Posted on October 6, 2010 - by Nurse Virginia
Results of Laxative abuse in the elderly.
Many elders abuse laxatives without realizing their regular use is abusive. The elder may be under the assumption that in order to be “regular” they must have a bowel movement every day. Regular use of laxatives makes the intestinal muscles flabby or referred to as a “Lazy bowel.” The ongoing use of these products eventually makes a person dependent on a laxative in order to have a bowel movement.
Laxatives work by irritating the walls of the intestines and causing an increase in the contractions of the muscles in the intestinal wall. The most gentle of these products contain milk and increase the amount of water in the intestine causing a softer stool. The nursing home usually favors the use of one of these milk products (Milk of Magnesium or MOM) for the elder with a constipation problem.
Glycerin suppositories have a more gentle action than Bisacodyl products. Glycerin works by attracting water through the intestinal wall into the bowel and will flush out the waste within 10 minutes. All suppositories are bullet shaped and designed for insertion with the pointed end first and placed next to the wall of the bowel.
A Bisacodyl product acts by irritating the muscles of the bowel, causing contractures (at times extreme) which expels the waste.
When Hypothyroidism is the cause of constipation.
When the elder has an ongoing problem with constipation despite eating a good diet, drinking water through out the day and getting regular exercise, the possibility of hypothyroidism should be looked into. Although hypothyroidism causes dementia, as well as a host of other conditions, physicians are more likely to address each symptom then the cause. A diagnosis of hypothyroidism is very difficult to receive from a physician.
The patient who presents with slow reactions, and moves slowly, you can then assume their digestive system is also moving slowly. A slow moving colon gives the intestinal wall more opportunity to remove fluid and create hard dry stools. Even when the physician suspects Hypothyroidism, unless their lab tests confirm it, the patient will not receive the diagnosis. Hypothyroidism used to be diagnosed strictly by the symptoms reported by the patient and the observation of the physician. Once the medical community determined that the only way to determine this debilitating condition was with the correct labs, many people were no longer diagnosed.
Although hypothyroidism is relatively easy to treat, with low cost thyroid medication and iodine the typical physician is going to dismiss this possibility if the labs don’t back him up.
Although constipation is a difficult condition to live with, the missed diagnosis of Hypothyroidism has the potential to cause many more conditions for the aging population in the future.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
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