What Should I Do About Constipation and Abdominal Pain?

Constipation is not only a problem that occurs in the elderly, but also a common issue for many young people nowadays. This problem is often caused by poor dietary habits in daily life. Therefore, it is important to change unhealthy eating habits, consume more fresh vegetables and fruits, develop good bowel habits, and avoid using laxatives, which may have counterproductive effects. Constipation in the elderly refers to a decrease in the frequency of bowel movements, along with difficult and dry stool. While normal individuals have bowel movements once or twice a day or once every two to three days, constipated patients have fewer than two bowel movements per week, with difficult and hard stool in small quantities. Constipation is a common symptom in the elderly, affecting approximately one-third of them and significantly reducing their quality of life.

(1) Organic constipation: Treat the underlying disease.

(2) Non-organic constipation:

First, adopt strict non-surgical treatment:

(a) Improve lifestyle to align with physiological bowel movement and defecation patterns. Increase fiber intake and water consumption, establish good bowel habits, and increase physical activity.

(b) Adjust mental state to help establish normal bowel reflexes.

(c) Treat underlying and accompanying diseases to facilitate the management of constipation.

(d) Avoid drug factors as much as possible to reduce the risk of constipation caused by various medications.

(e) Choose medications based on the pathophysiology of constipation. For colon slow-transit constipation, motility agents should be selected, along with appropriate use of bulk-forming laxatives, lubricating laxatives, and stimulant laxatives. Abuse of laxatives should be avoided.

(f) Biofeedback therapy to correct inappropriate and ineffective bowel movements.

(g) Traditional Chinese medicine therapy.

If non-surgical treatment does not yield significant results after a period of time, and special examinations reveal clear pathological anatomy and conclusive functional abnormalities, surgical treatment may be considered. Surgical indications should be carefully evaluated, and appropriate surgical procedures should be selected based on the lesion. When multiple lesions coexist, the main lesion causing constipation should be addressed surgically, while secondary or subsequent lesions should also be addressed.