tailieunhanh - Update on the management of constipation in the elderly: new treatment options

Although it has been suggested that we store one gallon of water per day per person for drinking and five gallons of water per day per person for all uses, guidance concerning how many days to plan for has varied. Such thinking is antithetical to most businesses that have changed from stockpiling and keeping inventories, into a “just-in-time” mentality. We are now being asking to consider shifting in the opposite direction yet again. Despite this fact, it is imperative that the level of supplies on hand be well-monitored, well-controlled, and kept at a level that has been carefully thought out. | Clinical Interventions in Aging Dovepress open access to scientific and medical research Q Open Access Full Text Article REVI EW Update on the management of constipation in the elderly new treatment options Satish SC Rao Jorge T Go This article was published in the following Dove Press journal Clinical Interventions in Aging 19 June 2010 Number of times this article has been viewed Abstract Constipation disproportionately affects older adults with a prevalences of 50 in community-dwelling elderly and 74 in nursing-home residents. Loss of mobility medications Section of Neurogastroenterology Division of GastroenterologyHepatology Department of Internal Medicine Iowa City University of Iowa Carver College of Medicine Iowa City Iowa underlying diseases impaired anorectal sensation and ignoring calls to defecate are as important as dyssynergic defecation or irritable bowel syndrome in causing constipation. Detailed medical history on medications and co-morbid problems and meticulous digital rectal examination may help identify causes of constipation. Likewise blood tests and colonoscopy may identify organic causes such as colon cancer. Physiological tests such as colonic transit study with radio-opaque markers or wireless motility capsule anorectal manometry and balloon expulsion tests can identify disorders of colonic and anorectal function. However in the elderly there is usually more than one mechanism requiring an individualized but multifactorial treatment approach. The management of constipation continues to evolve. Although osmotic laxatives such as polyethylene glycol remain mainstay several new agents that target different mechanisms appear promising such as chloride-channel activator lubiprostone guanylate cyclase agonist linaclotide 5HT4 agonist prucalopride and peripherally acting p-opioid receptor antagonists alvimopan and methylnaltrexone for opioid-induced constipation. Biofeedback therapy is efficacious for treating dyssynergic defecation and fecal .

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