Constipation in Seniors - Homage

Constipation in Seniors

Constipation in the elderly is common and could affect their quality of life. Learn the causes, complications, and home remedies for this health issue.

by Calvyn Ee

What is Constipation?

Constipation is what happens when you have difficulty passing stools or cannot empty your bowels. Constipation is generally classified as when you’re unable to have fewer than three normal bowel movements in a week, but this may vary depending on how often you normally have bowel movements. While it affects anyone at any age, elderly persons can also be at high risk of getting constipation: for those aged above 65 years, the prevalence of constipation is 16 percent among men and 26 percent among women.

Common signs of constipation include:

  • Difficulty passing stools
  • Infrequent bowel movements
  • Dry, hard, and/or lumpy stools
  • Frequent stomach aches or cramps
  • Bloating
  • Loss of appetite

If you do find yourself having fewer bowel movements than usual, and if you note that your stools seem dry and hard, you should seek a doctor immediately. Chronic constipation can also cause further complications later on if left untreated.

Causes of Constipation in the Elderly

Constipation happens when the large intestine – specifically, the colon – absorbs too much water from the waste that passes through it. This waste is what remains of food after the nutrients have been absorbed by the body and need to be excreted from the body. When constipation occurs, food that travels through your digestive tract moves slower, giving more time for the colon to absorb more water from them. As this waste loses its water content, it becomes dry and hard, making it harder to be removed from your body.

The exact cause of constipation can be hard to pinpoint, as different factors can have varying effects from person to person. A lack of fibre in your dietary intake is generally one of the most attributed causes of constipation. However, some other causes of constipation include:

  • Low physical activity: Frequent physical activity promotes healthy bowel movement
  • Dehydration: Elderly persons have a tendency to not feel thirsty quite often, which results in them drinking less water than they should
  • Impairments in your digestive tract: For example, muscle disorders can make it difficult to have any bowel movements
  • Medical conditions such as Parkinson’s disease or a spinal injury

Again, identifying the root cause of constipation can be tricky. It’s therefore crucial that you see a doctor so they can run tests to ascertain what the cause may really be. Sometimes, a modification of your loved one’s dietary intake can help them recover from constipation. Other times, it may require more attention to treat it properly.

Types of Constipation

Constipation is usually divided into two types: primary (or functional) constipation and secondary constipation.

Primary Constipation

Primary constipation occurs due to your body being unable to properly excrete waste from your body. It is further divided into three subcategories:

  • Normal transit constipation: Your bowels are functioning normally, but are still having a hard time removing waste from your body. Bloating and stomach ache may be symptoms that are present.
  • Slow transit constipation: Your bowels are not functioning normally, possibly due to the nerves not sending the right signals for normal bowel movement. Those with diabetes or hyperthyroidism may have this.
  • Defecation/evacuation disorders: This refers to muscle movements that are needed to remove stools from the body. Constant straining of the bowels or painful, forced defecation are some reasons why this occurs.

Secondary Constipation

This occurs due to other (sometimes external) factors that don’t involve your digestive system. This may include, but is not limited to:

  • Side effects of certain medications
  • Metabolic issues caused by diabetes
  • Neurological disorders such as dementia
  • Cancer

Complications of Constipation

Generally, constipation goes away on its own once you make changes to your lifestyle (such as eating more fibre) or once you receive treatment. Chronic constipation, however, can lead to any number of complications. This may include:

  • Hemorrhoids
  • Anal fissure (tears in the areas around the anus)
  • Fecal impaction (hardened stools that cannot be excreted)
  • Rectal bleeding
  • Rectal prolapse (the rectum stretches out of the anus)
  • Confusion due to discomfort or frustration due to symptoms or the overall impact of constipation (higher risk for those with dementia or similar conditions)

Any of these complications can have severe short and long-term impacts if not treated promptly.

Correlation Between Constipation and Bloating

Bloating is a common side effect that happens when you have constipation. When you feel bloated, your stomach feels as though it’s full of air. When you’re constipated, you not only have difficulty excreting waste from your body, but you also cannot release gas inside your body. As the stools remain in your digestive tract, it allows bacteria to continue fermenting; as a result, this causes even more gas and bloating. Interestingly, bloating can also be exacerbated if you chew gum while you’re feeling bloated, as you’re allowing more air into your belly.

Bloating can make you feel even more sickly, but treating your constipation will also be able to resolve the bloating at the same time.

Treating Constipation in Seniors

Lifestyle Changes

The best way to treat constipation usually involves simple lifestyle changes, mainly by improving your dietary intake, getting enough exercise, and drinking more water. All of these will slowly help to improve bowel functions.

Here are a few specific suggestions to start you on the right track:

  • Have more fibre in your meals
  • Have more fruits, as many are also rich in fibre
  • Have regular glasses of water to stay hydrated
  • Consider following a dietary plan, such as the low FODMAP diet
  • Avoid processed meats, fried foods, caffeine, and foods/drinks with a high sugar content
  • Avoid distractions when using the toilet
  • Don’t delay if you need to use the washroom as it can impair bowel movements to excrete waste from your body

If you or your loved one have been sedentary for too long, it’s important that you slowly step up physical activity over time. The same principle applies to a low-fibre diet: start small, then slowly build up your fibre intake as your body gets used to it.

We’ll go deeper into this in the next section.

Medication and Medical Treatment

When you have chronic constipation, you may require more than lifestyle changes to help you with your recovery. Some medical treatments that may be recommended include:

  • Taking laxatives to ease bowel movements. Laxatives come in various forms, including osmotic laxatives which draw water to the colon to soften stools, and stimulant laxatives that cause contractions in the intestines to make it easier to excrete waste
  • You may also be prescribed stool softeners instead of laxatives. As the name implies, these help to soften stools and make them easier to pass
  • An enema may be recommended if hardened stools make it very difficult to expel waste. There are side effects and risks associated with enemas, even if done by a medical professional

The doctor will recommend the treatment method that will work best depending on circumstances, such as you or your loved one’s current health condition.

Prevention Tips and Home Remedies

Preventing and treatment of constipation are almost interchangeable. Keep constipation at bay with these tips and remedies you can try at home.

Physical Activity

Movement helps to improve your digestion as it stimulates the abdominal muscles and increases blood flow in your abdomen. You don’t need heavy physical activity, either, as even a simple 20-minute walk around your neighborhood can have plenty of benefits. Make it a daily part of your week and slowly build up your stamina so you can exercise for longer. Just make sure you don’t overdo it or you might hurt yourself.

For seniors who may not be very mobile, try doing simple exercises while seated or lying down. Stretching and sitting exercises such as knee extensions and toe lifts are still worth doing; as you become more familiar with them, you can do these exercises more often. Focus on strengthening exercises, especially, so as to prevent your loved one from becoming frail over time.

Healthy Habits

When you need to use the toilet, you might want to adopt any of these healthy habits to help with your constipation:

  • Avoid straining yourself to force out stools. You’re only causing more harm to your digestive tract.
  • Avoid laxative cleanses, either from medical laxatives or supplements that have a laxative effect. You can end up dehydrating yourself or causing an electrolyte imbalance, both of which have harmful long-term effects.
  • Try a squatting position when using the toilet. If you’re using a regular toilet seat, put a small stool in front of you and place your feet on it to simulate a squatting position. This can help you pass stools without straining yourself.
  • Let your loved one have privacy when using the toilet.

Dietary Changes

Introducing fibre is just one way of preventing constipation. But why exactly is fibre a highly recommended solution?

Dietary fibre refers to non-digestible carbohydrates found in plants and can be found in fruits, vegetables, grains, nuts and seeds (among other food types). It’s categorized into soluble and insoluble fibre, both of which have significance to your gut health.

  • Soluble fibre dissolves in water, turning into a gel-like substance with many benefits, including lowering your blood cholesterol and glucose levels
  • Insoluble fibre can’t be dissolved but does promote the movement of food and waste through your digestive tract. It also increases stool bulk by attracting water into the stools, thus making it easier to remove them from your body

Studies have found that regular consumption of dietary fiber can also help relieve those with chronic constipation. In fact, the benefits of a high fibre diet include:

  • Improves your overall health
  • Normalizes bowel movement
  • Helps you maintain an ideal weight

Seniors who have dental or chewing issues, or even those with dysphagia, may usually have a soft, low-fibre diet since they can’t eat and drink properly. As a result, they may be getting less than the recommended fibre intake for their age. Various physical changes can also affect your overall diet, such as when you slowly lose your sense of taste; it can be difficult to convince a loved one to eat something that’s nutritious when they can barely perceive its taste, or not at all.

Ideally, you should have between 25 to 30 grams of fibre a day, with 6 to 8 grams derived from soluble fibres. Other recommendations can go up to 38 grams, but this will vary from person to person. As a general rule, however, you should aim to eat more of the following:

  • Whole-grain products
  • Fruits
  • Vegetables
  • Beans, peas and other legumes
  • Nuts and seeds

Whether it’s fibre-dense meals or small servings of fibre spread over a regular timeframe, or even drinkable fibre for those with chewing or swallowing issues, adding fibre into your everyday meals is a must to prevent constipation and promote better health in the long term.

Getting Help from a Professional Caregiver

If you need help with looking after your loved one with chronic constipation, our Care Pros can help. We provide highly trained and certified Care Pros to assist you and your loved one with activities of daily living, feeding your loved one during meals, and accompanying you for medical appointments. Let us help you with affordable home care and companionship whenever you need it. Download our app now to find out more and start booking quality care for your loved one.

About the Writer
Calvyn Ee
Calvyn is an aspiring author, poet and storyteller. He spends his time reading, gaming and building stories with his action figure photography.
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