GERIATRIC CONSTIPATION AND ITS MANAGEMET

Dr. Suneet Roy*, Dr. Avadhesh Kumar and Dr. Jitendra Kumar

ABSTRACT

According to Acharya Sushruta, mandagni is the main cause of Vibandha or constipation. It is to be noted that Dusti of Apan vayu and Pureesha causes Vibandha. And create symptoms like pain in Abdomen, gas formation, pain in anus while passing stool, headache, acidity, palpitation and in chronic cases, Piles and Fistula. Vibandha is a disease entity which usually occurs due to Vata Prakopaka Ahara-Vihara and non compliance of Asthavidha Ahara Ayatana and Dwadasha Ashana Pravichara. Prolonged table work, excessive consumption of aerated drinks and fast foods have become a part of present-day life style, which causes decreased secretion of digestive enzymes, and peristaltic movement leading to improper digestion and stagnation of semi-digested food and leads to Vibandha or Constipation. Constipation is a problem that affects all ages. However, it is a common problem in older adults and is often a concern to elders. Elders may falsely believe that constipation is a “natural” part of aging. but it‟s a disorder that is not caused by aging itself. Age-related anatomic changes within the lower gastrointestinal tract may contribute to delayed transit time and decreased stool water content, due to intestinal wall atrophy, reduced blood supply, and intrinsic neuronal changes and age-related neurodegenerative changes in the enteric nervous system (ENS), reductions in Internal Anal Sphincter (IAS) pressure and pelvic muscle strength, as well as changes in rectal sensitivity and anal function. In colons of people older than age 65, a 37% loss of enteric neurons was found when compared with younger people. Rectal sensation plays a critical role in normal defecation and it changes with aging. Elderly patients required significantly larger volumes of rectal distention to stimulate the normal urge to defecate. Fecal impaction should be treated with mineral oil or warm water enemas. Most patients are initially treated with lifestyle modifications, such as scheduled toileting after meals, increased fluid and dietary fiber intake. The next step in the treatment of constipation is the use of an osmotic laxative followed by a stool softener. They need special dietary attention because gastrointestinal function may be altered with advanced age, individual tolerances, their energy intake, and maintenance of a balanced diet with adequate fibre and fluid. There is also a decrease in microflora and metabolic activity. Long-term use of laxatives can lead to fewer bowel movements and maldigestion of food and nutrients.

Keywords: constipation, vibandh, geriatric, ayurvedic dietic.