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October 18, 1976

"Presbycolon" Problems in the Nursing Home

Author Affiliations

Medical College of Ohio Toledo

JAMA. 1976;236(16):1847. doi:10.1001/jama.1976.03270170013014

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To the Editor.—  It may be presumptuous of me to disagree with a writer as distinguished as Eddy D. Palmer, MD, but in my judgment he has made the "presbycolon" problem in nursing homes (235:1150, 1976) appear more hopeless than it really is.There are two characteristics of nursing home patients that must be understood and dealt with. To begin with, many of them (like their noninstitutionalized peers) do not realize that growing older is associated with eating less, having less waste to eliminate, and therefore having less frequent stools than might have been expected at a younger age. For many oldsters, the "problem" disappears with explanation; for others, the desired stools can be produced with bran cereals, pysillium hydrophilic mucilloid with dextrose (Metamucil), or (if one can accept a certain amount of bowel irritation) prunes.A second aspect of the problem arises from the fact that many nursing home