Constipation is a specific symptom of a number of diseases associated with a decrease in the number of bowel movements and a feeling of incomplete emptying of the intestines.. The disease occurs in every third person in the population over 65 years old.. Elderly people need laxatives for constipation in more than 60% of cases..

This article is for informational purposes, it should be remembered that the treatment of constipation, first of all, depends on its cause, and therefore it should be selected and monitored by a doctor..

In old age, constipation is very common and requires not only drug therapy, but also lifestyle changes Constipation in the elderly In old age, constipation has a number of features:.

Associated with the natural aging processes of the large intestine (atrophic changes in the mucosa, slowing of peristalsis and weakening of the pelvic floor muscles), as well as weakening of the muscles of the anterior abdominal wall, which leads to a decrease in intra-abdominal pressure.

A tendency to a chronic course of the disease and a low response to almost any treatment method (the problem is associated with natural irreversible anatomical changes in the intestinal wall).

The ratio of saccharolytic (bifidobacteria, lactobacillus) and proteolytic (Proteus, Escherichia) intestinal flora is disturbed in favor of the latter. This leads to an increased synthesis of substances, one of which is endotoxin, which has a general toxic and inflammatory effect..

Formation of a vicious circle: a decrease in muscle tone - a slowdown in peristalsis - a delay in feces in the intestinal lumen - an increase in intraintestinal pressure - an exacerbation of dysbiosis or the occurrence of a number of other complications such as diverticulitis - an increase in constipation.

Indications and contraindications for taking laxatives In addition to constipation itself, in older people there are special indications for the appointment of laxatives that are not associated with intestinal pathologies:.

myocardial infarction;

severe forms of arterial hypertension;

aneurysm and thrombosis;

retinopathy;

hernia.

In this case, laxative drugs are prescribed to relieve excessive stress with an increase in intra-abdominal pressure during bowel movements (at such moments, a sharp jump in blood pressure occurs).

There are also a number of indications when such drugs are indicated due to temporary disability (usually in bedridden patients):.

skeletal traction;

postoperative period;

plaster corset.

Contraindications to the appointment of funds in this group:.

abdominal pain syndrome of unknown etiology (including acute abdomen, peritonitis);

gastrointestinal bleeding (external or hidden);

paralytic intestinal obstruction (with extreme caution in other types of obstruction);

acute toxic and non-toxic megacolon.

In each case, the drug is selected strictly individually based on the data of laboratory and instrumental examination of the patient..

Effective quick-acting laxatives Classification of laxative drugs is presented in the table.

Group.

Mechanism of action.

List of drugs (examples).

Increasing the volume of intestinal contents (voluminous).

The action is associated with an increase in the volume of feces, which stimulates intestinal mechanoreceptors (stimulation of peristalsis).

Dietary fiber of plant origin (cellulose, hemicellulose, lignin);

flax seeds, plantain preparations (Mucofalk).

Osmotic.

The mechanism of action is associated with an increase in osmotic pressure in the intestinal cavity (stretching of water into the intestinal lumen and softening of feces).

Magnesium sulfate, sodium sulfate, Forlax, Sorbitol, Mannitol, Lactulose.

Emollients.

Mostly plant substances that are not absorbed in the intestine, but envelop the feces, facilitating their passage through the intestines.

Vaseline oil, almond oil.

Stimulating.

The action is mainly associated with irritation of the intestinal wall.

Anthraglycosides (rhubarb, buckthorn, senna preparations, Agiolax), diphenylmethane derivatives (Bisacodyl, Guttalax, Phenolphthalein), combined preparations Kafiol, Slabilen, Musinum, Agarol, castor oil.

Below is a detailed overview of the different groups with a description of the most popular drugs..

Drugs that increase the volume of intestinal contents These drugs are effective, but have a less rapid effect in comparison with other groups. They do not have a direct effect on the work of the intestines, however, by increasing the volume of feces, they significantly stimulate the nerve endings in the intestinal wall. It is optimal to take them at the same time in the morning or at night..

For the effective action of this group of drugs, a sufficient water regime is shown (at least 1.5 liters per day). With concomitant arterial hypertension, careful control of pressure is indicated (additional water load often leads to an increase).

Mucofalk (psilium) A herbal preparation (psyllium seed coat), contains soft dietary fiber, which makes it possible to use it in elderly patients with a burdened history (ulcerative colitis, for example).

It contains several fractions, which increases the spectrum of action:.

fraction A - creates volume;

fraction B - provides mucus formation;

fraction C - prone to rapid destruction and serves as an energy substrate for the intestinal microflora.

In addition, Mucofalk slightly reduces cholesterol and glucose levels (important in patients with arterial hypertension, atherosclerosis and type I diabetes mellitus). Serves as the prevention of diverticular disease and colorectal cancer. The course is 10-20 g 2-3 times a day. The duration of treatment is not limited, since the drug has a minimum of side effects.

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