老年人慢性便秘

Chronic Constipation in the Elderly

林詩淳(Shih-Chun Lin) ； 蔡坤維(Kun-Wei Tsai) ； 陳妙文(Miao-Wen Chen) ； 辜美安(Malcolm Koo)

《源遠護理》 12卷3期 (2018/11) Pp. 54-59

https://doi.org/10.6530/YYN.201811_12(3).0007

摘要

便秘在老年人是一種相當常見的症狀，往往由慢性疾病和藥物使用，加上飲食改變和活動量減少等多重原因所造成。當護理人員遇到老年人病患主訴便秘症狀時，須了解發生便秘的主因。針對老年人慢性便秘症狀應首先進行評估，包括病史和理學檢查，排除因其它疾病導致的繼發性便秘，接著給予患者膳食纖維和水分的攝取量、活動量及養成良好排便習慣等生活型態的衛教。需要時，可使用膨脹型瀉劑和高滲透壓型瀉劑等藥物。若藥物治療仍無法改善便秘的情況，應會診腸胃專家進一步檢查。便秘的症狀本身一般不致危害生命，但可影響老年人的生活品質、並增加醫療成本。因此，臨床護理人員應針對老年人個別的情況，給予切合的保健教育以預防便秘並提供安全有效的處置便秘方法。

關鍵字

便秘 ； 護理人員 ； 衞教 ； 老年人

並列摘要

Constipation is a fairly common symptom among elderly patients. It often has multiple etiologies, such as chronic diseases, medication use, changes in dietary habit, and reduced activity levels. Nurses should try to explore its primary causes when elderly patients complain of constipation. An initial assessment should include a complete medical history and a physical examination to exclude other secondary cause of constipation. Health education on lifestyle adjustments, including dietary fiber and fluid intake, increase in physical activity, and establishment of a good bowel habit. Medications such as bulking agents and osmotic laxatives should be used as appropriate. If the use of medications is unable to improve the symptoms of constipation, patients should be referred to gastrointestinal consultation for further investigation if indicated. Generally, constipation is not a life threatening condition, it can affect the quality of life and increase medical care expense. Clinicians should provide elderly patients individualized health education on the prevention of constipation, and also safe and effective treatment of constipation.

並列關鍵字

constipation ； nursing staff ； health education ； elderly patients

參考文獻

American Gastroenterological Association, Bharucha, A. E., Dorn, S. D., Lembo, A., & Pressman, A. (2013). American Gastroenterological Association medical position statement on constipation, Gastroenterology, 144(1), 211-217. doi:10.1053/j.gastro.2012.10.029

Belsey, J. D., Geraint, M., & Dixon, T. A. (2010). Systematic review and meta analysis: Polyethylene glycol in adults with non-organic constipation. International Journal of Clinical Practice, 64(7), 944-955. doi:10.1111/j.1742-1241.2010.02397.x

De Giorgio, R., Ruggeri, E., Stanghellini, V., Eusebi, L. H., Bazzoli, F., & Chiarioni, G. (2015). Chronic constipation in the elderly: A primer for the gastroenterologist. BMC Gastroenterology, 15, 130. doi:10.1186/s12876-015-0366-3

Emmanuel, A., Mattace-Raso, F., Neri, M. C., Petersen, K. U., Rey, E., & Rogers, J. (2017). Constipation in older people: A consensus statement. International Journal of Clinical Practice, 71(1), e12920. doi:10.1111/ijcp.12920

Gallegos-Orozco, J. F., Foxx-Orenstein, A. E., Sterler, S. M., & Stoa, J. M. (2012). Chronic constipation in the elderly. American Journal of Gastroenterology, 107(1), 18-25, doi:10.1038/ajg.2011.349