AGING AND CONSTIPATION
There are a number of age-related factors that can cause constipation in older adults.
Changes in the digestive system. Your digestive system moves food through your body by a series of muscle contractions. As we age, this process sometimes slows down, and this can cause food to move more slowly through the colon
Some of the reasons for this propensity include…
- A poor diet
- Lack of adequate fluids in the diet
- Lack of exercise
- The uses of certain drugs to treat other medical conditions
- Poor bowel habits.
In addition, there is a psychological angle and many older adults are excessively concerned about their bowel movements and constipation is frequently an imaginary ailment.
There is often a lack of interest in eating that is seen in single or widowed older people. This leads to the overuse of convenience foods, which tend to be low in fiber.
Loss of teeth may further make eating regular meals difficult. Many older adults thus choose soft, processed foods that are low in fiber. Many older adults suffer from urinary incontinence and stress incontinence. They may take inadequate fluids in order to avoid urinating. The fluids are also deficient in the diet if the elderly are not eating regular or balanced meals.
Water and other fluids add bulk to stools relieving constipation and making stools soft.
Digestive Problems as You Age
- Constipation. One of the most common things we see, certainly as people are getting into their 60s and 70s, maybe a change in bowel habits, predominantly more constipation,” says Ira Hanan, MD, associate professor of medicine at the University of Chicago Medical Center.
Symptoms include difficult or painful bowel movements, infrequent bowel movements, and hard, dry stool. There are a number of age-related factors that can cause constipation in older adults.
- Changes in the digestive system. Your digestive system moves food through your body by a series of muscle contractions. Just like squeezing a toothpaste tube, these contractions push food along your digestive tract.
As we age, this process sometimes slows down, and this can cause food to move more slowly through the colon. When things slow down, more water gets absorbed from food waste, which can cause constipation.
- Medication use. Older adults take a lot of medications. And as we age, we start to have more health problems that require medications. Several common medications can cause constipation.
One example is calcium channel blockers, used for high blood pressure. “Very good for blood pressure, very constipation causing,” says Stein.
Narcotic pain relievers are another common culprit. An older adult who has knee or hip replacement surgery will often be given narcotics for pain. “Narcotics have effects directly on the bowel,” Stein tells Web MD. “They actually slow the gut.”
- Inactivity. People often become less active as they age, says Stein, and being inactive can make you constipated. Bed rest during an illness can cause real problems.
If a person has joint-replacement surgery, for example, it takes time to recover and be fully active again. Add narcotic pain relievers to the mix, and “that might change manageable constipation into something that’s much more of a problem,” Stein says.
- Not drinking enough fluids. Staying hydrated helps prevent constipation at any age. It can become more of an issue for older adults who take diuretics for high blood pressure or heart failure.
Diuretics lower blood pressure by causing you to lose excess fluid by urinating more often. Some people may avoid drinking too many fluids so they don’t have to run to the bathroom all day long. Between urinating more and drinking less, you can become dehydrated.
- Diverticular Disease. About half of the people aged 60 and older have diverticulosis. This occurs when small pouches in the lining of the colon bulge out along weak spots in the intestinal wall. While many people don’t have any symptoms, gas, bloating, cramps, and constipation may occur.
“I tell my patients its part of the aging of the colon,” Hanan tells WebMD. “As we get older, we’re more prone to developing these pockets.” Why they occur with age is unclear, he says. While most of the time they don’t cause a problem and don’t require treatment, they can cause scarring and irregularity.
If the pockets become inflamed, it’s called diverticulitis, which can cause abdominal pain, cramping, fever, chills, nausea, and vomiting. Antibiotics, pain medications, and a liquid diet treat diverticulitis.
- Ulcers & NSAIDs. Many older adults use nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain from arthritis and other types of chronic pain.
Regular use of NSAIDs increases the risk of stomach bleeding and ulcers. So while aging alone doesn’t make your stomach more prone to ulcers, the chronic use of NSAIDs does raise your risk. But they can have painless gastrointestinal (GI) bleeding.
- Problems with the mouth and esophagus. The esophagus is the tube that connects our mouth to our stomach. Like the colon, the esophagus can also slow down with age, moving food through more slowly.
This can cause problems swallowing food or fluids. Dementia, stroke, and conditions such as Parkinson’s disease can also cause difficulty swallowing.
- Polyps. After age 50, the risk increases for developing polyps, or small growths, in the colon. Polyps may be noncancerous, they may become cancer, or they may be cancer. There’s been speculation that it’s something in the diet or something we don’t get enough of, plus genetics. It’s probably a cumulative effect over the years.
You can have polyps and not know it because they usually don’t have any symptoms. “That’s why screening colonoscopies are recommended for anyone over the age of 50,”. During this procedure, polyps can be removed before they become cancer. People with a family history of colon cancer or other risk factors may need to have screenings earlier.
- Gerd. Gastroesophageal reflux disease (GERD) is the most common upper GI disorder in older adults, although people of all ages can get it. GERD occurs when stomach acid backs up into the esophagus, causing heartburn and other symptoms.
Heartburn is more common as you get older, but it’s often caused by factors not related to aging. Eating late at night and eating the wrong types of foods, such as fast food and fried foods, can all cause reflux.
Certain medications, including some blood pressure medications, which many older adults take, can cause heartburn. Obesity increases your risk for heartburn and GERD, so if you gain weight as you get older, you could have more reflux.
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