Hemorrhoids and Constipation in the Elderly
Every living human being has the potential for developing hemorrhoids.
There are certain conditions and lifestyles, however, that carry a greater risk.
We've talked about hemorrhoids in pregnancy, obesity, teens, children, the sedentary, and truckers.
We've discussed the common element involved in almost all hemorrhoids...
that of increased anorectal pressure.
We've talked about symptoms, causes, prevention, diet, fiber, complications, home care, and medical treatment.
This time, we're going to focus totally on hemorrhoids in the elderly.
This population group experiences a concentration of circumstances which contribute to the risk of developing hemorrhoids, and its "right-hand man"...
constipation.
Among these risk factors are: Too many medications: Many elderly people take multiple prescription and over-the-counter medications.
A number of these formulations can cause constipation, such as: antacids with calcium or aluminum, drugs for high blood pressure, depression, and pain, blood thinners, and many more.
Not enough water: There are several reasons for inadequate fluid intake.
Some older folks are on fluid restrictions because of cardiac or renal disease.
Others have cognitive impairment and don't remember to drink fluid.
In some cases, they or their caregivers may hold back on fluid because of difficulty getting to the restroom on time.
Some simply have diminished thirst.
Too little exercise: Many seniors have painful joint conditions and so choose not to participate in exercise programs.
Difficulty in mobility often prevents them from walking even minimal distances.
Others need someone to be with them when they walk.
Since this is often not possible, they just sit.
A sedentary lifestyle is an engraved invitation to constipation and hemorrhoids.
Poor bowel habits: A regular schedule for the elimination of stool is of paramount importance in keeping the bowel healthy.
However, many of the elderly are dependent upon a caregiver to assist them to the bathroom.
The caregiver may not be available at the same time each day, or at the time the urge to empty the bowel first appears.
Establishing regularity is, therefore, not always possible.
Privacy: The senior will often be unable to relax for the passage of stool because of the presence of another person in the bathroom with them, usually a caregiver.
So, they just "hold it".
Body changes: Reduced tone of the muscles of the abdomen, and weak anal sphincter muscles impede timely bowel movement.
In other words, just because the bowel is full and ready to go, natural muscles within the abdomen and rectum may not be doing their part in getting the stool out.
And, the longer formed stool remains in the colon, the more water it loses and the harder and dryer it becomes.
An enlarged rectum caused by chronic constipation does not respond in a normal way to the presence of stool.
Again, the fecal matter stays in the colon where it becomes hard and dry.
Some seniors are immobile and require the use of a bedpan.
This is not a natural position for evacuating the bowel.
Some of the elderly have over-used laxatives because of a chronic constipation and the bowel no longer responds in an appropriate manner.
Chewing difficulties, poorly fitted dentures, cavities, or jaw tightness may restrict the intake of many fruits and vegetables.
Some older folks are preoccupied with their bowels because of chronic constipation.
As a result, they sit on the toilet for too long at a time which increases rectal pressure and predisposes toward hemorrhoids.
If they already have hemorrhoids, it is painful to pass stool so there is a tendency to hold it in, causing the fecal matter to become hard and dry.
Constipation is a recurring problem because each episode is treated as a one-time occurrence.
Ideally, a multi-pronged approach would be in place to address the causes of constipation.
Next time we'll discuss ideas for dealing with these problems.
The approach is not simple...
in fact, it is difficult, and seldom will it be possible to eliminate all factors contributing to the development of constipation and hemorrhoids in the elderly.
However, it is possible to address some of the problems...
and that's what we'll do.
Until next time!
There are certain conditions and lifestyles, however, that carry a greater risk.
We've talked about hemorrhoids in pregnancy, obesity, teens, children, the sedentary, and truckers.
We've discussed the common element involved in almost all hemorrhoids...
that of increased anorectal pressure.
We've talked about symptoms, causes, prevention, diet, fiber, complications, home care, and medical treatment.
This time, we're going to focus totally on hemorrhoids in the elderly.
This population group experiences a concentration of circumstances which contribute to the risk of developing hemorrhoids, and its "right-hand man"...
constipation.
Among these risk factors are: Too many medications: Many elderly people take multiple prescription and over-the-counter medications.
A number of these formulations can cause constipation, such as: antacids with calcium or aluminum, drugs for high blood pressure, depression, and pain, blood thinners, and many more.
Not enough water: There are several reasons for inadequate fluid intake.
Some older folks are on fluid restrictions because of cardiac or renal disease.
Others have cognitive impairment and don't remember to drink fluid.
In some cases, they or their caregivers may hold back on fluid because of difficulty getting to the restroom on time.
Some simply have diminished thirst.
Too little exercise: Many seniors have painful joint conditions and so choose not to participate in exercise programs.
Difficulty in mobility often prevents them from walking even minimal distances.
Others need someone to be with them when they walk.
Since this is often not possible, they just sit.
A sedentary lifestyle is an engraved invitation to constipation and hemorrhoids.
Poor bowel habits: A regular schedule for the elimination of stool is of paramount importance in keeping the bowel healthy.
However, many of the elderly are dependent upon a caregiver to assist them to the bathroom.
The caregiver may not be available at the same time each day, or at the time the urge to empty the bowel first appears.
Establishing regularity is, therefore, not always possible.
Privacy: The senior will often be unable to relax for the passage of stool because of the presence of another person in the bathroom with them, usually a caregiver.
So, they just "hold it".
Body changes: Reduced tone of the muscles of the abdomen, and weak anal sphincter muscles impede timely bowel movement.
In other words, just because the bowel is full and ready to go, natural muscles within the abdomen and rectum may not be doing their part in getting the stool out.
And, the longer formed stool remains in the colon, the more water it loses and the harder and dryer it becomes.
An enlarged rectum caused by chronic constipation does not respond in a normal way to the presence of stool.
Again, the fecal matter stays in the colon where it becomes hard and dry.
Some seniors are immobile and require the use of a bedpan.
This is not a natural position for evacuating the bowel.
Some of the elderly have over-used laxatives because of a chronic constipation and the bowel no longer responds in an appropriate manner.
Chewing difficulties, poorly fitted dentures, cavities, or jaw tightness may restrict the intake of many fruits and vegetables.
Some older folks are preoccupied with their bowels because of chronic constipation.
As a result, they sit on the toilet for too long at a time which increases rectal pressure and predisposes toward hemorrhoids.
If they already have hemorrhoids, it is painful to pass stool so there is a tendency to hold it in, causing the fecal matter to become hard and dry.
Constipation is a recurring problem because each episode is treated as a one-time occurrence.
Ideally, a multi-pronged approach would be in place to address the causes of constipation.
Next time we'll discuss ideas for dealing with these problems.
The approach is not simple...
in fact, it is difficult, and seldom will it be possible to eliminate all factors contributing to the development of constipation and hemorrhoids in the elderly.
However, it is possible to address some of the problems...
and that's what we'll do.
Until next time!