constipation. Table CQ related to the treatment of chronic constipation (reproduced with permission from Literature 3) As a basic strategy, laxatives (magnesium oxide) should usually be administered daily, and irritant laxatives (senna etc.) should be used as needed. . It is necessary to construct a new type of chronic constipation treatment medicine with high evidence level in China recently
Constipation is a type of condition characterized by difficulty in defecation. Difficulty in defecation includes laborious defecation, incomplete bowel movements, time-consuming defecation, prolonged defecation interval, and the need for manual defecation. constipation is not a trivial matter, the constipation may involve departments: urology, gastroenterology, psychologist, acupuncture, nutrition, physiotherapy, anorectal, etc., these are related to it, so you think how complicated it is. Once symptoms appear, most people think of this thing-“laxative”, but experts tell us that laxatives may instead cause a series of problems such as constipation. & nbsp. First, constipation is divided into three types: 1. & nbsp. The most common constipation (yin deficiency): long interval between toilets, dry stool, dry mouth and tongue 2. & nbsp. The easiest way to find constipation in the elderly ( Qi Deficiency): Weakness in bowel movements, weakness 3. The most easily overlooked constipation (qi secret): abdominal pain, abdominal discomfort, uncomfortable mood & nbsp. First explain to everyone, “can I use laxatives” during constipation? We do not recommend these methods. Long-term use will cause some side effects and bring many harms. For the treatment of constipation, the common practice of most patients is to take laxatives including various slimming teas and laxative teas. However, long-term or large-scale use of stimulant laxatives will not only cause abdominal pain, but also depend on laxatives. When you do not eat, you will still have constipation, and the symptoms will not be cured. In addition, the large intestine mucosa will appear pigmented large intestine melanosis under the stimulation of these drugs. Observed from the colonoscope, the entire large intestine becomes black. It may also damage the nerves and muscle tissue of the intestinal wall, resulting in the appearance of polyps. Become a risk factor for colorectal cancer. Therefore, it is recommended to take laxatives properly, preferably under the guidance of a physician. The types of laxatives should not be single, nor should they rely on laxatives for bowel movements for a long time.