Approaches to managing chronic constipation in older people within the community setting

Constipation is a common presenting problem within the community setting, but its treatment is often unsatisfactory. It is important for nurses to remember that constipation is a symptom and not a disease. For older adults, constipation can have a gradual onset over a number of years, with many people 'self-medicating' with over-the-counter laxatives and herbal products, which then result in the need for daily laxatives. This article will consider best practice for the assessment, treatment, and prevention of constipation in adults within the community.

Using behavioural methods to manage faecal incontinence

Faecal incontinence is a common problem for patients who have suffered a stroke. However, patients arriving at a neurorehabilitation unit are often reluctant to disclose their problem, and transfer documentation is sometimes incomplete. Nurses need to be aware that this is a sensitive area for patients, which can adversely affect their rehabilitation progress. Nurses and other professional practitioners must work together as a team, as the impact of faecal incontinence can be highly distressing for patients, and can result in inefficient use of therapy time. This article examines how the rehabilitation nurse, using evidence-based practice, can manage faecal incontinence effectively within a structured assessment and therapy programme, and shows it is possible to manage patients' bowel actions proactively. The benefits of this include maximizing therapy and nursing time and preventing delayed discharges. This article is based on a thorough assessment originating from a case study.

Management of the child with polymicrogyria

Polymicrogyria is one of several neuronal migrational defects. This disorder is derived from a malformation in cortical development characterized by many small gyri, shallow sulci, and abnormal cortical layering. The potential causes of polymicrogyria include genetic disorders, intrauterine cytomegalovirus infection, and fetal vascular supply disruption. A wide variation in the extent of findings exists, ranging from minor deficits to profound neurological dysfunction. Seizures, feeding problems, elimination, physical mobility, and psychosocial issues must be managed for children with polymicrogyria. Children with this disorder require collaborative care from healthcare practitioners and parents to achieve their highest level of health. The incidence of neuronal migrational defects is approximately 1 in 2,500 live births (L. Villard et al., 2002). The diagnosis of these disorders has increased with improvement of magnetic resonance imaging (MRI) technology (A. J. Barkovich, R. Hevner, & R. Guerrini, 1999).