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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
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Fecal Incontinence in the Elderly.

Trisha Pasricha1, Kyle Staller1

  • 1Division of Gastroenterology, Massachusetts General Hospital, Wang 5, Boston, MA 02114, USA; Department of Gastroenterology, Massachusetts General Hospital, 165 Cambridge Street, CRP 9, Boston, MA 02114, USA.

Clinics in Geriatric Medicine
|November 20, 2020
PubMed
Summary
This summary is machine-generated.

Fecal incontinence affects many elderly individuals, yet most patients don't seek care. Early diagnosis through history and physical exams, focusing on bowel disturbances, is crucial for effective treatment.

Keywords:
AlgorithmDiarrheaElderlyFecal incontinenceFecal seepageRectal examinationSacral nerve stimulation

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Area of Science:

  • Gerontology
  • Gastroenterology
  • Public Health

Background:

  • Fecal incontinence is a prevalent and stigmatizing condition, particularly in the elderly.
  • Despite available treatments, a significant gap exists in patient care for fecal incontinence.
  • Early identification and management are essential to improve patient quality of life.

Purpose of the Study:

  • To review the epidemiology and impact of fecal incontinence.
  • To outline a diagnostic and treatment strategy for primary care physicians.
  • To highlight key historical and physical examination findings for diagnosis.

Main Methods:

  • Literature review on fecal incontinence epidemiology and impact.
  • Development of a diagnostic algorithm for primary care.
  • Description of evidence-based treatment options.

Main Results:

  • Bowel disturbances are common triggers and treatable targets for fecal incontinence.
  • History and physical examination provide key diagnostic clues.
  • Primary care physicians can effectively manage many fecal incontinence cases.

Conclusions:

  • Directly inquiring about incontinence is vital for diagnosis.
  • A systematic approach enables primary care providers to identify and treat fecal incontinence.
  • Addressing fecal incontinence can significantly reduce patient suffering and improve outcomes.