Alzheimer's Disease and Constipation: How to Help Your Loved One?

Does your mother, father, or loved one with Alzheimer's disease have difficulty going to the toilet? Or is she not having enough bowel movements every day? In fact, constipation is common in about half of people over the age of 65. As their memory and communication skills change, it can be difficult for them to talk about these changes in their bodies. Therefore, it is very important for us to be aware of this in order to care for them.

How do you recognize constipation?

A person can only be diagnosed with constipation if they have at least two of the following symptoms. It is very important to pay attention to these.

Emergencies that require immediate medical attention

Sometimes constipation can be a sign of something more serious. If you have any of the following symptoms, take your loved one to a doctor or the hospital's emergency department (ETU) without delay.

• Severe stomach pain (especially if the pain gets worse after eating).
• If you see any swelling in your stomach.
• Blood in the stool, or if the stool is black, tarry, or dark red.
• If you have not had a bowel movement for more than a week and start vomiting .
• If you have a fever over 101°F (38.3°C) .

If you have these symptoms, talk to your doctor.

Even though these are not emergencies, it is very important to seek medical advice.

• If the constipation has just started or is now more severe than before.
• If you go several days without a bowel movement and then have watery stools, similar to diarrhea (this could be a sign of a bowel obstruction).
• If you constantly feel pain or discomfort in your stomach.
• If you have lost more than 10 pounds (about 4.5 kg) of weight for no reason.
• If you feel more tired than usual or sleep more .
• If you have a low-grade fever for more than 48 hours.

What causes constipation?

There are several causes of constipation. Some are normal things that happen with aging. Others can be caused by medications taken for medical conditions.

Causes caused by medical conditions and medications

• Certain medications: things like painkillers (especially opioids), calcium pills, and antidiarrheals.
• Aging: As you age, the muscles in the rectum and anus that help you pass stool weaken and the walls harden.
• Other medical conditions: Conditions such as thyroid problems, diabetes, or nervous system diseases (e.g. Parkinson's disease). When these conditions are properly treated, constipation can also be cured.

Causes that can be cured with lifestyle changes

• Low-fiber diet: Avoiding eating fiber-rich vegetables, fruits, and bran-rich grains (buckwheat, barley, oats).
• Drinking less water: Not drinking enough fluids (water, soup, fruit juice) during the day.
• Lack of exercise: Slowing down of bowel movements due to lack of physical activity.

Complications due to constipation

If constipation is not properly taken care of, some complications can occur.

1. Fecal Impaction

This is when a hard stool gets stuck in the lower part of the intestine. Only liquid stool can pass through it. Therefore, it looks like diarrhea. If your loved one has been constipated for several days and suddenly has diarrhea, it could be due to a stool blockage. Do not give them medicine for diarrhea at this time. It will only make the condition worse. Call your doctor immediately.

2. Hemorrhoids

Hemorrhoids are swelling of the blood vessels around the anus caused by straining to have a bowel movement. Although they are not serious, they can be painful. You may also notice a few drops of blood after a bowel movement. If you notice even a small amount of blood in your stool, tell your doctor.

3. Anal Fissure

When a hard, large stool passes, the skin in the anus can tear or break. These are usually painful and may also bleed a little. Even if you can't see hemorrhoids, if there's a little blood on the toilet paper, it could be an anal fissure. These usually heal on their own. But if the pain and bleeding last more than 7-10 days, see a doctor.

Things you can do at home to prevent constipation

There are some simple things you can do at home to help your loved one overcome this discomfort.

• Feed fiber-rich foods: Help your child eat about 20-35 grams of fiber per day. Include foods like spinach, kale, plantains, bananas, papaya, oats, and cranberries in their diet.
• Give plenty of fluids: Give your child about 1.5 - 2 liters of water a day. Not just water, but also soups, porridge, and fresh fruit juices are good.
• Light exercise: Encourage them to do something like a short walk if possible. This will stimulate bowel function.
• Establish a toilet habit: Tell them to go to the toilet shortly after a meal and wait a while. This is because the bowels are naturally active after eating.
• Record bowel movements: Keep a record of how many times a day and how many times a week your child usually has bowel movements. This will help you identify constipation and choose the best time to take him to the toilet.
• Give medication only on medical advice: Although laxatives ( laxatives ) are available from pharmacies, never give them without consulting a doctor. Giving them without medical advice can be dangerous, especially for someone with kidney, liver, or muscle disease.