Although the frequency of bowel movements varies from individual to individual, constipation can quickly lead to health problems. If there is no bowel movement over a long period of time, in extreme cases the feces are transported back to the stomach and vomited from there. This is the case, for example, with intestinal obstruction. If the intestinal wall can no longer withstand the pressure of the intestinal contents, the feces pours into the abdominal cavity and leads to life-threatening infections there.
What is constipation prophylaxis?
Constipation prophylaxis includes all measures designed to prevent constipation. Constipation prophylaxis includes all measures that serve to prevent intestinal constipation. It is present when bowel emptying does not occur at least every 3 days or excessive pressing is necessary during defecation. It is also associated with a hard lower abdomen and pain when pressure is applied to the lower abdomen. If the breath smells of feces or there is even vomiting of bowel movements, immediate medical intervention is necessary (suspect intestinal obstruction!). Constipation prophylaxis is intended to promote natural bowel movement and ensure more frequent bowel emptying so that the general health of the patient/patient in need of care improves. Before initiating them, the cause of the constipation should be verified. In some patients, certain medications are to blame. Sleep, sedatives, and pain medications often have an anti-digestive effect. For nursing home and hospital patients, there is often the added shame of having to defecate in a bedpan or go to the toilet right next to fellow patients. Restricted bowel movements also often occur after abdominal surgery not performed by endoscope and when fluid and electrolyte balance is disturbed. Diseases such as paralysis, Parkinson’s disease, hemorrhoids, colon cancer and depression can also cause constipation. Constipation prophylaxis involves a variety of measures. Only when natural remedies fail to achieve the desired outcome should laxatives be administered.
Function, effect, and goals
The goal of constipation prophylaxis is to counteract (chronic) constipation. Sometimes just a few measures are sufficient to promote bowel emptying. As a general rule, the patient should drink at least 2 liters of fluid daily to soften the stool. Sufficient exercise also promotes natural bowel movement. A high-fiber diet results in greater fecal volume and stimulates peristalsis. This includes whole grain products, nuts, vegetables and fruits. It is essential to drink plenty of fluids with these foods, as they swell strongly. It is also advisable to always have enough time for bowel movements: If the person feels abdominal pressure, it is essential to go to the toilet immediately, since a postponed bowel movement leads to hardening of the intestinal contents. It is best to get into the habit of regular toilet time. A regular rhythm of life and meals that are always taken at the same time also help. Flaxseed, Indian psyllium and wheat bran, taken with plenty of liquid, also have a supportive effect. If it is not possible for the constipated patient to do without anti-digestive medication, it is advisable to take a mild laxative in a low dosage. Special measures to bring about bowel emptying include moist warm abdominal compresses, abdominal exercises, deep abdominal breathing and bowel massages. The abdominal press is performed 5 times in a row after the patient wakes up: The patient pulls in the abdomen for 10 seconds and then slowly expands it again. In colon massage, the supine patient/caregiver massages the colon for 5 minutes, starting on the right side of the lower abdomen. If even these specific constipation prophylaxis measures do not help, the patient/caregiver must be given oral laxatives or suppositories. Alternatively, a bowel enema or – in very severe cases – bowel evacuation may be performed.
Risks, side effects, and hazards
If constipation occurs when the affected person leads a regular life with a healthy diet and sufficient exercise, it is sometimes a symptom of a serious illness. Therefore, the affected person should consult a trusted physician as soon as possible. People with limited mobility (physically disabled, bedridden) are at particularly high risk of chronic constipation.In their case, the nurse should ensure that the bowel is emptied as often as it was before hospital or home admission. The stool should also be checked regularly for abnormalities in color, consistency and possibly composition. Overflow incontinence – small amounts of feces and mucus leaking uncontrollably from the bowel – should be avoided at all costs. Other signs of chronic constipation may include foul breath, a coated tongue and loss of appetite. It becomes particularly critical if the breath smells of feces or feces are vomited. In this case, the emergency physician should be called. For nursing home residents who can still move around on their own, constipation prophylaxis usually consists of informing them which foods they are better off avoiding to prevent constipation and which they should prefer to eat. Caregivers should make sure patients don’t “forget” to drink plenty of fluids – something that often happens in the elderly – and encourage them to visit the toilet regularly. Toileting at the same time each day helps to remind them of the need to empty their bowels. For immobile patients, mobilization can be done in bed (abdominal exercise, bed exercises). People with limited mobility and patients who often “forget” to drink should generally not be given flaxseed, Indian psyllium and wheat bran, as they will otherwise promote constipation. Instead, it is recommended to give yogurt, buttermilk, crushed prunes and lactose. The latter sweetens the food and has a laxative effect at the same time.
