What Are the Most Common Causes of Diarrhea In the Elderly?

Studies have shown that this is a common functional disease, irritable bowel syndrome, with clinical manifestations of habitual diarrhea. The disease is caused by imbalances in the "brain-gut axis" caused by heavy work stress and excessive brain fatigue. Office buildings and white-collar workers are most vulnerable to this disease. For this reason, the experts reminded that the treatment must be "both body and mind", and it is important to maintain a comfortable mood.

Habitual diarrhea

Overview of habitual diarrhea

In the autumn, the air becomes cold, and the number of diarrhea patients increases. According to statistics from intestinal outpatient clinics of major hospitals, the majority of patients with diarrhea due to improper diet and coldness account for the majority, and those with repeated diarrhea and chronic diarrhea increased the most. The doctor said that these patients looked "tensed", had abdominal pain, urgency, and frequent defecation, but the laboratory tests showed no virus and bacteria, but they did not heal for a long time, showing habitual diarrhea.

High incidence of habitual diarrhea

Modern medicine has given habitual diarrhea a specialty name-irritable bowel syndrome. It is different from infectious diarrhea, and it is virus-free to detect bowel movements. It is also different from colitis and does not cause intestinal inflammation. The important symptoms of this disease are: diarrhea, frequent loose stools, and often a sense of emergency discharge of stool; constipation, difficulty or reduced bowel movements; or diarrhea, constipation alternately appear. According to the survey, it is a functional disease with the highest incidence among modern populations, with an incidence of 15% of the population, and patients account for more than 1/3 of gastrointestinal specialist clinics.

Etiology of habitual diarrhea due to dysfunction

Irritable bowel syndrome (IBS) is common in patients with abdominal cramps, abdominal distension, and changes in bowel habits. Some patients have symptoms of constipation (difficulty or reduced bowel movements), others have diarrhea (frequent loose stools, and often have a sense of emergency bowel movements), and some have experienced diarrhea and constipation. Sometimes the patient has spastic abdominal pain and wants to excrete stool but cannot excrete it. In the past, there have been many medical names for the performance of irritable bowel syndrome, such as mucoid colitis, allergic colitis, colon spasm, intestinal spasm, and functional bowel disease. Most of these names are inaccurately defined. For example: colitis means inflammation of the colon, but irritable bowel syndrome does not cause inflammatory lesions.

The cause of irritable bowel syndrome is unclear, and doctors call it dysfunction because no organic disease symptoms were found during colon examinations. The disease can cause great discomfort and pain to patients, but it does not cause permanent colon damage or distress; patients may be afraid to participate in social activities, go out to find work, or even go out for a short trip. However, some patients with irritable bowel syndrome can control their symptoms by eating, regulating nervousness, and taking medication prescribed by a doctor.

Colon sensitivity is too high

Irritable bowel syndrome is often thought to be caused by emotional conflict or stress because doctors don't find organic lesions. However, research has shown that, although depression, anxiety, and stress in life can aggravate the condition, other factors are also important. Studies have found that colonic muscles in patients with irritable bowel syndrome can experience spasms under mild stimuli. Colonic sensitivity and responsiveness are higher than normal people, so they respond to stimuli that do not affect most people.

Medical studies have shown that common events such as eating, flatulence, and stagnant colon can cause allergic reactions in patients with irritable bowel syndrome. Certain drugs or foods may trigger colon cramps in some people. Intestinal spasms sometimes delay the excretion of feces and cause constipation. Chocolate, dairy products, or large amounts of ethanol are often the cause. Caffeine can cause many people to loosen stools, but it is more likely to affect people with irritable bowel syndrome. Studies have also found that women with irritable bowel syndrome experience more severe symptoms during menstruation, suggesting that fluctuating hormone levels can aggravate the symptoms of irritable bowel syndrome patients.

Habitual diarrhea pathology

Rotavirus infection is usually the main cause of diarrhea, and many people don't know exactly how to prevent this type of rotavirus infection. In fact, this rotavirus usually breeds and spreads in the fall. Therefore, especially in the summer, we must pay attention to it, we must take good measures to keep warm, and do not allow rotavirus to have any room to survive. Generally speaking, children's resistance to rotavirus is weak, and their bodies can't withstand such toss. Because children's immune function is still weak, they cannot stand the serious invasion of external viruses. ^[1]

Prevention of habitual diarrhea improves diet and reduces symptoms

The cause of irritable bowel syndrome is unknown, and doctors can only call it dysfunction. The disease can bring to patients

Improve your diet-beans Great discomfort and pain. After treatment, you may relapse without notice. However, symptoms can be controlled by improving diet, regulating stress, and taking medication prescribed by your doctor.

Many people complain that their symptoms occur after meals and under stress and anxiety. Medical research has found that eating can cause colon contraction, which usually occurs 30 to 60 minutes after a meal, causing excitement of bowel movements. In some patients with irritable bowel syndrome, this excitement may come quickly and be accompanied by With abdominal pain, intestinal cramps and diarrhea. The intensity of this response is often related to the number of calories in the food, especially the fat content. Any form of fat in animals and vegetables is a strong source of colon contraction. Life stress can also cause colon cramps in some patients with irritable bowel syndrome, a process that has not been fully understood. Experts point out that the colon is dominated by the nervous system, and a healthy mental state and reduced stress (such as relaxation exercises) can alleviate the symptoms of irritable bowel syndrome. But this does not mean that irritable bowel syndrome is a result of personality splitting. Irritable bowel syndrome is caused at least in part by colonic motor and sensory disorders.

For many people, eating the right foods can reduce the symptoms of irritable bowel syndrome. Before adjusting your recipe, it's a good idea to keep a diary of which foods can worsen your symptoms. You can ask some diet experts, they will provide suitable

Improve your diet-fruits Recipe for you. For example, if dairy products can aggravate your symptoms, you can eat less of these foods. Lactic acid is easier to tolerate because it provides bioactive ingredients that contain lactase, which enzymes can digest glycogen in dairy products. In addition, in many cases, dietary fiber can reduce the symptoms of irritable bowel syndrome. Cereals, beans, fruits, and vegetables are rich sources of fiber. High-fiber foods slightly expand the colon and prevent progressive intestinal cramps. Fiber keeps water in the stool and prevents hard stools. High-fiber foods can cause flatulence and bloating. These symptoms will soon disappear within a few months after the body adapts to these foods. More meat can cause cramping pain and diarrhea in patients with irritable bowel syndrome. Reducing meat intake and small meals can help reduce symptoms.

Patients are susceptible to diarrhea when they are cold. They should not eat watermelon, cold drinks, and fried foods that easily cause diarrhea. But spleen foods such as yam, lentils, lotus heart, lily, red dates and other foods nourish the intestines and spleen, and can stop diarrhea. Office building crowds need to rest their minds. Relaxing the nerves can also reduce symptoms.

Recurrent episodes of habitual diarrhea

It is important to recognize that there are differences in bowel function between normal people. The range of normal stools can even be three times a day or twice a week, but it should be formed without hardening, bloodless, and excreted without spasmodic pain and pain. The clinical manifestations of irritable bowel syndrome patients are non-specific, have a long course and recurrent episodes, and are generally divided into 4 types: diarrhea type, constipation type, diarrhea constipation alternating type and mucus type.

Diarrhea patients mainly show diarrhea, many times a day or even more than 10 times, often having multiple defecations after breakfast, rarely happening at night and during sleep, and are closely related to mental factors and emotional changes. Mental stress can easily induce defecation; Patients with constipation type have a small amount of feces and difficulty in defecation, 1-2 times a week, and occasionally once every 10 days, often accompanied by abdominal pain or bloating, hard stools, or spherical, sometimes thin stools, and mucus on the surface; some people have constipation Diarrhea and diarrhea can occur alternately. Constipation and diarrhea usually have spasmodic pain, and sometimes patients defecate with mucus. Irritable bowel syndrome may also have esophageal and gastric manifestations such as esophageal obstruction, nausea, post-sternal burning, snoring, and fullness, as well as autonomic nervous system disorders such as palpitation, fatigue, sweating, and insomnia. But gastric bleeding, fever, weight loss, and persistent abdominal pain are not signs of irritable bowel syndrome and may be signs of other diseases.

There is no standard treatment for habitual diarrhea

Irritable bowel syndrome has complex symptoms, so there is no standard treatment. It is usually the doctor's care to rule out other more serious organic lesions before making a diagnosis. The doctor will make a complete medical history record, including a detailed description of the symptoms, a complete physical examination and laboratory tests. Such as fecal specimens to perform occult blood tests, routine X-ray barium penetration, and fiber bowel scopes can help rule out organic lesions. Doctors may give antidiarrheal or laxative drugs according to the patient's diarrhea or constipation. If the patient has mental anxiety, they will also give sedative anti-anxiety drugs or propose some treatment plans such as lifestyle improvement.

Nursing measures for children with diarrhea

Strict disinfection and isolation for habitual diarrhea

Prevent infection from spreading according to intestinal infectious diseases, isolate at the bedside, wash hands carefully before and after nursing children to prevent cross infection.

Habitual diarrhea according to the condition, supplement fluid

(1) Oral rehydration: For children with mild or moderate dehydration and no vomiting or vomiting that is not severe and can be taken orally, children are encouraged to take a small number of oral ORS rehydration salts (for the formula, see Chapter 5, Section 3).

(2) Intravenous fluid:

Establish a venous access to ensure that the fluid is input as planned, especially those with severe dehydration, must replenish blood volume as soon as possible (30 minutes).

According to the principles of salt first, sugar first, concentration first, then light, fast first, then slow, see the principle of urinary potassium supplementation. The potassium supplementation concentration should be less than 0.3%, and the total daily potassium supplementation time should not be shorter than 6 to 8 hours. Direct intravenous bolus.

Record the infusion volume every hour. The infusion rate must be adjusted according to the condition, and the first urination time after rehydration must be known to estimate the effect.

(3) Correctly record the amount of in / out of 24 hours.

Closely observe the condition of habitual diarrhea

(1) Monitoring body temperature changes: Children with excessive body temperature should be given plenty of water, wipe out sweat, reduce clothing, eye pillows, and other physical measures, and do oral and skin care.

(2) Monitor the manifestation of metabolic acidosis: when the child has deep breathing and is debilitated. When the lips are red, blood pH and CO2CP decrease, they should be reported to the physician and corrected with alkaline drugs.

(3) Observation of hypokalemia: often occurs when the dehydration is corrected after infusion, when the child is found to have general weakness, no crying or crying, weak feeding, low muscle tone, slow response, nausea, vomiting, abdominal distension and auscultation. Bowel sounds weakened or disappeared, heart sounds were dull, ECG showed flat or inverted T waves, obvious U waves, S-T segment shift down and (or arrhythmia, suggesting the presence of hypokalemia, and potassium should be added in time.

(4) Determining the degree of dehydration: By observing the clinical manifestations of the child's consciousness, spirit, skin elasticity, depression in the orbit of the forehead, body temperature and urine output, etc., estimate the degree of dehydration in the child, and at the same time, observe the dynamic observation of the fluid Whether dehydration symptoms have improved.

(5) Pay attention to the changes in stool: observe and record the frequency, color, traits, and amount of stool, make a dynamic comparison, and provide a reliable basis for the infusion program and treatment.

Habitual diarrhea

Children with diarrhea have digestive dysfunction. According to the condition of the child, reasonable diet can be arranged to reduce the burden on the gastrointestinal tract and restore digestive function. Generally, you can fast for 4 to 6 hours (except for breastfeeding) during the period of supplementary cumulative loss. After the number of diarrhea decreases, give a liquid or semi-liquid such as porridge, noodles, and small meals. As the condition stabilizes and improves, gradually transition to A normal diet. Disaccharide enzyme deficiency. It is not advisable to use sucrose and suspend milk.

Habitual diarrhea hip care

Choose a soft cloth diaper, change it frequently, wash the buttocks with warm water after each use and wipe dry. Apply 5% rubbing acid ointment or 40% zinc oxide oil to the red area of the skin and massage for a while to promote local blood circulation. Avoid using airtight plastic cloths or blankets to prevent diaper dermatitis.

Health education for habitual diarrhea

Diet hygiene (1) Guide rational feeding: Promote the advantages of breastfeeding and avoid weaning in summer. Gradually add complementary foods on time, and avoid adding several complementary foods at the same time to prevent sudden changes in food, partial food, and diet structure.

(2) Pay attention to food hygiene and cultivate good hygiene habits: pay attention to fresh food, cleanliness and disinfection of utensils to avoid intestinal infections. Educate children to wash their hands before and after meals, and to cut their nails frequently.

(3) Enhance physical fitness: Early treatment should be taken when malnutrition and morbidity are found, and appropriate outdoor activities.

(4) Pay attention to climate change: prevent cold or overheating, keep warm in winter and drink plenty of water in summer.

Prevention of habitual constipation in elderly with diarrhea

After long-term research, experts have found that the following two approaches can be changed:

Eat more crude fiber foods for habitual diarrhea

Crude fiber is a continuous stimulating factor for the intestinal muscle, which can promote intestinal peristalsis, shorten the time for fecal stagnation to stay in the large intestine, and make the stool smooth. For the elderly, due to tooth loss and inconvenience in chewing, they prefer to eat low-residue and fine foods. This will cause the lack of crude fiber and constipation will easily occur. It was found in the survey that the elderly who often eat celery, spinach and bamboo shoots. About 7% of constipation occurs, and 63% of elderly people who regularly eat apples, raw pears and other rich in fiber are not constipated. Among elderly people with constipation, only 28% eat fruit. This fully illustrates how important crude fiber is for the elderly. Therefore, the elderly should eat more crude fiber foods such as fruits and vegetables.

Habitual diarrhea strengthens physical exercise

With increasing age, the chance of constipation increases for two main reasons:

1. It is that the digestive glands of the elderly gradually shrink and degenerate, the secretory function is reduced, and the intestinal muscles are weak and weak;

2. It is the weakness of the intestinal muscle contraction, the fecal mass in the large intestine cannot be pushed, and the stagnation time is prolonged, so that it will be resolved once in a few days. But this is only one aspect of the problem. Why do some elderly people not have constipation? There are other reasons here. Studies at home and abroad have found that elderly people who lack exercise can find accumulation of fecal mass in the left half of the colon under x-ray irradiation, but in the elderly who have exercise habits, no accumulated fecal accumulation in the colon Piece. Through investigation, we have confirmed this situation, constipation in the elderly without exercise habits accounted for 40%, while only 20% of the elderly who insist on exercise. Especially those elderly who are bedridden, such as stroke paralysis and femoral neck fracture, are more likely to cause constipation. For this reason, we hope that the elderly can exercise as much as they can to reduce the possibility of constipation.

In addition, we found in the survey that 70% of the elderly rely on laxatives for laxative use. If these stimulant laxatives are repeatedly used for a long time, they can damage the nerves and blood vessels in the rectal muscles and eventually cause sphincter relaxation and fecal water outflow. The result for the "diarrhea-causing colon" is greater pain. The elderly should try not to use or reduce laxatives. When necessary, use alternately, do not use a laxative.

In addition, the elderly are prone to some diseases due to long-term constipation, which needs to be guarded against. Such as colon cancer caused by constipation, hemorrhoids, anal fissure, anal fistula, these are minor diseases, but improper treatment can cause secondary infections. Patients are afraid to defecate on time because of pain. Over time, the feces staying in the rectum will become dry and hard feces, which will make the lower abdomen bloated and uncomfortable. Therefore, the elderly should treat the diseases around the anus in time to prevent the occurrence of constipation.

Habitual diarrhea

Prolonged emotional tension and anxiety are currently recognized as the main triggers of irritable bowel syndrome. Studies have shown that the human intestine is related to the brain. Excessive fatigue of the brain can easily cause brain-gut axis imbalance, cause spasms of colon muscles under slight stimulation, and cause diarrhea.

In addition, chocolate, dairy products or a lot of coffee and alcohol that fashionable office workers like to eat are also the causes of the disease. Studies have also found that women with irritable bowel syndrome experience more severe symptoms during menstruation. Irritable bowel syndrome is a functional disease. At present, symptoms can only be controlled by improving diet, regulating nervousness and taking medications, but it will recur after a little careless treatment. Zhang Zhiguang suggested that patients with irritable bowel syndrome should learn to relax, while eating more cereals, beans, fruits, and crude fiber vegetables, so that the colon slightly expands and prevents intestinal irritation. Yam, lentils, lotus hearts, lilies, red dates and other foods that nourish the intestines and spleen have antidiarrheal effects, and you can eat more.