Qilu TV Station "Everyday Health" column
Moderator: Hello, everyone, my audience, I’m Wang Xi, and welcome to watch the "Healthy Everyday" program. Before the program starts, I have a small reminder to talk to you:
Reminder: Check blood sugar quickly after "the old man loses his teeth"
Everyone knows that when people are getting older, they can easily "get old and lose their teeth." Doctors suggest that for obese and diabetic elderly people, it is best to check blood sugar after tooth loss. Diabetes patients are often accompanied by chronic destructive diseases such as gingivitis and periodontitis, which often affect the stability of the teeth, causing tooth looseness, which in turn induces periodontal infection, and severe cases can cause tooth loss.
The doctor here reminds: If a diabetic has a toothache or swollen gums, don't be busy with complicated periodontal treatment. You must do the overall treatment of diabetes, otherwise it will easily lead to infection. Because diabetes not only has pathological effects on body organs, tissues, cells, etc., it can also cause oral diseases. At the same time, if oral diseases are not well controlled, diabetes will be further aggravated. Therefore, minor illnesses in daily life cannot be ignored, otherwise the consequences of delayed treatment will be serious.
Professor: Hello, host! Hello everyone, audience friends!
Moderator: Friends of the audience, although constipation in the elderly is only a symptom, more and more elderly people in life cause cardiac and cerebrovascular accidents due to constipation. Therefore, constipation is already a health killer that cannot be ignored for the health of the elderly. Today we will talk about the problem of constipation in the elderly with Professor Chen.
Moderator: Professor Chen, when the elderly do self-examination, what is constipation?
Professor: Constipation is a common disease caused by multiple causes. Patients often experience dry stools, difficulty in defecation, or incomplete defecation. When laxatives are not used, the number of times to completely empty the stool is significantly reduced. This situation can be called constipation. The Chinese diagnostic guidelines for constipation also do not make hard and fast rules on the timing of bowel movements. Generally speaking, the number of bowel movements should not be less than twice a week.
Moderator: Professor Chen, normal people have less bowel movements twice a week? You can see that many people are very nervous without defecation for 3 days, thinking that they are constipated.
Professor: Constipation cannot be defined only in terms of time in medicine. For example, people defecate every day, but dry stools, or uncomfortable stools, can be called constipation.
Moderator: Professor Chen, you think everyone is ill for a certain reason. Can you explain physiologically the causes of constipation in the elderly?
Professor: There are many reasons for constipation in the elderly. The first is the age factor. With age, the secretion of digestive enzymes in the elderly decreases, the colon muscles undergo degenerative disease, the smooth muscle tension of the bowel is weakened, the bowel reflexes decrease, the peristalsis slows down, and the stools are dry. Coupled with the decreased muscle strength of the diaphragm, abdominal muscles, levator ani muscle and intestinal smooth muscle in the elderly, it is difficult to assist defecation. These constitute constipation. Second, the food factor is also very important. Some elderly people consume less coarse grains, vegetables and fruits, and some elderly people do not have enough daily total calorie intake, and drink too little water, which reduces the volume of residues in the intestinal cavity, and the residues stay in the intestines for a long time and become dry and hard. , The formation of constipation. Dietary factors are also related to tooth loss in the elderly. Third, the impact of diseases and drugs. The elderly often suffer from chronic diseases, such as the diabetes mentioned by the host, which can also cause gastrointestinal disorders, resulting in constipation or diarrhea. Because of the need for disease treatment, some drugs may be taken for a long time or frequently, which will also inhibit the peristalsis of the intestines, causing the stool to stay in the intestinal cavity for too long and cause constipation. Elderly people with hemorrhoids and anal fissures, because they are afraid of pain and bleeding during defecation, they consciously suppress stool. Over time, the rectum is less sensitive to stool stimulation. In addition, if the stool stays in the intestinal cavity for too long, too much water will be absorbed, and constipation will also occur. Fourth, the problem of living habits. If some elderly people do not have the habit of defecation regularly, or read books and newspapers for defecation, or improper defecation posture, or bad mood changes, they can also induce constipation. Staying in bed for a long time or sitting in a wheelchair all day, with little activity, can also cause constipation.
Moderator: Professor Chen, we have found the cause of constipation. What harm will this kind of disease that we consider to be trivial?
Professor: (Professional question) Studies have found that chronic constipation has a significantly higher incidence of intestinal tumors. This is caused by the abnormal absorption of toxic substances in the intestinal lumen and waste, and the abnormal stimulation of the intestinal mucosa and muscle layer. Due to constipation, the pressure in the intestinal cavity will increase, causing Hirschsprung's disease and megarectal disease. Long-term chronic constipation in the elderly can also cause sigmoid volvulus, colonic diverticulum, rectal, anus fecal ulcers, proctitis, rectal prolapse, ischemic enteritis, hemorrhoid enlargement and bleeding, anal fissure, urethral obstruction and other diseases. Constipation may also cause intestinal obstruction and intestinal perforation. The most worthy of vigilance and attention is that when the elderly force defecation, they can cause sudden changes in cerebral blood flow and coronary blood flow, which can easily cause syncope, stroke, angina, arrhythmia, myocardial infarction, aneurysm or ventricular wall The rupture of the tumor caused sudden death. These are not uncommon in clinical practice.
Moderator: My goodness, it's terrible to hear you say this. Then what methods can we have to prevent or relieve constipation? Let's start with the simplest. First of all, the living habits of the elderly, please remind everyone.
Professor: You can drink a cup of light salt water when you go to bed in the morning. When you go to the toilet and defecate, you should relax and concentrate. Don't read or read the newspaper. At the same time, try to develop a daily defecation habit, such as: 9 o'clock every morning for our regular defecation Time, before 9 o’clock, we can take a walk at home, massage the abdomen, at 9 o’clock, even if there is no need to have a bowel movement, we try to sit on the toilet as much as possible to create a defecation atmosphere, and so on. There is another problem that everyone easily overlooks. People who have been bedridden for a long time are prone to constipation if they use the potty improperly.
Moderator: Oh, Professor Chen reminded me that by saying so, there are relatives around me who have been in bed for a long time, and constipation often troubles them. Do you see how long-term bedpans can prevent or reduce constipation?
Moderator: From the diet, how should we pay attention?
Professor: Some people think that constipation is mainly caused by eating too finely, so it is not advisable to start a long period of coarse tea and light rice. The diet is balanced and comprehensive. It should not be one-sided to emphasize eating more crude fiber. The crude fiber contains insufficient nutrition. Although crude fiber can promote bowel movements, Chinese medicine always says that eating this thing is weak, the intestines are weak, and it is not conducive to defecation. In principle, a scientific diet should include: motility factors, such as high-protein foods such as meat, fish and shrimp, to provide motivation support for defecation; volume factors, that is, proper consumption of crude fiber foods, so that the intestinal volume reaches a certain level, can produce It means, for example, grains include corn, millet, etc., vegetables, celery, onions, etc. Fruits can be considered, apples, pears, and more fungus, mushrooms, etc. Lubricants, namely fats. Moisturizer is also very important. In fact, many people have overlooked the problem of proper drinking.
Moderator: I often hear elderly people say that when they are old, problems will come. It is inevitable to take some medicine. Then, which medicine can induce constipation? (Speaking of seizing common medicine)
Professor: Professional issues (atropine, probensine, doxepin, scopolamine) Some drugs can inhibit bowel movement and cause laxative constipation of the colon. For patients with constipation, it is necessary to find out whether there is any drug-causing factor. If the drug is stopped, the constipation will get better, and the drug that causes constipation should be avoided, otherwise it will aggravate the constipation. There are several drugs that can cause constipation:
● Opioid analgesics, such as codeine, dolantin, morphine, etc., who use these drugs for pain often cause constipation.
● Antidepressants such as imipramine, amitriptyline, alprazolam, fluoxetine (Prozac), etc.
● Antipsychotic drugs such as perphenazine.
● Neuroactive drugs such as anticonvulsant sodium valproate (debajin) and carbamazepine.
● Muscle relaxants such as atracurium, tizanidine (Sonderox), etc.
● Gastrointestinal antispasmodic drugs such as atropine, probensine, etc.
● Antihypertensive drugs such as nifedipine (Xintongding) and amlodipine (Luohuoxi) in calcium channel blockers.
● Chemotherapy drugs such as vinblastine, etc.
● Diuretics such as furosemide (furosemide), etc.
● Aluminum-containing antiacids, calcium, iron, etc.
Wang Xi can help you ask:
1. A friend whose mobile phone end number is 136**5660 said that his father suffers from hemorrhoids, anal fissures, and severe constipation. Every time he has a bowel movement, he will cause pain and bleeding. What should I do in this situation?
2. A friend whose mobile phone end number is 138**6031 asked his spouse who suffers from severe heart, lung disease, advanced tumor, long-term bedridden or wheelchair use, little activity, and severe constipation. Ask how to improve this situation ?
Professor: There is a famous saying in Chinese medicine that the lungs and the large intestine are on the outside, and lung disease can cause abnormal bowel movements. Chinese medicine also emphasizes that prolonged lying injures seven and prolonged sitting injures the flesh. Therefore, the constipation of this patient you mentioned is a deficiency syndrome from the point of view of deficiency and reality. It should assist righteousness, and the diet should be adequately nutritious. Do not use stimulant laxatives for the medicine. You can use traditional Chinese medicine that can strengthen the body and relax the bowels.