Managing Constipation in the Older Adult
Published: 11 October 2022
Published: 11 October 2022
Constipation is a medical issue to be taken seriously, particularly when present in the older adult. Older adults are considered to be a primary at-risk group for chronic constipation. In fact, it’s estimated that older adults are five times more likely to develop constipated-related problems than younger adults (Mandal 2019).
Constipation is often defined as having fewer than three bowel movements a week (Mayo Clinic 2021).
It also encompasses the passing of hard, dry bowel motions that are infrequent, difficult to pass, or both (Better Health Channel 2014).
Constipation can usually be prevented and treated by maintaining a high fibre diet, increasing water intake and exercising regularly (Better Health Channel 2014).
The process of digestion is as follows: when food is consumed, it breaks down in the stomach and passes through the intestines. The walls of the intestines then absorb nutrients from the food. The waste that remains is then passed through the colon and rectum (Khan 2019).
However, if the waste moves through the colon too slowly through the digestive tract, too much water is absorbed from it. Consequently, the resulting stool is dry, hard and difficult to pass (AMBOSS 2022; Mayo Clinic 2021).
There are many reasons why constipation affects older adults. Examples include:
(DailyCaring 2022; Mandal 2019)
Constipation can also be the result of more serious illnesses and events, including tumours and systemic diseases (Better Health Channel 2014).
Constipation can be either primary - meaning there is no underlying medical cause - or secondary - meaning there is an underlying cause (AMBOSS 2022).
Types of primary constipation include:
(Mandal 2019)
(Better Health Channel 2014; Mayo Clinic 2021)
Being older than 65 is a major risk factor for chronic constipation. Other risk factors include:
(Djordjevic 2022; Better Health Channel 2014)
(Mayo Clinic 2021; Better Health Channel 2014)
Diagnosis can involve a detailed medical history; a physical examination; questions relating to diet, exercise and lifestyle habits; a colonoscopy; or a combination of these (Mandal 2019; Better Health Channel 2014).
From this examination, the cause of the constipation can be identified (Mandal 2019).
(Better Health Channel 2014; Mayo Clinic 2021)
(Mayo Clinic 2021; Better Health Channel 2014; Daily Caring 2022)
Drinking adequate amounts of water is a known strategy for preventing and aiding constipation. Water softens stools and stimulates the bowel (Daily Caring 2022).
If a person’s diet is lacking in fibre and they are reluctant to eat certain foods, consider advising the intake of a fibre supplement (Better Health Channel 2014).
Laxatives are a treatment option for constipation if diet and lifestyle modifications do not provide a solution. There are two primary types of laxatives: osmotic laxatives and bowel stimulants. Laxatives should be used appropriately to avoid adverse effects (Better Health Channel 2014; Mounsey et al. 2015).
Regular exercise is known to aid and regulate digestion. The minimum amount of exercise recommended is 30 minutes per day. In the case of an older person and/or where mobility issues are apparent, activity should be encouraged. Every small bit of exercise makes a difference (Better Health Channel 2014).
It’s been shown that depression and mood disorders can trigger constipation. Yoga, meditation or other relaxation techniques may aid this (MedicineNet 2021).
Try to establish a regular bathroom time in which the older adult tries to empty their bowels each day. In addition to this routine, they should be encouraged to go as soon as they feel the urge (DailyCaring 2022).
(Mayo Clinic 2021; Better Health Channel 2014)
Question 1 of 3
Which one of the following is recommended as a treatment of constipation?