Constipation can be associated with various gastrointestinal disorders, such as Crohn’s disease or ulcerative colitis, or it can be due to benign factors, such as eating spicy foods. There are lots of medications that can cause constipation, too. For example, if you’ve been on iron tablets for an extended period, you might have noticed that you’re having trouble going to the toilet.
Ageing is also associated with an increased risk of constipation and there are many reasons why this is the case. In this article, I am going to answer the question of, ‘Why do older people get constipated?’ First, I am going to cover what constipation is and its most common triggers or causes. I’ll finish up this article by giving some top tips for getting rid of constipation naturally.
What is Constipation?
Constipation is a common gastrointestinal symptom that is characterised by infrequent bowel movements, difficulty passing stools, and the sensation of incomplete evacuation from the bowels. The exact diagnosis of constipation can be difficult as there are a few different criteria out there and everybody’s usual toilet habits are unique to them.
When the colon absorbs too much water from food waste, it can cause issues with regularity and make having a bowel movement difficult and painful. A drier stool won’t pass as easily and is less responsive to the contractions of the smooth muscle in the colon (known as peristalsis), so it sits in the large bowel for longer than it should.
Over time, constipation can lead to a build-up of dry stools in the large intestines, worsening abdominal distention (bloating), and feelings of discomfort. This sense of blockage can cause general feelings of being unwell, especially if it persists for a while.
Everybody’s bowel regularity is unique and one person’s healthy is another person’s unhealthy. What’s important when considering constipation is identifying changes in bowel movement habits. If there is a significant reduction in bowel movements compared to an individual’s normal toilet habits and they’re experiencing the associated negative symptoms, it could be a sign that they’re becoming constipated.
What Triggers Constipation?
I’ve already mentioned a few of the triggers or causes of constipation in the article, but I want to cover them in more detail and mention some additional reasons why constipation occurs, whether acutely (short-term) or chronically (long-term).
Older age
Since this article focuses on constipation as an issue for older adults, I wanted to mention this trigger first. Older age is associated with an increased risk of constipation due to poor digestion, slow gut motility, and reduced physical activity and mobility.
Older adults tend to move around less often because they have poor mobility, weaker muscles, poor balance, or are scared to fall over, so they choose not to mobilise much. They also tend to be on more medications than younger adults, some of which could increase the risk of constipation.
Slower digestion, a lack of physical movement, and taking several medications that may negatively impact the bowels at once (some of which might contraindicate one another) contribute to a higher risk of constipation in the elderly population.
Low dietary fibre intake
Fibre is essential for bowel regularity and overall digestive health. Specifically, inadequate amounts of insoluble dietary fibre can contribute to bloating and constipation.
Insoluble fibre helps to speed up the passage of food through the intestines and bulks up the stool, making it easier to pass. Those who don’t consume very much insoluble fibre in their diets can, therefore, have difficulty going to the toilet, no matter how old they are.
Not drinking enough water and becoming dehydrated
Your body needs water for healthy digestion and the stool must retain some amount of moisture in order to pass through your bowels and into the toilet effectively.
Those who aren’t drinking enough fluids might find that they are constipated and have difficulty passing stools. When they do eventually go to the toilet, they might experience some pain and the stool might be dry and difficult to pass.
A lack of physical activity
Movement is necessary to help food move through the digestive tract without getting stuck. Physical inactivity and leading a sedentary lifestyle can cause digestion to slow down, increase the risk of constipation, and worsen its severity.
Taking certain medications that have constipation as a side effect
Certain medications are known to cause constipation as a side effect. Those taking aluminium or calcium-containing antacids, antidepressants, antispasmodics, diuretics, iron supplements, or opioids are at risk of constipation. These medications can slow down intestinal motility and negatively impact bowel regularity.
Travelling for extended periods of time
Travelling is associated with reduced physical activity and a change in dietary intake. Often, those travelling for several hours at a time find themselves struggling to go to the toilet and feeling sluggish and bloated. Thankfully, travel-related or holiday bloating is temporary and is easily fixed.
Pre-existing medical conditions (especially those that impact the digestive system)
Constipation is a symptom of a wide variety of medical conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hypothyroidism, diabetes, neurological disorders, pelvic floor dysfunction, and colorectal cancer. Those who have one or more of these conditions are more prone to experiencing constipation regularly.
Pregnancy and the associated hormonal changes
The hormonal changes that occur during pregnancy and the pressure from the growing uterus on the bowels can slow down intestinal motility and contribute to constipation. The prenatal vitamins and iron supplements that are commonly taken during pregnancy can also exacerbate constipation.
Why Does Constipation Get Worse When You’re Older?
Constipation can worsen with age for several reasons, including the following.
Decreased physical activity
Older adults are often less physically active than their younger associates because they lack mobility and muscle strength or are dealing with chronic health conditions that impact their ability to move around without pain or discomfort. Many elderly individuals choose not to mobilise simply because they don’t want to or are scared to do so without falling over.
Regular physical activity helps stimulate bowel movements by promoting peristalsis in the intestines. Therefore, a lack of exercise and daily movement can impact regularity and make constipation a significant issue for the older population.
Dietary changes
Older adults tend to have limited diets. This may be due to poor appetite, difficulty swallowing, lack of mobility and hand grip, or inadequate cooking facilities. Each of these factors can contribute to a poor diet that lacks variety and doesn’t contain the nutrients required for healthy digestion, such as vitamins, minerals, and fibre.
In turn, older adults are more prone to constipation and bloating. This is especially the case if the older adult’s diet lacks fibre and micronutrients but is high in salt, fat, and sugar, the latter three of which can slow down digestion and make bloating more prevalent.
Taking medications that impact digestive function
Older adults often take multiple medications to manage various health conditions. Constipation may be a side effect of some of these medications. For example, pain-reducing drugs, blood pressure-lowering medications, and diuretics that increase urinary output are all known to cause constipation, and they are all common medications in the older population.
Reduced bowel function and motility
Ageing is associated with weaker digestion and slower movement of food through the gastrointestinal tract. Weakening of the smooth muscle in the digestive tract means less effective peristalsis to push the ingested food towards the rectum (i.e. gut motility is reduced).
When food moves more slowly through the digestive tract can lead to a back-up in the lower part of the tract, leading to bloating, abdominal discomfort, and constipation.
Underlying medical conditions
Disorders that impact muscle or nerve function, such as stroke or Parkinson’s disease, can cause constipation, as the bowels are less able to respond to fullness signals and stimulate peristalsis to move the stool out of the body.
Similarly, endocrine or metabolic conditions that impact hormone balance and metabolic health are known to contribute to bloating. Examples include hypothyroidism, amenorrhea, and diabetes.
Cognitive considerations
Older adults are more prone to isolation, forgetfulness, and cognitive decline. Each of these things can lead to changes in dietary habits, physical inactivity, and a higher risk of constipation.
Being isolated may cause older adults to not want to eat or feel unmotivated to cook healthy foods. Forgetfulness or confusion might also contribute to a poor diet that lacks variety and contributes to worsening digestive health with age.
How to Relieve Constipation
Constipation can be difficult to manage for people of all ages, but it’s particularly challenging for older adults, who are often more vulnerable and dependent on others to meet their personal needs. Below are some helpful strategies for relieving constipation naturally in the elderly population.
Taking probiotics and digestive enzymes
Probiotics are live bacteria that are known to be beneficial for digestion. They exist in the human gut naturally (known as the gut microbiome or gut microbiota) but taking a probiotic supplement can support digestive processes and metabolism.
Beneficial probiotic bacteria include Bifidobacterium and Lactobacillus, both of which are found in our supplement, A Dose For Bloating. Our bloat-busting supplement combines one billion probiotic bacteria with six different digestive enzymes and seven plant extracts to optimise digestive health and alleviate bloating.
Digestive enzymes are also found naturally in the human body but, again, supplementation can be beneficial for those who are prone to constipation and other digestive issues. Combining probiotics and digestive enzymes can significantly reduce constipation risk and promote a healthy microbiome.
Increasing dietary fibre intake
As mentioned above, fibre is essential for supporting digestion and reducing the risk of a blockage down in the colon. Fibre is abundant in plant-based foods, such as fruits, vegetables, and whole grains (think oats, potatoes, pasta, rice, and bread!). Consuming more of these foods can tackle digestive symptoms and keep constipation at bay.
Staying hydrated
Hydration is key when it comes to tackling constipation. Keeping the body hydrated is an important daily habit for relieving bloating naturally, as it means the body won’t have to reabsorb more fluid from the stool to stay hydrated. Therefore, the stool will remain moist and easy to pass, preventing constipation.
Meal prepping
Meal prepping involves cooking meals in batches to provide ready-made meals for several days at a time. This is a great technique that older adults can use to ensure they consume a well-balanced diet that meets their nutritional needs and promotes healthy digestive function.
Whether the older adult has a family member or carer help them batch cook meals for the week or they’re able to do so themselves, meal prepping may also reduce stress and worry by pre-planning upcoming meals, alleviating the anxiety of choosing what to eat each day.
