By Ranjit N. Ratnaike
This textbook offers a pragmatic and entire account of the administration of diarrhea and constipation within the aged. those universal problems usually are not just a burden in themselves yet are usually manifestations of a extra critical underlying disorder; therefore, potent prognosis and remedy are necessary to enhance caliber of lifestyles. The chapters contain updates on pathogenesis, analysis and therapy, and spotlight the vulnerability of the aged to diarrhea and its issues. The etiology of diarrhea is defined, together with infections of the gastrointestinal tract, and systemic illnesses of which it's a symptom. The authors characterize various disciplines: immunology, body structure, microbiology, meals, and psychiatry. The publication is aimed toward geriatricians, common practitioners, gastroenterologists, and allied medical experts.
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Extra resources for Diarrhoea and Constipation in Geriatric Practice
Ratnaike Clinical assessment of dehydration in the elderly • • • • • • • Although dehydration is a frequent problem in the elderly, the criteria for the clinical assessment of this problem are meagre, in contrast to the extensive literature on assessment criteria in paediatric populations. Gross et al. (1992) conducted a prospective, correlational study with 55 subjects aged 60 or older, and concluded that the conventional signs and symptoms (derived from younger patients) are unreliable markers of dehydration in the elderly patient.
Field, pp. 115–38. New York: Elsevier. 4 History and physical examination Ranjit N. Ratnaike Introduction • • • • 31 A well taken history and careful physical examination provide substantial information to establish a working diagnosis. History taking from an elderly patient is more diﬃcult as compared with younger adult patients. A thorough medical evaluation is complicated and time consuming in the elderly patient who has a longer history of illness and many associated medical problems. At the initial stage of the clinical interview there is much to be gained by establishing: the patient’s normal bowel habit what is meant by diarrhoea whether the problem is spurious (overﬂow) diarrhoea due to constipation whether there is faecal incontinence.
In the colon further absorption occurs. The right side of the colon (embryologically distinct from the left side) is the major site of absorption. The conversion of ﬂuid intestinal contents to faeces begins; both Na and water are avidly absorbed. The concentration of poorly absorbed ions such as Mg, Ca, PO4 and SO4, if present, is increased due to ﬂuid absorption. At a suﬃciently high luminal concentration these ions act as osmotic agents and their role in the pathogenesis of diarrhoea is discussed later in this chapter.