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BACKGROUND: Constipation is highly prevalent in older adults and may be associated with greater frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We investigated the prevalence of lower defecation frequency (DF) and risk factors (including AECOPD) associated with lower DF among hospitalized elderly patients. METHODS: We conducted a retrospective case-control study in a community hospital of Southeast Ohio. Adults aged 65 years or older admitted during 2004 and 2006 were reviewed (N = 1288). Patients were excluded (N = 212) if their length of stay was less than 3 days, discharge diagnosis of Clostridium difficile-associated diarrhea, death or ventilator- dependent respiratory failure during hospitalization. Lower DF was defined as either an average DF of 0.33 or less per day or no defecation in the first three days of hospitalization; cases (N = 406) and controls (N = 670) were included for the final analysis. RESULTS: Approximately 38% had lower DF in this patient population. Fecal soiling/smearing of at least two episodes was documented in 7% of the patients. With the adjustment of confounders, AECOPD (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.01-2.13) and muscle relaxant use (AOR =2.94; 95% CI =1.29-6.69) were significantly associated with lower DF. Supplementation of potassium and antibiotic use prior to hospitalization was associated with lower risk of lower DF. CONCLUSIONS: Approximately 38% of hospitalized older adults had lower DF. AECOPD and use of muscle relaxant were significantly associated with lower DF; while supplementation of potassium and antibiotic use were protective for lower DF risk after adjusting for other variables.

Bakgrund: Avföringsproblemen förstoppning, avföringsinkontinens och irritabel tarm är vanliga åkommor hos människor i det västerländska samhället. Alla tre har liknande symtom och problematik. Åkommorna påverkar hela människan inte bara den fysiska kroppen. Få studier har fokuserat på människors upplevelse av att leva med avföringsproblem. Syfte: Syftet med litteraturstudien var att beskriva hur människor med avföringsproblem upplever sin livssituation. Metod: Studien var baserad på tio vetenskapliga artiklar med kvalitativ ansats. Resultat: Studien resulterade i tre huvudteman; upplevelsen av det egna lidandet, upplevelsen av det dagliga livet och upplevelsen av relationer med åtta underteman. Resultatet visade att människor som lider av avföringsproblemen förstoppning, irritabel tarm och avföringsinkontinens upplevde att hela deras livssituation påverkades av avföringsproblemen. Hela människan drabbades psykiskt, emotionellt, fysiskt och socialt. Människorna var tvungna att leva ett liv fullt av dagliga begränsningar. Slutsats: Att leva med avföringsproblem innebar för människorna att vara involverad i en evig kamp som de ofta var ensamma i. Resultatet indikerar på att avföringsproblem är ett dolt problem och tystnaden kring problemen gör att många människor inte får den hjälp och stöd som de behöver. / Background: Bowel movement problems as constipation, faecal incontinence and irritable bowel syndrome are common problems in the community. All three has similar symptoms and the same complex of problems. The disorders affect the whole human being not just the physical body. Few studies have been focusing on peoples experiences of living with bowel movement problems. Aim: The aim of this literature study was to describe how people with bowel movement problems experienced their life situation. Method: The study was based on ten scientific articles in qualitative approach. Results: The study resulted in three main themes; the experience of the own suffering, the experience of the daily life and the experience of relations with eight subthemes. The result showed that people suffering from bowel movement problems as constipation, irritable bowel syndrome and faecal incontinence experienced that their whole life situation was affected by the problems. The whole human being was affected psychological, emotional, physical and social. These people had to live a life full of daily restrictions. Conclusion: A life with bowel movement problems meant being involved in an everlasting fight, which they often fought alone. The result indicates that bowel movement problems are a hidden problem in the community and because of the silence many people does not get the help and support that they need.