You can't watch television for more than 5 minutes these days without hearing a

commercial for something to cure your "irregularity." No wonder our elderlies

are fixated on the issue. As a group they watch more television than anyone. As

a group the ones we care for also have more time to think about their aches and

pains, too, which doesn't help.

While just about everyone has felt constipated now and again, it is a real

documented problem for as many as 35% of people over the age of 65. Some sources

say that as many as 75% of patients in hospitals and nursing homes use laxatives

regularly.

Ask many of our seniors how often they should have a bowel movement and

almost to a man they will say "every day." This is the myth that leads many to

believe they are constipated when, in fact, they aren't. It is perfectly normal

to visit the bathroom anywhere from two or three times a day to every second or

third day. If your senior's pattern is regular for him or her, even when he or

she can't "go" for a day or so there is probably no real cause for concern.

If things regularly stretch much more than three days, or if your elder has

symptoms such as pain or cramps, unusual gas, bloating, loss of runny stool,

vomiting or unusual loss of appetite it could be cause for concern and should be

checked by a medical professional.

Why do our seniors

tend to feel constipated more often than younger people?

• They tend to get little exercise. Movement on the outside can get things

moving along on the inside, too. Less than 30 minutes of movement a day can

increase constipation;

• They don't drink enough fluid (6 to 8 glasses a day is recommended). Water

is needed to keep moisture in the colon so things move along smoothly and don't

harden;

• Their diet tends to be low in fiber. Many of our seniors eat

easy-to-prepare microwave meals, which are almost all low in fiber. If they are

choosing soft foods because of dental or denture discomfort, these foods are

also more often than not low fiber. Fiber helps retain the moisture that our

bowels need to work effectively;

• They take medications that can cause constipation: antihistamines, some

high blood pressure medications, diuretics, antidepressants, some cardiac

medications, antacids with calcium or aluminum, and many pain medications can

cause constipation;

• They have a medical condition that can contribute to constipation such as

Parkinson's Disease or Parkinsonism, under- or over-active thyroid, stroke,

scleroderma, diabetes or colon cancer, among many;

• They have become dependent on laxatives, which often causes  "rebound"

constipation. 

What to Do About

Senior Constipation

Before turning to laxatives or enemas, which are often our seniors' immediate

treatment of choice, most medical experts believe that diet and exercise changes

will usually be the biggest help. Check with your parent's doctor before making

any changes, just to be sure. Then, with the doctor's approval try:

• Increase the amount and selection of high-fiber foods. The old

tried-and-true whole grains, nuts, fresh or dried fruits, and raw or cooked

vegetables are the gold standard. If you can't get your elder to eat these, try

adding high fiber bran flakes, cooked in or sprinkled over just about anything.

Proceed cautiously with adding high fiber foods. If the body is not accustomed

to fiber it can cause uncomfortable gas and bloating.

• For many people cheese, dairy products, eggs and foods high in sugar can be

constipating. Try to reduce the amount of cheese, beef, and other rich high-fat

foods.

• Increase fluids. 24 ounces a day of liquid is recommended. Soup, sherbets,

gelatins, frozen juice bars and popsicles also all contribute fluid, so it

doesn't have to be just liquid in a glass. Remember that milk and milk

products can be constipating, and coffee, tea and other drinks with caffeine can

dehydrate.

• Try to get your senior moving (often easier said than done, but give it a

shot).

• As best you can, make sure your senior has time to use the bathroom without

feeling rushed at his or her usual optimal time. Simply feeling rushed can lead

to shut-down.

When Should You Turn

to Laxatives?

If dietary changes, increasing the amount of fluid and getting some exercise

aren't helping enough, then your doctor might recommend starting with a mild

laxative. Don't turn to laxatives without consulting with the doctor, because

you want to rule out any potentially serious medical issue.

Your doctor will probably recommend that you start with a natural fiber

laxative. Psyllium, which Metamucil contains, is a natural fiber laxative. Start

with the smallest dose your doctor recommends and do not increase it beyond the

maximum the doctor recommends. More is not always better.

For anyone who does not have renal failure Milk of Magnesia is often

effective.

Mineral oil, which our parents and grandparents often used to use, is not

recommended today. Mineral oil can interfere with the body's absorption of

certain vitamins, and it can reduce the effectiveness of certain medications

including blood thinners. It can also cause a nasty pneumonia if it is

accidentally inhaled (how one would do that I don't know, but the warning is

there).

Unless directed to them by a doctor, do your best to help your parent avoid

the siren call of "stimulant" laxatives that cause the intestinal muscles to

contract. These medications, which are not always as "gentle" as advertised, can

cause serious cramping and vomiting. They can also cause dehydration, which is

the last thing your senior needs. These laxatives can also create chronic

dependence, which might ultimately only make things worse.

Remember that if your parent complains of a sudden change in bowel habits,

blood in the stool, stomach pains or a sudden loss of weight without trying, see

the doctor. Otherwise, try to convince him or her to try increasing fluids,

eating more fiber, and getting more exercise. These changes won't offer the

instant "cure" or the nice visit with the doctor that many seniors crave, but

they are a much better place to start than laxatives.