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Constipation in older adults
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As we get older, our bodies go through many different stages and changes. Constipation in older adults is very common. Before it can have an impact on your happiness and quality of life1, it's important to understand what's happening to your body and what you can do to get things moving again.
Causes of constipation in older adults
Constipation in older adults is very common, particularly after the age of 652.
There are many different causes of constipation in older adults. These can include inactivity, poor diet, depression and confusion, as well as certain medications. There are also certain disorders which affect the nervous system of the bowels, responsible for stimulating the bowel muscles and moving food through the digestive system1,3,4.
Your body is changing
As people get older, the process of digestion slows down. The ageing bowel needs more time to move food through the digestive system, which can trigger constipation1.
Taking medication
Many older adults take long-term medication. Some of these medicines can cause constipation as a side-effect.
New lifestyle habits
When we get older, we tend to move around and exercise less. Our diet might change overtime as well. Lifestyle changes like this can have an impact on our digestive systems2.
What happens to your body as you get older?
Constipation can often be a sign of changes that are happening in your body as you get older. Let's explore some of these changes:
Changes in your digestive system
Your digestive system is a series of muscles that need to contract to process your food. These muscle contractions depend on a coordinated innervation by the nerves of the large intestine. This process slows down as your digestive system ages, resulting in a slower paced bowel movement. The longer it takes for your poo to travel through your system, it becomes harder, dryer and more difficult to pass. This can often lead to straining, along with painful and infrequent trips to the toilet2,4.
Changes caused by medication
Many older adults require long-term medication. Several of these medicines are well known to slow down the digestive process. These include some drugs used to treat depression, antacids containing aluminium or calcium, iron supplements, some allergy medicines (antihistamines), certain painkillers (NSAIDs, opioids), some drugs for high blood pressure, including diuretics, and some drugs used to treat Parkinson’s disease5. If you’re taking any new medication and start having difficulty going to the toilet, talk to your doctor.
Changes to your diet
Your digestive system becomes more sensitive to unhealthy eating habits as you get older. Eating a lot of high-fat meats, prepared food, dairy products and eggs, or rich desserts and sugary sweets while not eating enough high-fibre foods like vegetables, fruits and whole grains may cause constipation6 in older adults.
Less physical exercise
Your body needs to stay active to keep your digestive system moving. As we get older, we tend to exercise less and our bodies tend to relax more. This makes muscle stimulation in the digestive system a bit more difficult. Modest physical activity can help people with constipation. On the flipside, prolonged physical inactivity can make people less regular. And long periods in bed after illness or surgery may cause constipation2.
A few tricks to get things moving
here are a number of simple things you can try - at any stage of your life - to prevent or relieve constipation.
1. Adapt your diet
If you’re experiencing constipation, start adding more fibre to your diet. This includes whole wheat bread, brown rice, nuts, pumpkin seeds, along with fresh fruits and vegetables. Simply adding salad and eating fruit for dessert could help move things along7. You should increase your fibre intake gradually, because putting more fibre into your diet can have side effects, including bloating, distension, flatulence, and cramping. Though it's helpful for many, fibre may not help everyone with constipation2,1.
2. Get some exercise
Physical inactivity, especially in older adults, can slow down the large intestine and increase the time it takes for poo to pass through the colon. Modest physical activity, like walking and swimming, has been found to help people with mild constipation2.
3. Teach your body to stay regular
Many people find going to the toilet at a specific time each day can help their body create a new routine. You may not know this, but the way you sit on the toilet can also affect your ability to poo. Make sure you lean well forward with a straight back and with your feet supported9.
4. Talk to your doctor about your medication
Some medicines can make you constipated. These include some drugs used to treat depression, antacids containing aluminium or calcium, iron supplements, some allergy medicines (antihistamines), certain painkillers, some drugs for high blood pressure, including diuretics, and some drugs used to treat Parkinson’s disease. If you suffer from occasional constipation and use these kinds of medicines, speak to your doctor.
5. Get comfortable
Constipation can cause uncomfortable ailments and complications. These include haemorrhoids (piles), feeling blocked by a poo that you can't pass (faecal impaction), or even parts of the intestine protruding from the anus (rectal prolapse)8. The sooner you deal with your constipation, the sooner you’ll feel comfortable again. Your doctor can advise.
6. Try laxatives as a solution for occasional constipation
Often, you can relieve constipation by making changes to your diet and lifestyle. But when you've tried this, and it hasn't helped, you may need to think about a laxative. Your doctor may recommend a laxative for short-term use10,7.
- De Giorgio R, Ruggeri E, Stanghellini V, Eusebi LH, Bazzoli F, Chiarioni G. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015 Oct 14;15:130.
- Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005 Jan;100(1):232-42.
- Schuster BG, Kosar L, Kamrul R. Constipation in older adults: stepwise approach to keep things moving. Can Fam Physician. 2015;61(2):152-158.
- Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020 Apr;158(5):1232-1249.e3. doi: 10.1053/j.gastro.2019.12.034. https://doi.org/10.1053/j.gastro.2019.12.034
- Camilleri M, Ford AC, Mawe GM, Dinning PG, Rao SS, Chey WD, Simrén M, Lembo A, Young-Fadok TM, Chang L. Chronic constipation. Nat Rev Dis Primers. 2017 Dec 14;3:17095.
- Basilisco G, Coletta M. Chronic constipation: a critical review. Dig Liver Dis. 2013 Nov;45(11):886-93.
- John Hopkins Medicine. Health conditions and diseases – Constipation. 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation Accessed 14/11/2022
- Mayo Clinic 2019 https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253 Accessed 14/11/2022
- World Gastroenterology Organisation. Coping with common gastrointestinal symptoms in the community: a global perspective on heartburn, constipation, bloating, and abdominal pain/discomfort May 2013. J Clin Gastroenterol. 2014 Aug;48(7):567-78.
- U.S. Department of Health and Human Services National Institutes of Health (NIH) – National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Constipation. 2018 https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/definition-facts Accessed 14/11/2022
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