DIGESTIVE-ENDOCRINE PATHOLOGY
CONSTIPATION
It is not a
disease but rather a symptom of some other problem. Constipation is defined as
hard, dry stools that are difficult to pass.
Causes of
the constipation:
- Obstructive, cancer, hernias…
- Diet poor in fibre, anal fissure, haemorrhoids, irritable colon.
- Laxative, antidepressant, antacid, opiate.
- Diabetes, uraemia, hypothyroidism.
- Trauma, Parkinson, dementia, depression.
Complications
of constipation
- Faecal impaction:
- Anal fissure:
- Circulatory disorders:
- Faecal incontinence:
- Urinary retention.
Treatment and
nursing intervention:
Dietary
treatment should be the first therapeutic step in the management of constipated
patients. A diet rich in fibre is associated with an increased frequency and
weight of stools.
Fibre works
by increasing faecal bulk and decreasing intestinal transit time by stimulating
bowel motility.
To achieve
normal bowel function is advised to eat a moderate amount of fibre and plenty
of fluids and physical exercise regularly.
Insoluble fibre
is more advisable since it captures more water, which results in a greater
increase in faecal mass and acceleration of intestinal transit.
It is also
important to educate the patient to gain or regain the habit of defecating
regularly, preferably every day.
Regular
physical exercise and particularly those exercises that strengthen the
abdominal pressure and pelvic floor are particularly beneficial for the
treatment of constipation and faecal incontinence
OSTOMY
Stoma:
surgical creation of a temporary or permanent opening which brought about the digestive
tract to the exterior through the abdominal wall.
The
objective of dietary recommendations in the elderly ostomised is to regulate
intestinal transit and prevent diarrhea and constipation, as well as reset a
good nutritional status
Types of stoma
FECAL INCONTINENCE
Is one of
the principal geriatrics syndromes that affects in quality of life and
overloading to the principal career. The impact isn’t only physical, also
economic and psychosocial.
Types of faecal incontinence:
Minor:
- Soiling (get dirty the
underwear): haemorrhoids, diarrhea, immobility, dementia and depression.
- Gas incontinence: avoid
flatulent food and carbonic drinks.
- Urgency to defecate: they feel
the dregs in the rectum but they aren’t able to maintain the incontinence
until go to the toilet.
Greater:
- Lesion in the pelvic floor.
- Drugs: laxatives and
antibiotics.
- Rectum cancer.
- Neurologic alterations:
central, spinal cord, and peripheral.
Risk factors:
- Urinary incontinence.
- Immobility.
- Previous neurologic diseases.
- Cognitive alteration.
- More than 70 years.
Nursing
care:- Lifestyle modifications.
- Treatment of perianal discomfort: avoid soap, toilet pape. Wash with warm water and cotton.
- Treatment of faecal impaction
- Modification of architectural barriers
- Uses of absorbent
DYSPHAGIA
Difficulty
to swallow the liquids or solids elements because one or more phases of
swallowing are affected.
Treatment
- Present the food in little
quantity.
- Not mix solids with liquids
consistency.
- Avoid the contact the spoon
with the spoon
- Relax ambient, not force.
- Flavour the food with
nutrients, proteins…
- Respect taste and experience new flavours
1.
Gloria Hoffmann Wold.
Basic Geriatric Nursing. 5th ed. Milwaukee , Wisconsin
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