Saturday, January 14, 2006


(see Tables 9, 19, 20 below) Constipation is decreased motility of the colon or retention of feces in the lower colon or rectum. The longer feces remains in the colon, the greater the reabsorption of water and the dryer the stool becomes. This makes it more difficult to expel. Bowel habits vary greatly from person to person. Some people have daily bowel movements, whereas others only have two or three BMs a week. A major factor leading to constipation in the elderly is lack of mobility due to stroke, senility, or other chronic diseases. Lack of appetite, poor dentition, inability to pay for meals, and psychological unwillingness to prepare and eat a meal alone are underlying reasons for constipation in the aged.
Many prescription drugs can cause constipation. For example, codeine, antidepressants, aspirin, and antacids can cause constipation. Fecal impaction can occur as a complication of constipation. Fecal impaction occurs when the stool remains in the colon and becomes hard.
Symptoms of constipation include abdominal pain, decreased appetite, headache, and fatigue. With a fecal impaction the symptoms may include watery diarrhea-like stools with intermittent constipation. Emphasis is placed in teaching the person habits that promote normal elimination. Avoiding laxatives allows the bowels to function normally. Eating raw fruits, vegetables, whole grain bread and cereal, increasing fluid intake, and regular rest and exercise are important. When initial attempts at retraining the bowel are unsuccessful, the patient needs to be encouraged to continue efforts, as it may take time to change this condition.
Phipps, W. J., et al. Medical Surgical Nursing. St. Louis, C. V. Mosby Co., 1983.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.


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