Constipation in the elderly refers to the reduction of defecation times, difficulty in defecation and dry stool. Normal people defecate 1 ~ 2 times a day or1~ 2 days/kloc-0 times a day, while constipation patients defecate less than 3 times a week, and defecate laboriously, with hard stool and small amount. Constipation is a common symptom of the elderly. About13 of the elderly have constipation, which seriously affects the quality of life of the elderly.
Etiology: 1. It is related to age.
The prevalence of constipation in the elderly is significantly higher than that in young adults, mainly because with the increase of age, the food intake and physical activity of the elderly are obviously reduced, the gastrointestinal tract secretes less digestive juice, the tension and peristalsis of the intestine are weakened, the abdominal cavity and pelvic floor muscles are weak, the internal and external sphincter of anus are weakened, the gastrocolon reflex is weakened, and the rectal sensitivity is reduced, which makes food stay in the intestine for too long and causes constipation due to excessive absorption of water. In addition, elderly people often lose defecation reflex due to senile dementia or mental depression, causing constipation.
2. Bad living habits
Dietary factors: Old people's teeth fall off, they like to eat fine food with low residue, or a few patients try to save trouble, and the diet is simple, lacking crude fiber, which reduces the volume of feces, increases the viscosity, slows down the movement in the intestine, and causes constipation due to excessive absorption of water. In addition, because the elderly eat less, the calorie content of food is low, and the gastrointestinal transit time is slowed down, which can also cause constipation. It has been reported that gastrocolonic reflex is related to the amount of food intake. 1000cal diet can stimulate colon movement, but 350cal has no such effect. Fat is the main food to stimulate reflex, but protein has no such effect.
Defecation habit Some elderly people do not develop the habit of regular defecation, and often ignore normal defecation, which leads to the inhibition of defecation reflex and constipation.
Decreased activity The elderly people have reduced their activities due to certain diseases and obesity factors, especially those who are bedridden or in wheelchairs due to illness, and are often prone to constipation due to lack of sports stimulation to promote the movement of feces.
3. Mental and psychological factors
People suffering from psychological disorders such as depression, anxiety and obsessive-compulsive disorder are prone to constipation.
4. Intestinal lesions
Intestinal diseases include inflammatory bowel disease, tumor, hernia, rectal prolapse, etc. These diseases lead to functional outlet obstruction and defecation disorder.
5. Systemic lesions
Systemic diseases include diabetes, uremia, cerebrovascular accident and Parkinson's disease.
6. Iatrogenic (laxative abuse)
Because of the long-term use of laxatives, especially irritating laxatives, the intestinal mucosal nerves are damaged and the intestinal muscle tension is reduced, which leads to serious constipation. In addition, other drugs that cause constipation include opioid analgesics, anticholinergics, antidepressants, calcium antagonists, diuretics and so on.