Constipation Is Very Common as We Age, Here’s How to Get Relief and Stay Regular 

Key takeaways

• Constipation is a common issue for older adults. It involves infrequent bowel movements, difficulty passing stools, and a sensation of incomplete emptying.
• The primary causes of constipation in older adults include underlying medical conditions, certain medications or supplements, and lifestyle factors, such as a low fiber diet and lack of physical activity.
• To help prevent and treat constipation, older adults can increase fiber and fluid intake, engage in regular physical activity, maintain a consistent bathroom routine, and, if necessary, consider over-the-counter or prescription treatments, such as laxatives.

Constipation can be uncomfortable, but it is treatable and preventable in most cases

This article describes the symptoms and causes of constipation in older adults — those 65 years and older — and outlines some home remedies and treatment options.

It also discusses preventing constipation and when to contact a doctor.

Information for caregivers

As a person’s condition progresses, they may need help reading or understanding information regarding their circumstances. This article contains details that may help caregivers identify and monitor symptom progression, side effects of drugs, or other factors relating to the person’s condition.

Symptoms of constipation in older adults

According to the National Institute on AgingTrusted Source, people differ in how regularly they have bowel movements. Having “regular” bowel movements simply means that bowel movements occur at a frequency that is typical for that individual. If a person experiences infrequent bowel movements, they may have constipation.

Around 1 in 3 older adults experiences occasional symptoms of constipation. These may include:

• producing fewer than three bowel movements in a week
• having difficulty passing stools
• producing lumpy or hard stools
• experiencing a sensation of having blocked bowels or not fully emptying the bowels

What causes constipation in older adults?

The following sections describe the three leading causesTrusted Source of constipation in older adults.

Medical conditions

Medical conditions that may cause or contribute to constipation include:

• disorders affecting the nerves or muscles necessary for bowel movements, such as:
  • a stroke
  • Parkinson’s disease
  • spinal cord injury
• diseases that can affect a person’s diet or daily habits, such as Alzheimer’s disease or other types of dementia
• conditions affecting the hormones or metabolism, such as diabetes
• pelvic floor disorders
• gastrointestinal disorders, such as irritable bowel syndrome
• tumors and other blockages in the bowel

Medications and dietary supplements

Some over-the-counter (OTC) and prescription medications can cause constipation. Examples include:

• some pain relievers
• antacids containing aluminum or calcium
• some medications to treat high blood pressure
• diuretics
• certain antidepressants
• certain antihistamines
• anticholinergics
• antispasmodics
• anticonvulsants
• drugs to treat Parkinson’s disease
• anesthetics

Dietary supplements containing iron may also cause constipation.

Lifestyle factors

The following lifestyle factors may increase a person’s risk of constipation:

• not eating enough high fiber foods, such as:
  • vegetables
  • fruits
  • whole grains
• eating too many high fat meats, dairy products, eggs, sweets, and processed foods
• not drinking enough fluids, which may make stools hard and difficult to pass
• changes in routine, such as traveling
• not getting enough physical activity

Home remedies for constipation

Older adults can try the following home remedies for constipation:

• eating three meals per day and avoiding skipping meals
• increasing intake of fiber-rich foods gradually
• drinking 6 to 8 glasses of water per day
• limiting or avoiding highly refined and processed foods
• exercising regularly and including walking or other weight-bearing exercises 3 or more times per week
• going to sleep at the same time each night, and getting good quality sleep
• managing stress

Treatment for constipation in older adults

If home remedies do not help, a person may want to consider OTC or prescription treatments.

A 2020 reviewTrusted Source outlines some common treatment options for chronic constipation in older adults. These include:

• Osmotic laxatives: These medications draw water into the stool, helping to soften the stool and ease its transit through the digestive tract. According to the National Health Service (NHS) in the United Kingdom, osmotic laxatives may take 2 to 3 days to take effect. Examples include:
  • lactulose
  • macrogel
  • polyethylene glycol
  • magnesium citrate or magnesium oxide
• Stimulant laxatives: These medications stimulate the muscle lining the gut, helping move stools through the digestive tract. The NHS indicates they take 6 to 12 hours to work. Examples include bisacodyl and sodium picosulfate.
• Suppositories and enemas: Anal suppositories and enemas can help alleviate constipation and prevent fecal impaction in older adults with impaired mobility. An enema involves inserting liquid directly into the rectum to stimulate defecation. According to a 2020 reviewTrusted Source, doctors generally recommend water-based enemas for older individuals, as these are safer than phosphate-based enemas.
• Prokinetic agents: These medications stimulate the gastrointestinal tract, helping move stools through the colon. An example is prucalopride, which doctors may prescribe when other laxatives are ineffective.
• Lubiprostone: This medication increases the secretion of intestinal fluids and improves stool transit through the colon.
• Biofeedback: This training practice helps train the muscle functions necessary for regular bowel movements. Biofeedback incorporates visual and auditory input that helps people learn more effective techniques for passing stools.

How to prevent constipation

The NHS offers the following tips on helping to prevent constipation:

• Making dietary changes: To soften stools and ease their passage through the colon, people can:
  • eat foods rich in sorbitol, such as apples, apricots, and strawberries
  • add wheat bran, oats, or linseed to the diet
  • drink plenty of water and other fluids
  • avoid alcohol
• Improving the bathroom routine: The following tips can help prevent constipation:
  • keep to a regular bathroom schedule as much as possible
  • ensure plenty of time to use the toilet
  • avoid delaying the urge to empty the bowels
  • rest both feet on a low stool while using the toilet, and raise the knees above hip level if possible
• Increasing activity levels: Daily walking or other forms of exercise can help stimulate the bowels, resulting in more regular bowel movements.

When to contact a doctor

According to the Trusted SourceNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDKTrusted Source), a person experiencing constipation should speak with a doctor if their symptoms do not improve with home remedies or if they have a family history of colon or rectal cancer.

If individuals over 45 years experience persistent, worsening constipation that does not resolve with treatment, they should consider speaking with a doctor to rule out a more severe underlying issue.

The NIDDK adds that a person should contact a doctor immediately if they experience constipation alongside any of the following symptoms:

• bleeding from the rectum
• blood in the stool
• inability to pass gas
• persistent abdominal pain
• lower back pain
• vomiting
• fever
• unexplained weight loss

Summary

Constipation is common among people of all age groups, but especially among older adults. Symptoms include having fewer regular bowel movements than usual, difficulty passing stools, or incomplete bowel emptying.

Medical conditions, medications and supplements, and lifestyle factors, such as an inadequate diet and insufficient exercise, are common causes of constipation in older adults.

People with constipation may benefit from gradually increasing their intake of fiber-rich foods, drinking more fluids, and exercising regularly.

If home treatments do not help ease constipation, a person can talk with a doctor or pharmacist about laxatives and other treatment options. Anyone who continues to experience chronic constipation should contact a doctor to determine the cause.