Constipation is a symptom, not a disease. You may be constipated if you are having fewer bowel movements than usual, with a long or hard passing of stools. Older people are more likely than younger people to become constipated.
Experts agree that older people often worry too much about having a bowel movement every day. There is no right number of daily or weekly bowel movements. Being regular is different for each person. For some people, it can mean bowel movements twice a day. For others, movements just twice a week are normal.
Questions to Ask
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Some doctors suggest asking these questions to decide if you are constipated:
- Do you often have fewer than three bowel movements each week?
- Do you often have a hard time passing stools?
- Is there pain?
- Are there other problems such as bleeding?
Did you answer “yes” to more than one of these questions? If so, you may have a constipation problem. Otherwise, you probably do not.
What Causes Constipation?
Doctors do not always know what causes constipation. Eating a poor diet, not drinking enough water, or using laxatives too often can be causes. Also, some medicines can lead to constipation. These include some antidepressants, antacids containing aluminum or calcium, antihistamines, diuretics, and antiparkinsonism drugs.
The role of diet. People may become constipated if they do not eat enough high-fiber foods like vegetables, fruits, and whole grains. Some research shows that high-fiber diets can help prevent constipation. Eating a lot of high-fat meats, dairy products and eggs, or rich desserts and sugary sweets also may cause constipation.
People who live alone sometimes lose interest in cooking and eating. As a result, they start using a lot of prepared foods. These foods tend to be low in fiber, and so may lead to constipation. In addition, bad teeth can cause older people to choose soft, processed foods that contain small amounts of fiber.
People sometimes do not drink enough fluids. This often is true when people are not eating regular meals. But water and other liquids are important. They add bulk to stools, which helps make bowel movements easier.
Misuse of laxatives and enemas. Many people think of laxatives as a cure for constipation. But heavy use of laxatives often is not needed, and laxatives can become habit forming. If you use laxatives too often, your body can begin to rely on them to bring on bowel movements. (Using laxatives too often also can cause diarrhea.) Over time, your body will forget how to work on its own.
For the same reason, if you use enemas too often, your body may begin to depend on them. Too many enemas may stop you from having normal bowel movements. Too much mineral oil, another popular laxative, can lower your body's ability to use key vitamins (A, D, E, and K). Sometimes mineral oil, if taken along with other drugs that stop blood clots (anticoagulants), can cause unwanted side effects.
Other causes of constipation. Lack of exercise or long periods in bed, such as after an accident or illness, may cause constipation. Doctors sometimes suggest medicine for people who stay in bed and suffer from chronic constipation. But being more active, when possible, is best.
People also can become constipated if they ignore their natural urge to have a bowel movement. Some people prefer to have bowel movements only at home. But holding in a bowel movement can cause constipation if the delay is too long. In some people, disorders or a blockage of the intestines may cause constipation. These disorders may affect the muscles or nerves responsible for normal bowel movements. A doctor can perform tests to see if a problem like this is the cause of constipation. If so, the problem often can be treated.
If you become constipated, first see your doctor to rule out a more serious problem. If test results show no disease or blockage, and if your doctor approves, try these remedies:
- Increase fiber by eating more fresh fruits and vegetables, either cooked or raw, and more whole-grain cereals and breads. Dried fruit such as apricots, prunes, and figs are especially high in fiber.
- Drink plenty of liquids (1 to 2 quarts daily), unless you have heart, blood vessel, or kidney problems. (But keep in mind that some people can become constipated from drinking large amounts of milk.)
- Some doctors suggest adding small amounts of unprocessed bran (“miller's bran”) to baked goods, cereals, and fruit. Some people suffer from bloating and gas for several weeks after adding bran to their diets. Make diet changes slowly to allow your digestive system to adapt. Remember, if your diet is well balanced and contains a variety of foods high in natural fiber, it may not be necessary to add bran to other foods.
- Stay active.
Do not expect to have a bowel movement every day or even every other day. Remember, being regular is different for each person. If your bowel movements are usually painless and occur regularly (whether 2 times a day or 3 times a week), you are probably not constipated.
If you still have concerns about constipation, check with your doctor to find out what you should do.
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National Institute on Aging U.S. Department of Health and Human Services National Institutes of Health January 2002