Constipation in the Elderly

Nearly everyone becomes constipated at one time or another, but the elderly are sometimes more likely than younger people. When you are a family carer, you may worry when there are no bowel movements every day but just remember that everyone is different. Being regular varies from person to person and for some, it can mean bowel movements twice a day. For others, movements just three times a week. Here are some facts regarding constipation in the Elderly and how to look for any warning signs that may suggest they need treatment.

Overview of constipation in the elderly

Earlier, we spoke about regular bowel movements and how they differ for each person. This happens because constipation is generally classified into two types: functional and rectosigmoid outlet delay.
Functional constipation means the constipation is chronic or persists over a long period of time, but there are no other secondary causes such as with other medical conditions or medications.
Rectosigmoid outlet delay means there is anal blockage more than 25 percent of the time and may include an inability to coordinate bowel movement with pelvic floor muscles. In this situation, there is a functional outlet obstruction which results in a need for excessive straining to have bowel movements.

How many days refers to being constipated?

Constipation is a very common complaint among older persons but, when bowel movements happen less than three times a week or there is straining at least a quarter of the time; there is a problem. With normal bowel habits, there is the passage of soft, formed stool at least three times a week, without straining. Although the elderly are more prone to constipation, it’s not simply a fact that this is a normal part of ageing. You should seek the services of a physician when the discomfort doesn’t ease because you want to do whatever you can to improve their quality of life.

Causes of Constipation

Research suggests that there is a link between some drugs used for pain, depression, high blood pressure and constipation. Calcium and iron supplements, combined with other medications, can also affect the stool. These are not the only factors, decreased food intake can also cause constipation; an underactive thyroid or sometimes just plain dehydration affects the elderly. It’s best to tell a doctor what’s going on to help safely determine the cause.

Opioid-induced constipation

Opioids are used medically to relieve pain and are in many strong painkiller such as morphine. The Australian Government Department of Veterans’ Affairs reports that one of the most common adverse effects with chronic opioid therapy is constipation.

With the elderly, there is already a higher risk of constipation because of immobility, decreased food intake or not enough fluids but, when you add opioid analgesics to help with cancer and acute pain, there is no question of these factors having an effect. The Department of Veterans’ Affairs found that of the 42,000 veterans dispensed an opioid analgesic, none had any laxatives dispensed for them as well. Guidelines suggest that this will help prevent the acute discomfort associated with opioid use and in this case, seeking help is a must.

Treatment

  • This depends on the cause of the constipation, but could include:
  • Added fiber in the diet – this can be found in foods like prunes, kiwis, flax seeds, oranges, oats, spinach, beans
  • More water and less tea, coffee and alcohol
  • Fiber supplements
  • Enemas, stool softeners or laxatives
  • More Exercise
  • Surgery

It’s often helpful to keep a diary of bowel habits and that a simple examination can alleviate concerns and help the doctor determine the cause. When they can gain better insight into a person’s medical history, medications, diet and lifestyle habits, this can solve the problem in a majority of patients.

Where to get more help

Always remember that you are not alone. If you have concerns with the care of an elderly person, it’s always a good idea to speak to a doctor. They can suggest different treatments, review and prescribe medication, order clinical tests and refer you to a specialist, if needed. Pharmacists can also provide advice on products that may help as well as direct you towards local clinics.

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