Keeping things Moving: Preventing and Managing Constipation

Gandell, Dov; Alibhai, Shabbir M.H.

doi:10.1002/9781118281796.ch11

Cited by 1 publication

(2 citation statements)

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“…In our study, magnesium oxide was commonly prescribed and even used at high dosage (over 1000 mg/day). Physicians may favor magnesium salts for their rapid action and effects on softening the stool, but the risk of dehydration, fecal incontinence, and hypermagnesemia in the elderly people should be considered (8, 14, 19). In this study, 43 (39%) of the residents treated for constipation did not obtain normal bowel function.…”

Section: Discussionmentioning

confidence: 99%

“…As a result of the high prevalence of laxative-use in elderly nursing home residents, adverse effects and overuse are the main concerns. Side effects such as abdominal discomfort, electrolyte imbalances, allergic reactions, and hepatotoxicity have been reported (3, 19). Over-prescription of laxatives to the elderly can be attributed to two factors: lack of objective confirmation of the diagnosis and ineffective prescribing patterns (14).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Effectiveness of Laxative Use Among Elderly Residents in a Regional Hospital Affiliated Nursing Home in Hsinchu County

Chen¹,

Huang²,

Yang³

et al. 2014

Nurs Midwifery Stud

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Background: Long-term care residents are susceptible to constipation and one-half to three quarter of older nursing home residents receive laxatives regularly. Objectives: The purpose of this study was to evaluate the factors related to abnormal bowel function and explore the effectiveness of laxative treatment among the elderly residents of a nursing home. Patients and Methods: A total of 110 residents older than 65 years old was enrolled in this study. The following variables were gathered: age, gender, body mass index (BMI), length of stay, daily fluid intake, type of food, functional level, cognitive ability, physical therapy status, somatic and psychiatric diseases, number of medications, and medication use. The use and dosage of laxatives were recorded by means of Anatomical Therapeutic Chemical (ATC) classification system. Normal bowel function was defined as defecation frequency from three defecations per day to three defecations per week and stool consistency score of three to five on Bristol Stool Form Scale. A comparison between groups with normal and abnormal bowel function was drawn. Results: Low BMI, increased fluid intake, liquid food intake, poor functional level, poor cognition, and a history of stroke were significantly associated with altered bowel function (P < 0.05). The most frequently used laxatives were glycerol, senna glycoside, and magnesium oxide. There were significant differences in laxative regimens between residents with normal and altered bowel function; those with altered bowel function tended to take more laxatives than those with normal bowel function. Conclusions: This study suggested that treatment of constipation in the nursing home was unsatisfactory. To improve treatment outcomes in those susceptible to altered bowel function, a coordinated approach with involvement of physicians, nursing staff, and other professionals including dieticians and pharmacists seems necessary. Keywords:Nursing Homes; Constipation; LaxativesImplication for health policy/practice/research/medical education: Treatment of constipation in the nursing home is unsatisfactory. For those who are susceptible to altered bowel function, a coordinated approach is necessary with the involvement of physicians, nursing staff, and other professionals including dieticians and pharmacists to improve the treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%