By Guest Blogger Robin Amylon
Constipation is a very common complaint among older adults. 42% of individuals aged 65 and older experience constipation. This number increases to 62% in those who are older than 84 years of age. Constipation occurs when bowel movements become difficult or less frequent. The normal length of time between bowel movements varies from person to person. The elderly are more prone to experience constipation because they have decreased colonic motility. Several other factors, however, predispose older adults to constipation that are closely associated with but not directly a result of normal aging. Let’s take a look at what constipation is, what causes it and what you can do to prevent and/or manage it.
What is Constipation?
As I already stated, frequency of bowel movements varies from person to person. Normal stool elimination may be three times a day or three times a week, depending on the individual. Constipation is defined as having a bowel movement fewer than three times per week. With constipation stools are usually hard, dry, small in size, and difficult to eliminate. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating, and the sensation of a full bowel. You are considered to be constipated if you have two or more of the following for at least 3 months:
- Straining during a bowel movement more than 25% of the time
- Hard stools more than 25% of the time
- Incomplete evacuation more than 25% of the time
- Two or fewer bowel movements in a week
What Causes Constipation?
- Inadequate water intake
- Inadequate fiber in the diet
- Inadequate activity, exercise or immobility
- Stress
- Resisting the urge to have a bowel movement
- Overuse of laxatives (stool softeners), which, over time, weaken the bowel muscles
- Neurological conditions such as Parkinson’s disease or multiple sclerosis
- Antacid medicines containing calcium or aluminum
- Depression
- Irritable bowel syndrome
- Colon cancer
- A disruption of regular diet or routine
- Eating large amounts of dairy products
- Several medications cause constipation including:
- Pain medications (especially narcotics)
- Blood pressure medications (calcium channel blockers)
- Anti-Parkinson drugs
- Anti-spasmodics
- Anti-depressants
- Iron supplements
- Diuretics
- Anti-convulsants
How Can You Prevent Constipation?
- Eat a well-balanced diet with plenty of fiber. Fiber is a type of carbohydrate the body cannot digest that has several health benefits including preventing constipation. It increases colonic fecal fluid, microbial mass, stool weight and frequency, and the rate of colonic transit. Fiber also softens stools and makes them easier to pass. Good sources of fiber are fruits, vegetables, legumes and whole grains such as brown rice, oatmeal, whole wheat bread, legumes, quinoa, couscous and bran cereals.
- Drink plenty of fluids. Older adults should drink at least 6-8 cups of fluid per day (unless fluid restricted for another medical condition). Water is the best choice. Caffeine containing liquids, such as coffee and soft drinks, can have a dehydrating effect and should be avoided until your bowel habits return to normal. Some individuals may need to avoid milk, as dairy products may be constipating for them
- Exercise regularly
- Move your bowels when you feel the urge
What Should You Do If You Are Constipated?
- Drink 2-3 extra glasses of water a day (unless fluid restricted)
- Try drinking warm liquids, especially in the morning, as warm fluids can stimulate the urge to go
- Add more fiber to your diet, but make sure to add it slowly. Increasing fiber too quickly can cause bloating and gas. Be patient. It may take time for your body to adjust.
- Add prunes, oatmeal and bananas to your diet
If you have tried all the above suggestions and are still experiencing constipation, contact your doctor. It is important to contact your physician especially if it is a new issue for you, if you have blood in your stool, have severe pain with bowel movements or your constipation has lasted for more than two weeks. Also, consult with your doctor before using laxatives as these medications can also add to the problem.
Robin Amylon is an NYC-based Nutritionist. She received her Bachelor of Science from Queens College in Nutrition and Exercise Science and is currently finishing a program at New York-Presbyterian Hospital to become a Dietitian.
