CONSTIPATION AND THE PURSUIT OF GENERAL HEALTH IN GERIATRIC PEOPLES
Constipation is a symptom, not a disease. Nearly everyone becomes constipated at one time or another. Usually, this condition is not serious. Older people are five times more likely to complain about the symptom than younger people, possibly because of an undue concern about their bowel movement. To avoid most of the problems related to constipation, it helps to know what causes it, how to prevent it, and how to treat it. Experts agree that older people often worry too much about having a bowel movement every day. Normal frequency of bowel movement or volume of stool varies widely from person to person. A decrease in the frequency of bowel movements, accompanied by prolonged or difficult passage of stools, or a sense of incomplete evacuation are all expressed constipation. Constipation is a common symptom among older people.
CAUSES OF CONSTIPATION IN OLDER ADULTS: Older adults are more likely to have constipation for the following reasons: Poor diet: Eating foods rich in animal fats (dairy products, meats, and eggs) or refined sugar but low in fiber (whole grains, fruits, and vegetables). Inadequate fluid intake: Not drinking enough water can lead to hard dry stools. Fluid is absorbed in the intestine, and people who don't drink enough water may not pass enough water into the colon to keep their stools soft. Caffeine and alcohol: These induce increased urination of water. This leads to (relative) dehydration that increases water absorption from the intestine. This can in turn lead to constipation when not enough fluid is retained in the stool. Poor bowel habits: Ignoring the desire to have bowel movements may initiate a cycle of constipation. After a period of time, the person may stop feeling the desire to move the bowels.This leads to progressive constipation. For example, some people may avoid using public toilets or ignore going to the toilet because they are busy Medications: Many medications can cause constipation. Antacids that contain aluminum hydroxide(Alternagel, Alu-Cap, Alu-Tab, Amphojel, Dialume) and calcium carbonate (Rolaids, Mylanta, Maalox, Tums, etc.), Antispasmodic drugs, Antidepressants, Iron tablets, Anticonvulsant drugs, Diuretics (because they can work like caffeine and alcohol as mentioned previously), Painkillers, narcotic-containing drugs, for example, may suppress bowel function. Lack of exercise Prolonged bed rest, for example after an accident or during an illness Habitual use of enemas and laxatives - The person may eventually require increasing amounts of laxatives to move the bowels.In some instances, the bowel will become insensitive to laxatives and the person will not be able to move the bowels even with laxatives. Travel: Changes in lifestyle, low fluid intake, and eating fast food may cause constipation. Irritable bowel syndrome (IBS): Because of changes in bowel function, if a person has this disorder, he or she may have crampy abdominal pain, excessive gas, bloating, and constipation, sometimes alternating with diarrhea. Intestinal obstruction: Mechanical compression and interference with the normal functions of the bowel may occur due to diverticulitis or Crohn's disease (an inflammatory bowel disease), Inflammatory adhesions and joining of tissues, Intestinal cancers, Abdominal hernia, Gallstones, Twisting of the intestine upon itself (volvulus), Foreign bodies (swallowed or introduced into the intestine from the anus), Intussusception, Postoperative adhesions Connective tissue diseases: Conditions such as scleroderma and lupus SYMPTOMS OF CONSTIPATION Symptoms of constipation depending on his or her normal bowel habits, diet, and age. Symptoms includes • Difficulty in starting or completing a bowel movement, • Infrequent and difficult passage of stool, Passing hard stool after prolonged straining, • If the person has irritable bowel syndrome(IBS) then crampy abdominal pain, excessive gas, a sense of bloating, and a change in bowel habits, • If the person has an intestinal obstruction, nausea, vomiting, no defecation, and inability to pass gas, Distended abdomen, headaches, and loss of appetite, • Coated (furred) tongue, bad breath(halitosis), and bad taste in the mouth The tests may help diagnose the cause of constipation are Anorectal manometry (pressure measurements of the anus and rectum), Barium enema, Complete blood count (CBC), Blood clotting tests ( PT or PTT), Colonoscopy, Proctosigmoidoscopy (an examination of the lower bowel), Stool studies, Upper GI series, X-rays of the abdomen Tips for Preventing and Managing Constipation Many factors can lead to constipation, including a poor diet, lack of exercise, and overuse of laxatives. We can help prevent or relieve constipation by: Eating healthfully. Getting plenty of high-fiber food in our diet, including whole grains, vegetables, and fruits, can help stave off constipation. It’s a good idea to avoid high-fat meals, excessive dairy products and eggs, and rich, sugary foods, since these can lead to constipation. The foods that all good sources of dietary fibre are Beans, lentils and peas, Fresh and dried fruits - particularly if the skins are eaten, Vegetables - particularly if the skins are eaten, Nuts and seeds, Wholemeal and granary breads, Jacket potatoes, Wholegrain breakfast cereals, Wholemeal pasta and brown rice Drinking plenty of fluids. Not drinking enough fluids can lead to constipation, so upping our intake of water and other liquids can help keep your bowels moving. Being careful when using laxatives. If use laxatives or enemas too often, our body can begin to rely on them and stop working the way it should. So talk with doctor about laxative use. Exercising regularly. Keeping active on a regular basis can help stay regular. Going when feel the urge. Waiting too long to have a bowel movement can lead to constipation, so go as soon as sense the need. Treating medical conditions. Certain medical conditions, including stroke, diabetes, or intestinal blockage, can lead to constipation. Working with our doctor to manage these conditions is important. Talking with doctor about medications. Some drugs, including certain antidepressants, antacids, supplements, antihistamines, pain relievers, high blood pressure medications, and Parkinson's disease medications, are known to lead to constipation, so talk with doctor to see if adjusting medications would help.
HOMOEOPATHIC MANAGEMENT: Homoeopathic remedies indicated for constipation often work at a deeper level than nutritional supplements and most herbs because they target the mind and the emotions in addition to the physical body. Essentially homeopathic remedies assist in unlocking the stress that may be underlying the constipation symptoms, ideally leading to a permanent resolution of the problem, since constipation symptoms are often difficult to differentiate on a physical level. Remedies used for relieving constipation: The most common and effective medicines to cure constipation are: Aesculus, Aletris, Aloes, Baptisia, Bryonia, Calc carb, Carbo veg, Chelidonium, Collinsonia, Dioscorea, Graphites, Hydrastis, Iris vers, Lycopodium, Natrum mur, Nux vom, Opium , Plumbum, Podophyllum , Pulsatilla, Sepia, Silicea, Sulphur, Veratrum album. In old people: Old people suffering from constipation could be relieved from the complaints by the following medicines: Aloes, Alumina, Antimonium crudum, Baryta carb, Bryonia, Lachesis, Opium, Phosphorous, Phytolacca, Rhus tox, Ruta. Person who have habitual constipation: For habitual constipated persons Abies nigra, Alumen, Alumina, Bryonia, Calc carb, Causticum, Collinsonia, Conium, Graphites, Lachesis, Lycopodium, Sepia, Sulphur. Persons who lead sedentary life: Aloes, Bryonia, Iris, Hydrastis, Lycopodium, Nux vomica, Opium, Platina, Podophyllum, Sulphur. Alumina: dry and slow, Confused and depressed, especially in the morning. Mind slows down, forgetful and absentminded. Easily disoriented: gets very distressed if hurried. Skin is dry and itches without an eruption. Severe constipation even with a soft stool. Weakness with trembling. Dry, hacking cough. Bladder weak: urination slow,has to wait for it to start. Aversion to/Aggravation from potatoes. Worse from warmth in general. Ambra grisea: erratic and embarrassed, Many bereavements and losses. Forgetful and confused. Easily embarrassed: shy and anxious in company (especially with strangers). “Prattles” and asks questions without waiting for answers. Prefers to be alone. Constipation: with anxiety and ineffectual urging and straining. Can’t pass stool or urine if others are within hearing distance. Dry, nervous cough which is worse from talking and is followed by burping. Insomnia: finds it difficult to fall asleep beforemidnight. Vertigo: with feeling of weakness in the stomach. Numbness, twitching and/or trembling anywhere. Generally worse from company (from conversation) and from music. Symptoms are erratic and worse when lying down. Arsenicum album: anxious, fussy, and restless Very scared of disease, of cancer, of death. Fears are worse when alone; to the point of despair. Extremely tidy, cannot rest until everything is in its place. Indigestion with burning pains and nausea. Loss of appetite and weight. Diarrhea, which is worse in the morning. Involuntary urination: day and night. Insomnia with restlessness and anxiety. Skin eruptions: itching without eruption. Palpitations with anxiety. Chilly. Burning pains which are better for heat. Symptoms are generally worse from midnight to 3 a.m. Thirsty for warm drinks; sips them frequently. Baryta carbonica: childish and petty, Absent-minded, confused and forgetful. Revisits childhood in old age. Has great difficulty making decisions. Extremely anxious about little (unimportant) things. Gets upset thinking others are talking about them. Vertigo: when getting up or bending down. Headache when bending. Indigestion and weakness after eating. Constipation with straining and an unfinished feeling. Weak bladder with involuntary urination: frequent urination at night with great urgency. Rattling cough with difficulty coughing anything up. Insomnia: restless sleep, wakes frequently from getting overheated. Much worse from the cold and damp. Carbovegetabilis: sluggish and gassy, Great indifference and apathy. Sudden, recurring loss of memory and difficulty concentrating. Rude and irritable, especially with relatives. Indigestion, flatulence, and diarrhea. Severe, painful bloating with gas, better for burping. Rattling cough with breathlessness, better for burping. Sluggish mentally and physically. Worse eating rich foods and fats; worse overeating. Much worse for getting overheated. Wants to be fanned; wants fresh air and breezes. Coniummaculatum: withdrawn, slow, and dizzy, Absent-minded, forgetful, and confused. Difficulty understanding when reading. Tired of life: becomes withdrawn; doesn’t want company. Superstitious. Everything is slow: thinking, answering, moving. Digestion, respiration, pulse, healing are all slow. Vertigo: worse lying down, when rolling over in bed or turning the head, better for closing the eyes; everything swirls. Dry tickling cough which is worse at night. Weak bladder: frequent, dribbling urination. Ignatia amara: loss and grief, Very upset after a loss or a big disappointment. Wants to be alone and doesn’t want any comforting. Finds it difficult to cry but eventually sobs hysterically. Sighs a tremendous amount. Feels as if there’s a lump in the throat. Headache, indigestion, diarrhea, palpitations, insomnia and/or weakness from grief. Twitches and spasms and unexplained numbness anywhere. Contradictory symptoms accompany physical complaints (e.g., cough worse coughing). Can’t stand tobacco smoke. Lycopodium: irritable, anxious, and gassy, Depressed and anxious: worries about absolutely everything. Any changes or responsibilities are very stressful. Lacks self confidence. Becomes absent-minded and forgetful. Snappy: irritable and critical. Sentimental: cries when thanked. Thin and gassy. Appetite poor: feels full after only a few bites. Everything turns to gas, terrible indigestion with bloating. Frequent urination especially with prostate problems (in men). Rattling cough with lots of expectoration (mucus). Craves sweet things and chocolate. All symptoms are worse between 3 and 4 p.m. and between 4 and 8 p.m. Nux Vomica : Anxiety ridden, worries about work and money, stays awake at night thinking of all the work that must be done the next day; extremely irritable when people or situations (traffic, lines, slow clerks, etc) get in the way of them staying on the schedule they had in mind, interfering with their productivity, impacting their ability to make money; also extremely irritable at colleagues and co-workers who don't pay attention to detail, waste time or make mistakes that causes loss of money. Work hard, play hard archetype - always has plans for what to do when not working, the sophisticated and accomplished city dweller. Physical symptoms: chronic constipation, irritable bowel syndrome; muscle cramps and spasms; lower back pain; tends to run very cold; hypersensitive to noise; craves spicy food; likes alcohol. Opium : Disconnected and blissed out, often the individual becomes disassociated from their feelings and their physical body following a fright and/or head injury, it's as if they're floating above their body, not really dealing with reality. They may suffer from narcolepsy, and/or painlessness from complaints that are normally painful. Alternatively, the individual may also be a workaholic that is hurried and impatient and has great mental clarity. Phosphoric acid: weakness and apathy, Overwhelmed by loss especially bereavements. Ailments from grief and disappointment. Forgetful; mind is too weak to even think. Severe weakness. Painless diarrhea, palpitation, headache, and extreme weakness after grief. Headache. Wants refreshing things (like fruit and fruit juices) to eat and drink. Feels better after a nap. Rhustoxicodendron: restless, stiff, and achy, Anxious and forgetful. Terrible restlessness; can’t rest in any position (because of the aching). Joint and back pains (rheumatism and arthritis) which are worse on first motion and better for continued motion and stretching. Shingles. Symptoms are worse at night; worse for cold and for damp in any form; better for warmth.
CAUSES OF CONSTIPATION IN OLDER ADULTS: Older adults are more likely to have constipation for the following reasons: Poor diet: Eating foods rich in animal fats (dairy products, meats, and eggs) or refined sugar but low in fiber (whole grains, fruits, and vegetables). Inadequate fluid intake: Not drinking enough water can lead to hard dry stools. Fluid is absorbed in the intestine, and people who don't drink enough water may not pass enough water into the colon to keep their stools soft. Caffeine and alcohol: These induce increased urination of water. This leads to (relative) dehydration that increases water absorption from the intestine. This can in turn lead to constipation when not enough fluid is retained in the stool. Poor bowel habits: Ignoring the desire to have bowel movements may initiate a cycle of constipation. After a period of time, the person may stop feeling the desire to move the bowels.This leads to progressive constipation. For example, some people may avoid using public toilets or ignore going to the toilet because they are busy Medications: Many medications can cause constipation. Antacids that contain aluminum hydroxide(Alternagel, Alu-Cap, Alu-Tab, Amphojel, Dialume) and calcium carbonate (Rolaids, Mylanta, Maalox, Tums, etc.), Antispasmodic drugs, Antidepressants, Iron tablets, Anticonvulsant drugs, Diuretics (because they can work like caffeine and alcohol as mentioned previously), Painkillers, narcotic-containing drugs, for example, may suppress bowel function. Lack of exercise Prolonged bed rest, for example after an accident or during an illness Habitual use of enemas and laxatives - The person may eventually require increasing amounts of laxatives to move the bowels.In some instances, the bowel will become insensitive to laxatives and the person will not be able to move the bowels even with laxatives. Travel: Changes in lifestyle, low fluid intake, and eating fast food may cause constipation. Irritable bowel syndrome (IBS): Because of changes in bowel function, if a person has this disorder, he or she may have crampy abdominal pain, excessive gas, bloating, and constipation, sometimes alternating with diarrhea. Intestinal obstruction: Mechanical compression and interference with the normal functions of the bowel may occur due to diverticulitis or Crohn's disease (an inflammatory bowel disease), Inflammatory adhesions and joining of tissues, Intestinal cancers, Abdominal hernia, Gallstones, Twisting of the intestine upon itself (volvulus), Foreign bodies (swallowed or introduced into the intestine from the anus), Intussusception, Postoperative adhesions Connective tissue diseases: Conditions such as scleroderma and lupus SYMPTOMS OF CONSTIPATION Symptoms of constipation depending on his or her normal bowel habits, diet, and age. Symptoms includes • Difficulty in starting or completing a bowel movement, • Infrequent and difficult passage of stool, Passing hard stool after prolonged straining, • If the person has irritable bowel syndrome(IBS) then crampy abdominal pain, excessive gas, a sense of bloating, and a change in bowel habits, • If the person has an intestinal obstruction, nausea, vomiting, no defecation, and inability to pass gas, Distended abdomen, headaches, and loss of appetite, • Coated (furred) tongue, bad breath(halitosis), and bad taste in the mouth The tests may help diagnose the cause of constipation are Anorectal manometry (pressure measurements of the anus and rectum), Barium enema, Complete blood count (CBC), Blood clotting tests ( PT or PTT), Colonoscopy, Proctosigmoidoscopy (an examination of the lower bowel), Stool studies, Upper GI series, X-rays of the abdomen Tips for Preventing and Managing Constipation Many factors can lead to constipation, including a poor diet, lack of exercise, and overuse of laxatives. We can help prevent or relieve constipation by: Eating healthfully. Getting plenty of high-fiber food in our diet, including whole grains, vegetables, and fruits, can help stave off constipation. It’s a good idea to avoid high-fat meals, excessive dairy products and eggs, and rich, sugary foods, since these can lead to constipation. The foods that all good sources of dietary fibre are Beans, lentils and peas, Fresh and dried fruits - particularly if the skins are eaten, Vegetables - particularly if the skins are eaten, Nuts and seeds, Wholemeal and granary breads, Jacket potatoes, Wholegrain breakfast cereals, Wholemeal pasta and brown rice Drinking plenty of fluids. Not drinking enough fluids can lead to constipation, so upping our intake of water and other liquids can help keep your bowels moving. Being careful when using laxatives. If use laxatives or enemas too often, our body can begin to rely on them and stop working the way it should. So talk with doctor about laxative use. Exercising regularly. Keeping active on a regular basis can help stay regular. Going when feel the urge. Waiting too long to have a bowel movement can lead to constipation, so go as soon as sense the need. Treating medical conditions. Certain medical conditions, including stroke, diabetes, or intestinal blockage, can lead to constipation. Working with our doctor to manage these conditions is important. Talking with doctor about medications. Some drugs, including certain antidepressants, antacids, supplements, antihistamines, pain relievers, high blood pressure medications, and Parkinson's disease medications, are known to lead to constipation, so talk with doctor to see if adjusting medications would help.
HOMOEOPATHIC MANAGEMENT: Homoeopathic remedies indicated for constipation often work at a deeper level than nutritional supplements and most herbs because they target the mind and the emotions in addition to the physical body. Essentially homeopathic remedies assist in unlocking the stress that may be underlying the constipation symptoms, ideally leading to a permanent resolution of the problem, since constipation symptoms are often difficult to differentiate on a physical level. Remedies used for relieving constipation: The most common and effective medicines to cure constipation are: Aesculus, Aletris, Aloes, Baptisia, Bryonia, Calc carb, Carbo veg, Chelidonium, Collinsonia, Dioscorea, Graphites, Hydrastis, Iris vers, Lycopodium, Natrum mur, Nux vom, Opium , Plumbum, Podophyllum , Pulsatilla, Sepia, Silicea, Sulphur, Veratrum album. In old people: Old people suffering from constipation could be relieved from the complaints by the following medicines: Aloes, Alumina, Antimonium crudum, Baryta carb, Bryonia, Lachesis, Opium, Phosphorous, Phytolacca, Rhus tox, Ruta. Person who have habitual constipation: For habitual constipated persons Abies nigra, Alumen, Alumina, Bryonia, Calc carb, Causticum, Collinsonia, Conium, Graphites, Lachesis, Lycopodium, Sepia, Sulphur. Persons who lead sedentary life: Aloes, Bryonia, Iris, Hydrastis, Lycopodium, Nux vomica, Opium, Platina, Podophyllum, Sulphur. Alumina: dry and slow, Confused and depressed, especially in the morning. Mind slows down, forgetful and absentminded. Easily disoriented: gets very distressed if hurried. Skin is dry and itches without an eruption. Severe constipation even with a soft stool. Weakness with trembling. Dry, hacking cough. Bladder weak: urination slow,has to wait for it to start. Aversion to/Aggravation from potatoes. Worse from warmth in general. Ambra grisea: erratic and embarrassed, Many bereavements and losses. Forgetful and confused. Easily embarrassed: shy and anxious in company (especially with strangers). “Prattles” and asks questions without waiting for answers. Prefers to be alone. Constipation: with anxiety and ineffectual urging and straining. Can’t pass stool or urine if others are within hearing distance. Dry, nervous cough which is worse from talking and is followed by burping. Insomnia: finds it difficult to fall asleep beforemidnight. Vertigo: with feeling of weakness in the stomach. Numbness, twitching and/or trembling anywhere. Generally worse from company (from conversation) and from music. Symptoms are erratic and worse when lying down. Arsenicum album: anxious, fussy, and restless Very scared of disease, of cancer, of death. Fears are worse when alone; to the point of despair. Extremely tidy, cannot rest until everything is in its place. Indigestion with burning pains and nausea. Loss of appetite and weight. Diarrhea, which is worse in the morning. Involuntary urination: day and night. Insomnia with restlessness and anxiety. Skin eruptions: itching without eruption. Palpitations with anxiety. Chilly. Burning pains which are better for heat. Symptoms are generally worse from midnight to 3 a.m. Thirsty for warm drinks; sips them frequently. Baryta carbonica: childish and petty, Absent-minded, confused and forgetful. Revisits childhood in old age. Has great difficulty making decisions. Extremely anxious about little (unimportant) things. Gets upset thinking others are talking about them. Vertigo: when getting up or bending down. Headache when bending. Indigestion and weakness after eating. Constipation with straining and an unfinished feeling. Weak bladder with involuntary urination: frequent urination at night with great urgency. Rattling cough with difficulty coughing anything up. Insomnia: restless sleep, wakes frequently from getting overheated. Much worse from the cold and damp. Carbovegetabilis: sluggish and gassy, Great indifference and apathy. Sudden, recurring loss of memory and difficulty concentrating. Rude and irritable, especially with relatives. Indigestion, flatulence, and diarrhea. Severe, painful bloating with gas, better for burping. Rattling cough with breathlessness, better for burping. Sluggish mentally and physically. Worse eating rich foods and fats; worse overeating. Much worse for getting overheated. Wants to be fanned; wants fresh air and breezes. Coniummaculatum: withdrawn, slow, and dizzy, Absent-minded, forgetful, and confused. Difficulty understanding when reading. Tired of life: becomes withdrawn; doesn’t want company. Superstitious. Everything is slow: thinking, answering, moving. Digestion, respiration, pulse, healing are all slow. Vertigo: worse lying down, when rolling over in bed or turning the head, better for closing the eyes; everything swirls. Dry tickling cough which is worse at night. Weak bladder: frequent, dribbling urination. Ignatia amara: loss and grief, Very upset after a loss or a big disappointment. Wants to be alone and doesn’t want any comforting. Finds it difficult to cry but eventually sobs hysterically. Sighs a tremendous amount. Feels as if there’s a lump in the throat. Headache, indigestion, diarrhea, palpitations, insomnia and/or weakness from grief. Twitches and spasms and unexplained numbness anywhere. Contradictory symptoms accompany physical complaints (e.g., cough worse coughing). Can’t stand tobacco smoke. Lycopodium: irritable, anxious, and gassy, Depressed and anxious: worries about absolutely everything. Any changes or responsibilities are very stressful. Lacks self confidence. Becomes absent-minded and forgetful. Snappy: irritable and critical. Sentimental: cries when thanked. Thin and gassy. Appetite poor: feels full after only a few bites. Everything turns to gas, terrible indigestion with bloating. Frequent urination especially with prostate problems (in men). Rattling cough with lots of expectoration (mucus). Craves sweet things and chocolate. All symptoms are worse between 3 and 4 p.m. and between 4 and 8 p.m. Nux Vomica : Anxiety ridden, worries about work and money, stays awake at night thinking of all the work that must be done the next day; extremely irritable when people or situations (traffic, lines, slow clerks, etc) get in the way of them staying on the schedule they had in mind, interfering with their productivity, impacting their ability to make money; also extremely irritable at colleagues and co-workers who don't pay attention to detail, waste time or make mistakes that causes loss of money. Work hard, play hard archetype - always has plans for what to do when not working, the sophisticated and accomplished city dweller. Physical symptoms: chronic constipation, irritable bowel syndrome; muscle cramps and spasms; lower back pain; tends to run very cold; hypersensitive to noise; craves spicy food; likes alcohol. Opium : Disconnected and blissed out, often the individual becomes disassociated from their feelings and their physical body following a fright and/or head injury, it's as if they're floating above their body, not really dealing with reality. They may suffer from narcolepsy, and/or painlessness from complaints that are normally painful. Alternatively, the individual may also be a workaholic that is hurried and impatient and has great mental clarity. Phosphoric acid: weakness and apathy, Overwhelmed by loss especially bereavements. Ailments from grief and disappointment. Forgetful; mind is too weak to even think. Severe weakness. Painless diarrhea, palpitation, headache, and extreme weakness after grief. Headache. Wants refreshing things (like fruit and fruit juices) to eat and drink. Feels better after a nap. Rhustoxicodendron: restless, stiff, and achy, Anxious and forgetful. Terrible restlessness; can’t rest in any position (because of the aching). Joint and back pains (rheumatism and arthritis) which are worse on first motion and better for continued motion and stretching. Shingles. Symptoms are worse at night; worse for cold and for damp in any form; better for warmth.
