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Constipation Causes in the Elderly

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1. Constipation Causes in the Elderly

Constipation Causes in the Elderly Constipation Causes in the Elderly Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Constipation (...) Causes in the Elderly Constipation Causes in the Elderly Aka: Constipation Causes in the Elderly , Constipation in Older Adults II. Epidemiology: Prevalence over age 60 years: 33% in residents: >50% III. Pathophysiology: Types (most common) Normal stool frequency, but hard consistency Slow Transit Bowel or Infrequent with bloating and Disorders of (common in elderly) Decreased rectal smooth muscle contraction or relaxation Decreased stooling urge response to rectal sensation of Consult

2018 FP Notebook

2. Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation. (PubMed)

Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation. Constipation is a common and often debilitating condition in the elderly, which may be caused by underlying disease conditions, structural abnormalities in the bowel, and a variety of medications such as anticholinergics, antidepressants, and opiates. In this review, we focus on opioid-induced constipation (OIC), which is often underrecognized and undertreated in the elderly. When opioid therapy (...) is initiated, healthcare providers are encouraged to evaluate risk factors for the development of constipation as part of a thorough patient history. To this end, the patient assessment should include the use of validated instruments, such as the Bristol Stool Scale and Bowel Function Index, to confirm the diagnosis and provide a basis for evaluating treatment outcomes. Healthcare providers should use a stepwise approach to the treatment of OIC in the elderly. Conventional laxatives are a first-line option

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2016 Drugs & Aging

3. Constipation

cause. Secondary constipation is caused by a drug or medical condition (such as endocrine and metabolic diseases (...) , myopathic and neurological conditions, and certain bowel conditions). Faecal loading/impaction is retention of faeces to the extent that spontaneous evacuation is unlikely. Constipation is common at all ages especially in women, the elderly, and during pregnancy. Assessment should determine: The person’s understanding of constipation . The severity and impact of the constipation (...) by raising the feet on a low stool. A stool stool, if you will. Sitting with hips at 90 degrees means the puborectalis muscle is not relaxed, which means the kink 2016 11. Constipation in Elderly Patients with Noncancer Pain: Focus on Opioid-Induced Constipation . Constipation is a common and often debilitating condition in the elderly, which may be caused by underlying disease conditions, structural abnormalities in the bowel, and a variety of medications such as anticholinergics, antidepressants

2018 Trip Latest and Greatest

4. Side-to-Side Ileosigmoidostomy Shunting Surgery for the Treatment of Elderly Patients With Chronic Constipation (PubMed)

Side-to-Side Ileosigmoidostomy Shunting Surgery for the Treatment of Elderly Patients With Chronic Constipation Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic (...) be considered as an alternative therapy for elderly patients with chronic constipation.

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2017 Annals of coloproctology

5. CRACKCast E032 – Constipation

the patient define what they mean by constipation* Chronic constipation > 3 months Constipation + inability to pass flatus = obstipation Constipation is most common in Women Elderly low SES high BMIs low fiber sedentaryism multiple medication GI tract normally sees 10 L of fluids and secretions. The small intestine absorbs all but 500 ml The colon uses these residues from the ileum to ferment and salvage nutrients and water. Stool evacuation and transport depends on: Neurotransmitters Colonic reflexes (...) for severe constipation Disposition People with medically necessary medications causing constipation NEED to be on a regular regimen Some people need special medications for chronic constipation Relistor or Amitiza In palliative patients use of: Methlynatrexone for blocking the opioid receptors in the gut This post was copyedited and uploaded by Michael Bravo ( ). 1. Marx J. Rosen’s Emergency Medicine – Concepts and Clinical Practice . Mosby; 2015. (Visited 1,071 times, 1 visits today) Adam Thomas

2017 CandiEM

6. Constipation in older adults: Stepwise approach to keep things moving

, constipation is often multifactorial, especially in the elderly, and laxatives might still be required. Box 3. Diseases and conditions that can cause constipation Causes of constipation Cancer or cancer-related causes: colorectal cancer, dehydration, intestinal radiation, tumour compression of large intestine Endocrine causes: hormonal changes, hypothyroidism, diabetes, hyperparathyroidism Gastrointestinal disorders: diverticulosis, Hirschsprung disease, irritable bowel syndrome, megacolon, pelvic floor (...) ( ). , , , The Beers and STOPP (Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions) criteria are often used to identify medications that might be unsuitable for elderly patients. – Both lists include medications that can cause or exacerbate constipation in older adults. – Box 4. Examples of medications that can cause constipation Medications that can cause constipation: Analgesic drugs: nonsteroidal anti-inflammatory drugs, opioids (25% to 40% in noncancer patients and ≤90% in cancer patients

2016 RxFiles

7. Diagnosis, Assessment and Management of Constipation in Advanced Cancer: ESMO Clinical Practice Guidelines

by the patient and diagnostic criteria do not always clearly ex- press the diversity of factors, which may lead to constipation as a clinical problem [2]. Widespread use of opioid analgesics for cancer pain poses speci?c challenges for patients [3]. Despite its clinical im- pact, constipation is both poorly recognised and poorly treated. Oncologists must be familiar with the common causes of constipa- tion among cancer patients and the strategies to evaluate and man- age this distressing symptom (...) Table 2. Speci?c treatment-related causes of constipation in cancer patients Medication Rationale Opioid analgesics All opioids cause constipation. Tolerance is not observed over time. Dose–response relationship to this effect is ?at, and se- verity is not strongly dose-related. Some data indicate minor severity with fentanyl and, possibly, methadone [3, 83] and with oral oxycodone/naloxone combined formulation [41, 84] Serotonin 5-HT3 receptor antagonists 5-HT3 receptor antagonist antiemetics slow

2018 European Society for Medical Oncology

8. Clinical Practice Guideline for the Evaluation and Management of Constipation

) and approved by the entire Clinical Practice Guidelines Committee. Evaluation of Constipation 1. A directed history and physical examination should be performed in patients with constipation. Grade of Rec- ommendation: Strong recommendation based on low- or very-low-quality evidence, 1C a lthough constipation is a benign condition, a thorough history and physical examination can help ensure that a serious life-threatening disease is not the underlying cause of the constipation. Patients who also report (...) rectal bleeding, change in caliber of stools, blood in the stool, weight loss, anemia, or a family history of colorectal can- cer should be evaluated for a colorectal malignancy that may be causing obstruction. 11,12 in addition, a careful his- tory may elicit modifiable behavioral factors, such as diet, dehydration, or immobility, as well as medications that may be contributing to constipation. 8,11 o pioids, antide- pressants, anticholinergics, calcium channel blockers, and calcium supplements

2016 American Society of Colon and Rectal Surgeons

9. Constipation

. Faecal loading/impaction describes retention of faeces to the extent that spontaneous evacuation is unlikely. Functional (primary or idiopathic)constipation is chronic constipation without a known cause. Secondary (organic) constipation is constipation caused by a drug or underlying medical condition. Constipation may occur at any age but is more common in women, the elderly, and during pregnancy. Assessment of a person with constipation should include: Any red flag symptoms or signs that may suggest (...) a serious underlying cause, such as colorectal cancer. The person’s understanding of constipation and their normal pattern of defecation. The frequency and consistency of stools, including symptoms of faecal impaction and/or incontinence. Associated rectal, abdominal, or urinary symptoms. The severity and impact of symptoms on daily life and functioning. Any risk factors or secondary causes. Any self-help measures or drug treatments tried. Abdominal and internal rectal examination. The management

2019 NICE Clinical Knowledge Summaries

10. Treatments for Constipation

consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. 1 Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. 2 Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely. 2 It can substantially affect quality of life and be debilitating. 2 It is estimated that between 2% to 27% of the population are affected depending upon (...) motility in individuals with non-neurogenic causes of constipation. 3 Considering the different causes and patient populations that may experience constipation, there are questions with regards to the efficacy and safety of the treatments available. A recent Rapid Review concluded there was a paucity of good quality of evidence to support the use of stool softeners for the management or prevention of constipation in adults in a hospital or long- term care setting. 7 Docusate appeared to be no more

2014 Canadian Agency for Drugs and Technologies in Health - Rapid Review

11. Dioctyl Sulfosuccinate or Docusate (Calcium or Sodium) for the Prevention or Management of Constipation

to fewer than three times per week while patients identify more with the symptoms associated with constipation such as difficulty passing stool, hard stool consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. 1 Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. 2 Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely (...) . 2 It can substantially affect quality of life and be debilitating. 2 It is estimated that between 2% to 27% of the population are affected depending upon the definition of constipation used. 1 Chronic constipation is a significant problem in the elderly, 1,3 in patients with chronic conditions, 3-5 and in patients receiving opioids as part of a treatment regimen. 5-7 Up to 20% suffer from chronic constipation in the community-dwelling elderly population while this number increases

2014 Canadian Agency for Drugs and Technologies in Health - Rapid Review

12. Management of Constipation in Adult Patients Receiving Palliative Care

, constipation causes considerable suffering for the affected individual, either as a direct consequence of the physical symptoms or due to related social and psychological complications. Constipation remains poorly recognised and undertreated by healthcare providers (7, 9). This is driven by the lack of a universally agreed definition of constipation and the disparity between patients and health professionals as to what constitutes constipation (4). Constipation will have a different meaning to each (...) Management of Constipation in Adult Patients Receiving Palliative Care Management of Constipation in Adult Patients Receiving Palliative Care National Clinical Guideline No. 10 November 2015Guideline Development Group The Management of Constipation in Adult Patients Receiving Palliative Care Guideline was developed by a subgroup of the Health Service Executive (HSE)/Royal College of Physicians of Ireland (RCPI) National Clinical Programme for Palliative Care, known as the Guideline Development

2015 National Clinical Guidelines (Ireland)

13. Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement

than a year and after failed conservative treatment. The patient should have slow transit constipation and/or symptoms of outlet obstruction without a mechanically correctable cause. (Abstained 0, voted 22. Agree/strongly agree 16. Agreement 73%. Evidence grade 4. Recommendation none.) Investigations before PNE Baseline investigations should include estimation of colonic transit time and defaecography. Anorectal physiology testing may be useful. Hirschsprung's disease must be excluded (...) Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement - Maeda - 2015 - Colorectal Disease - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term Consensus Statement Free Access Sacral nerve stimulation for faecal incontinence and constipation: a European

2015 Palliative Care Evidence Review Service (PaCERS)

14. Constipation Causes in the Elderly

Constipation Causes in the Elderly Constipation Causes in the Elderly Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Constipation (...) Causes in the Elderly Constipation Causes in the Elderly Aka: Constipation Causes in the Elderly , Constipation in Older Adults II. Epidemiology: Prevalence over age 60 years: 33% in residents: >50% III. Pathophysiology: Types (most common) Normal stool frequency, but hard consistency Slow Transit Bowel or Infrequent with bloating and Disorders of (common in elderly) Decreased rectal smooth muscle contraction or relaxation Decreased stooling urge response to rectal sensation of Consult

2015 FP Notebook

15. EFFECTS OF FRUCTO-OLIGOSACCHARIDE SUPPLEMENTATION ON CONSTIPATION IN ELDERLY CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS. (PubMed)

EFFECTS OF FRUCTO-OLIGOSACCHARIDE SUPPLEMENTATION ON CONSTIPATION IN ELDERLY CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS. ♦Fructo-oligosaccharides (FOS) exhibit soluble-fiber properties that beneficially affect bowel function and relieve constipation. The effects of FOS supplementation on constipation and biochemical parameters were examined in elderly continuous ambulatory peritoneal dialysis (CAPD) patients. ♦This randomized, double-blind, placebo-controlled, cross-over study (...) was performed in elderly CAPD patients (5 males and 4 females) with chronic constipation. All subjects were randomly assigned to receive either 20 g FOS or placebo daily for 30 days. After a 14-day washout period, the patients were switched to the other substance for 1 more month. Before and after each treatment period, frequency of defecation, characteristics of feces, and colonic transit were evaluated. Biochemical parameters were also assessed. ♦Fructo-oligosaccharides significantly increased

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2014 Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis Controlled trial quality: uncertain

16. Palliative care - constipation

Palliative care - constipation Palliative care - constipation - NICE CKS Share Palliative care - constipation: Summary Constipation is defecation that is unsatisfactory because of infrequent stools, difficult stool passage, or seemingly incomplete defecation. Stools are often dry and hard, and may be abnormally large or abnormally small. About 80% of people with cancer will require treatment with laxatives at some time. People receiving palliative care have multiple causes of constipation (...) , such as: Drugs, for example, opioid analgesics, antimuscarinic drugs, antacids. Secondary effects of disease, for example, dehydration, inadequate dietary fibre, inactivity, delirium, spinal cord compression, lack of privacy. Direct effects of malignant tumours, causing bowel obstruction, hypercalcaemia, nerve damage. When assessing a person with constipation in palliative care: The history should include information about the frequency and character of stools, discomfort, blood or mucus with the stool

2016 NICE Clinical Knowledge Summaries

17. Stercoral perforation of the rectosigmoid colon due to chronic constipation: A case report (PubMed)

Stercoral perforation of the rectosigmoid colon due to chronic constipation: A case report Chronic constipation is very common in elderly patients. As a result of this situation fecaloma is also frequently seen at these ages. However, the stercoral perforation caused by fecaloma is a rare situation to occur. The rectosigmoid colon is the most affected colonic segment. It is seen in older patients with concomitant diseases and a low quality of life.Here in this case, we have to report an 83 (...) - year-old male patient who came to the emergency room with complaints of abdominal pain and constipation for two days. He had Type II Diabetes Mellitus, had a cardiac stent and also Alzheimer's disease. We diagnosed a rectosigmoid perforation due to a large fecaloma. This case presentation was prepared in accordance with the scare checklist guidelines (Agha et al., 2016 [1]).Constipation and faecal impaction are common entities, particularly in elderly and bedridden patients. Fecalomas

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2017 International journal of surgery case reports

18. Coping with Common GI Symptoms in the Community: A Global Perspective on Heartburn, Constipation, Bloating, and Abdominal Pain/Discomfort

Europe/Western countries • Functional disorders of the gastrointestinal tract are estimated to occur in up to 30% of the adult population in Western countries [6,7] and are recognized as a frequent cause of abdominal pain. Only 20–50% of these symptoms can be formally attributed to IBS [1,8]. • In IBS, abdominal pain and/or discomfort is the central symptom; other intestinal symptoms are altered bowel habit, which may be dominated by constipation or diarrhea or may alternate between them, as well (...) in European populations, with almost one in five people being diagnosed, depending on the criteria used. There is controversy about the value of applying the strict Rome III criteria for diagnosis of constipation, with poor construct validity and a 10% false-negative rate being reported in one series [10]. Amongst the elderly and institutionalized population, over 50% of patients require laxatives [11]. • GERD symptoms are increasingly prevalent in the United States, as well as in the rest of the world

2013 World Gastroenterology Organisation

19. Colonic Motility in Constipation and Aging: A Study With a New 3D Transit System

Update Posted : June 21, 2016 Sponsor: University of Aarhus Information provided by (Responsible Party): University of Aarhus Study Details Study Description Go to Brief Summary: To study the motility of the bowel in constipated patients. Looking at the difference between young and elderly patients with constipation. Condition or disease Intervention/treatment Constipation Device: MTS2 Study Design Go to Layout table for study information Study Type : Observational [Patient Registry] Estimated (...) Enrollment : 20 participants Target Follow-Up Duration: 1 Week Official Title: Colonic Motility in Constipation and Aging: A Pilot Study With a New 3D Transit System Study Start Date : June 2016 Estimated Primary Completion Date : April 2017 Resource links provided by the National Library of Medicine related topics: (AHRQ) related information: Groups and Cohorts Go to Group/Cohort Intervention/treatment Constipated, Elderly Investigation with MTS for motility Device: MTS2 Constipation, Young

2016 Clinical Trials

20. Use of Gastrografin in the Management of Fecal Impaction in Patients With Severe Chronic Constipation

: August 9, 2017 Sponsor: Jinling Hospital, China Information provided by (Responsible Party): Jianfeng Gong, Jinling Hospital, China Study Details Study Description Go to Brief Summary: Fecal impaction (FI) is a common cause of lower gastrointestinal tract obstruction, and it is the result of chronic or severe constipation and most commonly found in the elderly population. Gastrografin is a water soluble contrast mediate that could act as an osmotic laxative. It has been shown to confer a therapeutic (...) . Rome III criteria for chronic constipation present for ≥8 weeks. Exclusion Criteria: Patients with a history of colorectal surgery or an organic cause of constipation; pregnancy. Patients with long-term medical conditions potentially associated with constipation (ie, cystic fibrosis, cerebral palsy, hypothyroidism, spinal and gastric anomalies). Patients with medical or psychiatric illness. Patients with abnormal laboratory data or thyroid function. Contacts and Locations Go to Information from

2016 Clinical Trials

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