Sunday, 25 June 2017

Constipation: A Real Pain in the Butt !!

When Elderly Bowels are ALL SHOW - but NO GO.




Being constipated STINKS.  And you can bet your pants there's very little amusing about trying to write on the topic either!

Certainly nobody likes talking about constipation, let alone having to endure the often excrutiating pain associated from suffering with it.  In fact truth be told, and much like being constipated... I’m finding it hard work bearing-down to squeeeeeze out some thoughts on it.

Let's face it, as distasteful (and stinky) as the subject of constipation is... and as much as we might poo-poo it, the fact remains that as human beings, sooner or later we all have to ‘go’. 

The problem is of course when you CAN’T go.

And although we are each so physiologically different (and what’s normal for one isn’t necessarily normal for another)… most doctors generally consider that five days (or more...eek!) of NOT being able to evacuate your bowels, means you pretty much to some degree, have become constipated. 

Unsurprising to me, is how merely mentioning the word constipation in the presence of my elderly clients can result instantly in a defiant screwed up nose or clenched teeth.  Which is a worry because if there’s one thing bunged-up old people don’t need - is MORE clenching!

Unfair as it may be though (and for a whole toilet-load of reasons), it is becoming typical... nay, almost expected, that chronic constipation become more prevalent the older we get.

Oh, the joy!



Constipation in Old People

Pleeease let today be the day...



11 Reasons Why Seniors are Prone to Constipation:

  • An ageing colon, as per the rest of an elderly peep's body, is just not as peppy as it once was
  • Some medications (eg: pain meds) have constipation as their pesky side-effect
  • Diuretics cause people to wee more - resulting in an increase in fluid loss ie: Dehydration is bad
  • Retirement can mean a more sedentary lifestyle ie: slow down your life = slow down your bowels
  • Dietary changes (eg: during travel) or a loss of appetite mean a lack of proper nutrition involving ample quantities of fruit n veg.  You can never have too much fibre, Fibre, FIBRE!
  • Drinking less allows for more chance of the dreaded Dehydration (again, that's baaad)
  • Frequent digestive tract issues can mean the likelihood of constipation is also increased
  • Various medical conditions are symptomatically linked to constipation – MS, Diabetes, Parkinsons
  • Being sick and/or bedridden for long periods encourages a lower metabolism rate.  You can't remove it - if you dont move it!
  • Depression, anxiety, stress, lack of sleep can all contribute to a sluggish bowel due to upset bodily functions and a hormonal balance thats's thrown everything out of whack
  • Blockage in or around the bowel/colon regions can physically prevent the elimination process from occuring...  an indication that something medically sinister may be afoot (a-bottom?) 



Mind you, it's not only pensioners who battle with the anguish of infrequent faecal evacuation.  Most of us at some stage in our lives, have been 'privy' to the gassy, smelly delights associated with constipation.  And we know only too well how much it can disrupt our quality of life by zapping our energy levels and leaving us feeling uncomfortable, bloated and… well, just SHIT really.

Sadly, it's the older generation who seem to get struck more frequently with ongoing bouts of chronic constipation - and usually as a symptom of an underlying age-related health condition.


And then I helped an old lady write in her Poo Diary!

I'll never forget the time I arrived at the home of one of my sweetest client's for the very first time.  A charming and unassuming lady, Mrs Annie Turdsworth was the most kindly person you could ever meet – real cookie-baking, jumper-knitting 'grandmother' material.

On this particular day, I found her pouring over a pile of paperwork at her kitchen bench. 

It turns out, Annie has put up with a lifetime of suffering from various ongoing gastrointestinal complaints and long story short, since the day she turned 65, has been diagnosed with the crappiest lot of bowel disorders imaginable.  Ranging from IBS to diverticulitis and now most recently at age 87, they have decided she may have colon cancer.

And being that the specialist needed to know what her bowels were dishing out, Annie was instructed to keep a record of every time she 'went' to the toilet; how her stool looked, its colour, texture and shape etc. 

Oh dear, you can imagine... the demure and deeply private Mrs Turdsworth was appalled!

Luckily, her doctor had a copy of the Bristol Stool Form scale (BSF) to wave in front of her and put her mortified mind at ease.

As a simple user-friendly picture rating system, the BSF enables people like Annie (who would rather DIE than discuss their bathroom habits out loud to anyone) to utilise the handy dandy illustrations to best match up with the appearance of their own stools.

So rather than having to say horrific words like “runny” or “hard pebbles”,  Annie could instead work discretely off her BSF guide and record the corresponding number of the day into her Poo Diary (that is, once she got over the terror of looking into the toilet bowl!)


Elderly people with Constipation

What kind of STOOL am I?



And I'm flattered that Annie feels brave enough to open up to me about something as personal as bowel movements (or lack thereof)...although it took a while for her to gain confidence.

“I think today Dollie, I’m more of a 2 than a 3” 

Together we mark it off in her book along with the food she’s consumed in the last 24 hours, all nice and neatly, for the doctor to peruse later.  Annie then pops the diary into an empty chocolate box, twists a large rubber band around it and then tucks the whole sordid package away out of sight in a drawer beside her bed. 

At the other end of the Constipational spectrum, I should definitely make mention of another of my cherished clients, Mrs Maggie Cementballs.  Not only does the brazen 94 year old Maggie NOT require a picture chart to categorise her faecal formations, but because she is deaf (and refuses to wear hearing aids) – we get to discuss it LOUDLY. 

“JUST SO YOU KNOW... I HAVEN’T BEEN TO THE TOILET SINCE 1973!”

You have to laugh.

All kidding aside though, it would be fair to say dear old Mags suffers with what must surely be some the most crippling waste elimination woes in the entire universe.

Throw in a blossoming set of haemorrhoids, ongoing colon surgery and a couple of rectal prolapses - there’s not much poor Maggie hasn’t experienced when it comes to digestive complications and the torturous impaction her bowels insist on putting her through. 

And she is more than happy to give me the full detailed account on her constipation problem-o-the-week.  I recall last week’s pooping particulars went something like this (note: this is in SHOUT format):

“WELL I DON’T LET IT GO ON AND ON, OR I END UP IN AGONY - ONE CAN ONLY PUSH FOR SO LONG!  

AND FOR ONCE, THE PROBLEM IS NOT WITH THE ACTUAL GOING… IT’S THE FINISHING OFF BIT THAT’S ALL TOO HARD AT THE MOMENT...

...BUT I HAVE TO GET IT OUT, DOLLIE!  

I CAN’T WALK ROUND WITH THE THING HALF HANGING OUT OF ME, CAN I?” 


“CRIKEY MAGGIE, YOU JUST CAN’T!”  I bellow back, with my extra concerned face on.

Unfortunately, there’s not a lot that I or anyone else can do for the long-suffering Maggie.  Due to her advanced age, doctors have advised that further surgery just isn’t viable ie: it would most likely kill her.

And therefore all they can do is pump her full of pills, top up her pain-killers and assist her to manage the condition at home as best she can. Not much fun when you're a frail old girl in your nineties and much like every other poor soul having a crappy time in the bathroom - all she ever really wants from life is a happy ending.

Literally.


Cheers
Dollie

Constipation in old people

Tell it like it is, Maggs!









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