What changes in your body as you get older?
Getting older means experiencing new signals from your body. Constipation increases when people get older, particularly after the age of 652.
The cause of constipation in elderly patients is often multifactorial and may include inactivity, inappropriate diet, depression and confusion, certain medications, and disorders which affect the nervous system of the bowels responsible for stimulating the bowel muscles. And the bowel muscles are the ones which need to move the food through the digestive system1,3,4.
Your body is changing
As people get older, the digestion process slows down a bit because the aging bowel needs some more time to move the food through the digestive system, which could trigger constipation1.
Long term medication is common among seniors, and some of them can lead to constipation symptoms, as side effects.
New lifestyle habits
When we get older, we are susceptible to move around less or exercise less, and our diet habits might change overtime as well, putting our bodies through another change. In the long run, these kinds of changes can have an impact on our digestive systems2.
What is happening to your body as you get older?
Constipation can often be a sign of changes happening in your body, and as you get older, these signs can come from different factors:
Your digestive system is a series of muscles that needs to contract to process your food along your stomach and intestines. These muscle contractions depend on a coordinated innervation by the nerves of the large intestine. The process slows down as your digestive system ages, resulting in a slower paced and also less well coordinated bowel movement. which can lead to constipation symptoms. The reduced ability of nerves to stimulate proper and coordinated bowel muscle contractions causes a prolonged stool transit which in turn results in more absorption of water. This makes the stool harder and dryer and the passing of stool more difficult (straining), painful and infrequent2,4.
Long term medication is widespread in older people. There are several types of medication that are known to slow down the digestive process and thus could be triggering constipation symptoms. These include some drugs used to treat depression, antacids containing aluminum 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 experiencing difficulty going to the bathroom or related discomforts, consult your doctor.
Your digestive system becomes more sensitive to unhealthy eating habits when you get older. Originally, sudden changes in our diet habits can trigger some constipation, but as you grow older, it turns out that it might happen more often. Nutrition has a direct impact on your transit and your ability to manage a peaceful routine. Eating a lot of high-fat meats, prepared food, dairy products and eggs, or rich desserts and sugary sweets while not eating enough high-fiber foods like vegetables, fruits, and whole grains may cause constipation6.
Your body needs to stay active and move around to keep the energy to maintain your digestive system. As we get older, we tend to exercise less and our bodies tend to relax even more, making muscle stimulation a bit more difficult, including for our digestive system. Modest physical activity may help individuals with constipation while prolonged physical inactivity in those who are normally physically active, especially in the elderly, can reduce colonic transit. Especially long periods in bed due to illness or following surgery may cause constipation2.
A few tricks to move things along
There are a number of simple measures you may consider and try at any stage of your life in order to prevent or to get rid of constipation symptoms.
1. Adapt your diet habits
If you’re experiencing constipation symptoms, start adding more fiber in your diet (whole wheat bread, brown rice, nuts, pumpkin seeds…). Fresh fruits (apples, raisins, prunes…) and vegetables (sweet potatoes, spinach, lentils...-) will also help your body’s transit. Simply adding salad and eating fruits for dessert could help moving things along7. Fiber intake should be increased gradually, and it should be noted that an increase of fiber consumption can have side effects, e.g., bloating, distension, flatulence, and cramping which may limit their use. In addition, fibers may not be useful in all patients with constipation2,1.
2. Get some exercise
Physical inactivity, especially in the elderly, can slow down the large intestine by increasing the time the stool needs to move through the colon. While moderate increased activity does not change bowel function in healthy subjects, modest physical activity may help people with mild constipation2.
3. Try to have a regular bowel movement
Many people find that going to the bathroom at a specific time each day can help their body create a new routine. The toilet sitting position can affect bowel function—lean well forward, with a straight back and with feet supported9.
4. Talk to your doctor about the medicines you are taking
Some medicines can make you constipated. These include some drugs used to treat depression, antacids containing aluminum 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 constipation from time and use those kinds of drugs, talk to your doctor.
5. Get discomforts treated
Constipation may cause you troublesome discomforting complications, these may include swollen veins in your anus (hemorrhoids), stool that can't be expelled (fecal impaction), or even parts of the intestine protruding from the anus (rectal prolapse)8. Consult your doctor because the sooner you act on it, the sooner you’ll feel better, and you will be able to go on with your life.
6. Laxative as a good solution for occasional constipation
Often, constipation can be treated through dietary and lifestyle changes, which relieve symptoms and help prevent the condition. However, these measures alone may not be sufficient and may be unpredictable. When diet and lifestyle changes have failed to be effective, your constipation may be resolved by using the right laxative. Your health care professional may recommend using a laxative for a short time10,7.
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- 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
- Mayo Clinic 2019 https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
- 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