Constipation:
Excessively dry bowel movement, rare or uncommon. Its
more common in women with serious complications in the elderly.
Etiology:
-
Mechanical: obstruction, neoplasms, hernias…
-
Functional: diverticulitis, fissures, haemorrhoids…
-
Pharmacological: laxatives, opiates…
-
Metabolic and endocrine: diabetes, hypothyroidism, uremia…
-
Neurological: injuries, central nervous system
diseases…
Complications:
-
Fecaloma
-
Anal fissure
-
Circulatory disturbances
-
Fecal incontinence
Treatment:
The most recommended treatment
to combat constipation is based on a high-fiber diet along with plenty of
fluids and regular exercise, thus increasing fecal bulk and decreasing
intestinal transit time.
It is also important to
educate the patient to acquire the habit of defecating regularly.
Regular physical exercise
individualized.
Ostomy:
Surgical creation of a
temporary or permanent opening which lead outside the disgestive tract through
the abdominal wall.
The old ostomy should follow
some dietary recommendations to regulate intestinal transit and prevent both
diarrhea and constipation and restore a good nutritional status.
▪ Sigmoid or transverse colostomies close to sigma, feeding it more next
to normal.
▪ Right or transverse colectomy next to duodenum, avoid fats, exciting
drinks, raw vegetables
Types:
-
Sigmoid colostomy
-
Transverse colostomy
-
Ascending colostomy
-
Ileostomy: liquid and
continuous odor
Bags:
There are different types
for the elderly ostomates.
Colostomy bag multipurpose
adhesive closure and clear filter à Liquid or soft stools
Colostomy bag single use
adhesive and transparent filter à Solid stool
Adhesive colostomy bag
closing faucet, unfiltered and transparent à Very liquid stool
Colostomy bag ring plate and
single-use filter opaque à solid stools
Fecal incontinence:
Its one of geriatric
syndromes most affects the quality of life of the elderly because it is not
part of normal aging. Deterioration personal and social relationships, of the
patient.
Types of lower fecal
incontinence:
-
Soiling: dirty underwear
-
Gas incontinence
-
Defecatory urgency
-
True to liquid stool
incontinence
Types of major fecal
incontinence:
-
Pelvic floor injury
-
Drugs: lexantes and
antibiotics
-
Complete rectal prolapsed
-
Rectal cancer
-
Neurological disorders:
central, spinal or peripheral
-
Myopathic diseases
-
Systemic diseases
Nursing care:
-
Lifestyle modifications:
schedule bowel movements, increase fluid and fiber intake, physical exercise.
-
Treatment of perianal
discomfort: avoid soap, toilet pape. Wash with warm water and cotton.
-
Treatment of fecal
impaction: disimpaction manual or enemas
-
Modification of
architectural barriers
-
Uses of absorbent
Dysphagia:
Difficulty swallowing or swallowing liquids elements
and/or solids by affecting one or more phases of swallowing.
General measures of treatment:
-
respect taste and experience new flavours
-
presenting smaller amounts
-
Do not mix liquid and solid
-
Devise meals that can take with hands
-
Avoid contact with the spoon
-
Peacefully atmosphere
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Personal reflection:
Once we
have detected the etiology of the patient, we must follow up to avoid further
complications.
Always
inform the patient of the disease and geriatric treatment.
BIBLIOGRAPHY:
Gastrointestinal disorders in the geriatric patient. Gastroesophageal reflux disorders. Bowel disorders. Diagnostic evaluation and therapeutical attitude. C. Verdejo Bravo,M Montiel Carbajo. MC Sevilla Mantilla. A Ruiz de León San Juan.Medicine 2003 08:58
De la Llave B., Arriero Anes A. Manejo de estreñimiento en personas mayores. Boletin de enfermeria de atencion primaria. España. 2010. Revisado en: http://sescam.jccm.es/web1/gaptalavera/prof_enfermeria/boletines/boletin_enfermeria6_2008.pdf
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