Health Topics for Aging

Nursing Homes/Care Centers

Geriatric Assessment Clinic

Constipation and aging

Older people are more likely than younger people to become constipated. Constipation is a symptom, not a disease. A person may be constipated if having fewer bowel movements than usual or when having excessive difficulty and straining at stool, painful bowel movements, passing of hard stools, or feeling of incomplete emptying of the bowel.

There is no right number of daily or weekly bowel movements. Being regular is different for each person. For some people, it can mean bowel movements twice a day. For others, movements just twice a week are normal. The stools may be hard, or dry. The bowel movements may be painful, or hard to pass causing straining.

There are a number of causes of constipation. Many of these the older person has some control over, such as:

• not drinking enough water or other liquids
• eating a poor diet
• not eating enough fiber
• lack of exercise
• ignoring nature's call
• using laxatives too often
• some medications, such as antidepressants, antacids, antihistamines, diuretics, and antiparkinsonism drugs

Older people are less able to tell when their body needs fluids. They are usually already dehydrated when they feel thirsty. Drink at least 1 to 2 quarts of liquids a day, unless heart, blood vessel, or kidney problems exist. Some people can become constipated from drinking large amounts of milk.

Go to the bathroom when you feel the need. Timing is very important to prevent constipation. Do not wait for a better time. Holding in a bowel movement can cause constipation if the delay is too long. Some people may have a disorder or blockage of the intestines that may be causing the constipation. Tests can be performed and the problem treated.

Lack of exercise or long periods in bed, such as after an accident or illness may cause constipation. Physical activity whenever possible is best. If you have joints that hurt, try exercising in a swimming pool.

Fiber in the diet is important. It increases the size of the stools and helps hold water in them. Eat 25 to 30 grams of fiber everyday. Vegetables, fruits, whole grains, and beans are all high in fiber. Add unprocessed bran (like miller's bran) to baked goods, cereals, and fruit. If your body is not used to a high fiber diet, then too much fiber too fast can cause gas and bloating. Start with small amounts and slowly increase the amount each week to help the body adjust.

Avoid taking laxatives or enemas. They are not a cure for constipation. Relying on laxatives over time will cause the body to forget how to work on its own. Prolonged use of laxatives can cause diarrhea. Enemas may stop the body from having normal bowel movements and those with mineral oil can cause the body to lose vitamins A, D, E, and K.

Reasons to see a healthcare provider include:

• stomach cramps, pain, bloating, and no bowel movement for 3 or more days
• any change in normal bowel habits for 2 weeks or more
• any change in appearance, such as blood, or mucous in the stool, or oddly colored stools
• regular use of over-the-counter laxatives or enemas to have a bowel movement
• medication that is causing constipation or
• presence of a disease or treatment that affects the immune system (such as diabetes, HIV, AIDS, chemotherapy, organ transplant, or long-term steroid use)

Remember, being regular is different for each person. Anyone with regular bowel movements that are usually painless (whether 2 times a day or 3 times a week) is probably not constipated.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File AGIN3369.rf2 VRS# 7812 Data Version 7.0 Copyright 1999-2000, 2002-2003 McKesson Health Solutions LLC. All rights reserved.