Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 515

The management of chronic constipation in the elderly aims to relieve symptoms related to constipation and for defecation to occur at least three times a week with a soft, formed stool. The initial treatment strategy for constipation nearly always includes the ingestion of more dietary or supplemental fibre. Increased fibre intake improves stool consistency and accelerates colon transit in many individuals and generally provides a safe and inexpensive first‐line approach.⁴² Increased fluid intake is also frequently recommended. Although this may have value in the dehydrated patient, increasing fluid intake in chronic constipation rarely improves constipation symptoms.⁸ Likewise, increased physical activity is also recommended without clear evidence of efficacy.⁸ General non‐pharmacological advice given first line includes information about a normal bowel habit, ingestion of a healthy, fibre‐rich diet (20–30 g per day), taking advantage of the meal‐related increase in colonic motor activity, and avoiding postponing defecation. Given the strong association of constipation in older people with medication use, medications should be eliminated or adjusted, substituting less‐constipating alternatives where possible. Medications used in the treatment of constipation are listed in Table 20.4.

Table 20.4 Medications used in the treatment of constipation.