ELIMINATION

The two major systems involved in waste elimination are urinary and gastrointestinal systems.
A large percentage of the older adult population suffers elimitation problems. One of the most common elimination problems experienced by older adults is constipation. This problem may result from changes in the function of the GI system or may be related to changes in other body systems such as musculoskeletal and nervous system.
Well, I want with this introduction make a short resume of the relationship between body systems and the gastrointestinal problems.

 In this post I make a brief summary of diferents gastrointestinal problems:
Constipation, is defined as hard, dry stools that are difficult to pass. It is important bring out that constipation is not a disease but rather a symptom of some other problems. A diagnosis for constipation must include two or more of the following symptoms during 3 months:

• straining
• hard and lumpy stools
• sensation of incomplete evacuation or anorectal blockage
• less than three defecations per week
• loose stool rarely present without use of laxatives
• use of manual maneuvers such as digital stimulation to facilitate defecation

 
We have to keep in mind the importance of this geriatric syndromes because they affects patient's quality of life, and they have lots of importants consequences for older adult like fecal impactation, anal fissure....
Nurses have to help the patient and we have to give some advices to prevent or resolve constipation, some of them are:

• rich fiber diet and intake 2 liters of líquids
• make regular exercise
• go to the bathroom after breakfast
• make pelvic floor exercises
• provide privacy for elimination

ostomies, in this topic I want to bring out the importance of the education about ostomy patient. This intervention lead to suppose a great challenge fot the patient and for him social enviroment because it is a difficulty related with the disease process.As nurses we have to try to understand the difficulties that the patients could have.

Ostomy is a new "style of life" for the patient, fot this reason I think that it is important that we know some advices for the ostomy patient such as:

• eat and chew slowing
• a correct stoma hyigiene.
• increase progressively intake
• try and eat new food sparingly.
• intake 1,5 liters of water
•  do not abusse of fried food or spicy.

Bowel Incontinency, from my point of view this is the elimination problem that could produced major numbers of problems to quality of life. A lot of older adults haven't go out because they have fear for the possibilite of maybe have a bowel incontinence situation. 

Dysphagia, difficult to swallow liquids or solid food for the affectation of one or most swallowing phases. It is important in this disease adjust the differents consistency depending on lesion places.
Some general advice for the patient that suffers disfasia are:

• present small quantities of food in the dish
• no mix solid and liquids
• take food in small pieces  
• avoid contact spoon with teeth to let lose reflex to bite this.
• enrich foods
• no force
• calm enviroment

It is important bring out the most important consequences of dysphagia, they are malnutrition and dehydration. For this reason, we have to pay attention to dysphagia symptoms.
We have to improve patient's quality of life, for this it is important that we manage a good nutrition and if we observe some desnutrition symptom we have to dismiss dysphgia syndrome early.











Bibliography:
Wiskur. B; Greenwood-Van Meerveld. B. The aging colon: the role of enteric neurodegeneration in costipation. December, 2010. Springer science bussines media.
Galan. N. Recomendaciones al paciente ostomizado. 2011. Enfermería gastroenterología.
Neuman HB, Park J, Fuzesi S, Temple LK. Rectal cancer patients' quality of life with a temporary stoma: shifting perspectives. Dis Colon Rectum. 2012 Nov.