Get things moving smoothly again by uncovering the cause of your clog.
Between exercise classes, book club meetings, and coffee dates, life isn't slowing down. But your bowels? That may be another story.
“Constipation is more common in older adults than younger people,” says Richard Saad, M.D., an associate professor of gastroenterology at the University of Michigan.
In fact, research published in Canadian Family Physician shows 26 percent of women and 16 percent of men ages 65 and older deal with constipation. And once you hit age 84, those numbers increase to 34 percent of women and 26 percent of men.
But what exactly classifies as constipation?
There’s actually a wide range for a healthy frequency of bowel movements—anything from three times per day to three times per week is considered normal, Dr. Saad says.
But having a limited number of movements per week isn't the sole defining factor of constipation. To meet the diagnostic criteria, you have to have at least two of the following:
- Fewer than three bowel movements per week
- Hard stool that is difficult to pass
- A sense of incomplete evacuation
- A feeling of a blockage or an obstruction
- The use of manual maneuvers—like putting a finger in the rectum—to elicit a bowel movement
When to Talk to Your Doctor
While constipation is common as you get older, it’s not something you should ignore. Sudden changes in your bowel habits, including signs of constipation, may signal more serious issues like a large polyp or even colon cancer, Dr. Saad says.
If your symptoms persist for one month or longer, check in with your doctor for an evaluation.
It's also important to know there are many other, less serious reasons you could feel blocked up-some of which may be well under your control. Here are seven potential causes of constipation every older adult should know.
Common Clog Cause #1: You Started New Meds
“The single most overlooked explanation of constipation in older adults is medications,” Dr. Saad says.
Common culprits include drugs that treat overactive bladder, prostate problems, Parkinson’s disease, or high blood pressure—especially calcium channel blockers. Opioids, which many older adults take for pain relief, can also be constipating, he says.
"Some meds cause the stool to become drier, so it has less water in it," Dr. Saad explains. "Others slow down the intestines and make the stool move through more slowly."
If you've noticed symptoms of constipation within a week or two after starting a new drug, tell your doctor. "There are frequently alternatives, but the provider won't know that there is a problem unless they're made aware of it," Dr. Saad says.
Common Clog Cause #2: You Have a Neurological Condition
Health issues that affect your nervous system—like dementia, Parkinson’s, or after a stroke—can cause some bowel symptoms too.
“These conditions can affect the strength or function of muscles in the rectum or pelvic floor, which play an important role in evacuating effectively,” Dr. Saad says.
That can lead to trouble with bowel movements, potentially causing constipation down the line. As always, talk to your doctor if you're concerned. He or she can suggest healthy ways to keep things moving.
Common Clog Cause #3: You Take Certain Supplements
A study published in the American Journal of Medicine looked at more than 1,400 postmenopausal women taking calcium supplements and found 18 percent of them reported feeling symptoms of constipation.
“Calcium carbonate supplements are more likely to cause constipation than calcium citrate,” says Jen Bruning, R.D.N., a spokesperson for the Academy of Nutrition and Dietetics.
What about calcium-rich foods? They aren't likely to cause a problem, because other components in the food help reduce the binding effects of calcium, she says.
Calcium isn’t the only supplement that may cause constipation, so be sure to talk with your doctor about any over-the-counter supplements you’re taking and any GI issues you’re experiencing. That way, he or she can help you determine the best plan moving forward, Bruning says.
Common Clog Cause #4: You’re Eating Too Much Fat and Not Enough Fiber
Cheese has a reputation of being constipating, but that’s not totally true: At normal serving sizes, cheese won’t pose a problem for most people, Bruning says.
The problem is that by choosing high-fat foods like cheese over fiber-rich options, you may be missing out on the opportunity to chow down on foods that can help prevent constipation, she explains.
"Because fiber is not fully digested, it stays in the digestive tract and helps provide bulk to stool," Bruning says. Fat, on the other hand, is fully digested and absorbed.
It sounds counterintuitive, but a bulking agent can actually help ease constipation. It gives the stool a higher water content, making it softer and easier to pass, Dr. Saad explains.
The National Academy of Medicine recommends that women 51 and older consume at least 21 grams of fiber per day, and men 30 grams. But most Americans are falling short: Women ages 60 and older are averaging only 15 grams per day, and men just 18, according to a survey from the U.S. Department of Agriculture.
The solution isn't to fill the gap fast. Loading up on fiber too quickly can actually cause more GI distress. Instead, try to increase your fiber intake gradually-by no more than five grams per day beyond your current intake-and then wait a week or two before upping it again to hit your quota, Dr. Saad says.
Look to add more vegetables, fruits, legumes, and whole grains to your diet. Here are some ideas:
- 1 cup chopped broccoli, cooked: 5 grams of fiber
- ½ cup green peas, cooked: 4.5 grams of fiber
- 1 medium apple with skin: 4.5 grams of fiber
- 1 cup blueberries: 3.5 grams of fiber
- ⅓ cup black beans, cooked: 5 grams of fiber
- ⅓ cup lentils, cooked: 5 grams of fiber
- 1 cup brown rice, cooked: 3.5 grams of fiber
- 2 slices whole wheat bread: 4 grams of fiber
Common Clog Cause #5: You’re Forgetting to Hydrate
Refilling that water bottle can do much more than quench your thirst. Proper fluid balance is an important tool in preventing constipation, Bruning says. And it's especially important if you're working on eating more fiber.
Soluble fiber absorbs fluid, so if you aren't drinking enough when you add fiber to your diet, it can actually make constipation worse. Your stool can become drier and harder to pass.
Exactly how much you should drink each day varies from person to person, depending on factors like your size, activity level, and any health conditions you may have.
“A good rule of thumb is that when your urine is pale yellow, you’re likely hydrated properly,” Bruning says.
Thirst is less acute in older adults, so try to drink before you feel thirsty and dehydration sets in. Keep a refillable water bottle with you whenever possible, and drink a full glass with every meal.
Plus, make sure you’re familiar with these five sneaky signs of dehydration.
Common Clog Cause #6: Your Eating Schedule Has Changed
Your bowels like routine, and changing up your eating schedule can mess with your gut. Eating less frequently or consuming smaller-sized meals, for example, can cause bowel symptoms, Dr. Saad says.
"The general tenet is regular eating can lead to more regular bowel movements," he says. "Eating stimulates the bowels. There is a connection between the stomach and the bowels-when food hits the stomach, it activates the intestines."
If you start to notice symptoms of constipation, consider your diet and any changes you've made recently. Your body may simply need time to adjust to a new routine.
Common Clog Cause #7: You’re Skipping Exercise
Too much sedentary time can make constipation worse. It can slow the motility of your GI tract, making waste take longer to move through your system, Bruning explains.
“The general belief is increased physical activity makes everything more active, including your bowels,” Dr. Saad says.
You don't have to go all out, all the time. Aim to fit in at least 150 minutes of moderate-intensity activity per week, broken into however many sessions you need. Walking, jogging, hiking, biking, dancing, and swimming are all great options.
If you want to get more serious about your workout routine, check out our guide to three types of exercise older adults should do every week.
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