HEALTHIER AGING: Preventing constipation in older adults

June 2005 
Volume 35  Number 6
Pages 22 - 23
  PDF Version Available!


  • Assessing the patient

  • Adding oral medication to the regimen

  • How rectal medication fits in


    IF YOUR OLDER PATIENT is constipated, she may be too embarrassed to bring it up. That's why you need to make checking for constipation part of your regular assessment routine.

    Constipation is the most common bowel management problem in older adults. Age-related factors that may be involved include decreased gastric motility, dehydration, impaired mobility, adverse reactions to medications, and chronic illness. In this article, I'll discuss how to identify problems and establish an appropriate bowel management program for your patient.

    Assessing the patient

    First, conduct a thorough history. If coexisting conditions could be causing chronic constipation, they need to be addressed. Ask your patient about her diet, prescription and over-the-counter medications (including suppositories, laxatives, enemas, and herbal remedies), level of activity, and bowel habits. Remember, normal elimination patterns can vary widely, from three times a day to three times a week. If the patient has a regular pattern and passing stool isn't uncomfortable or painful, consider her pattern to be normal. Also ask her if she has symptoms, such as bloating or pain, between bowel movements.

    Then perform a physical assessment. Assess for abdominal distension and decreased bowel sounds. If she has these and she hasn't had a bowel movement for several days, you may need to perform a digital rectal exam to check for impaction; manually remove stool if necessary.

    If your patient is constipated, her health care provider will need to rule out common medical conditions that might be causing the problem. Develop a workable bowel management program that's realistic and natural. Focus on factors that can be modified, including the patient's diet, ...

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