88 year old suffering from constipation. Please help.

Question

Hello doctor,

An 88 year old woman approaches the pharmacist seeking a recommendation. She has been suffering from constipation for the past several weeks and has not found relief with the remedies she has tried, including eating prunes and using a daily fiber supplement. On reviewing her pharmacy profile, the pharmacist confirms she is taking multiple long-term medications including the one to treat hypertension, diabetes, thyroid disease, osteoporosis, and asthma. What can the pharmacist recommend to alleviate this patient’s acute constipation and prevent recurrence?

Answer 1

Hi,

Welcome to icliniq.com.

You have mentioned many drugs that can cause constipation by reducing intestinal peristalsis or by reducing the secretion into colon. For example, beta blockers used for hypertension can reduce the colon peristalsis and result in constipation.

So, in this case, we need to see the drug list whichever is already consumed by the patient and can replace it with other drugs which never cause constipation. This will give long-term relief and should be done strictly by the physician, not by the pharmacist.

In order to relieve the constipation instantly, pharmacist can give Bisacodyl (Dulcolax) or Senna (stimulant purgative). This should not be taken daily.

If the old age patient is bedridden, then better choice is enema with Glycerine or Liquid Paraffin by oral.

To prevent recurrent constipation, advice Isabgol or Methylcellulose (fibers) daily at night.

For further information consult a pharmacologist online.