CONSTIPATION
A few at-home tips can help you avoid the need for harsh laxatives.
We often make light of constipation, but it’s no laughing matter. When you can’t go to the bathroom for days on end, you feel bloated and miserable. Straining day after day can also lead to more serious problems, like hemorrhoids or even prolapse (bulging) of rectal tissue.
An estimated 40% to 60% of older adults regularly deal with constipation, although the aging process itself is not to blame. “It’s what goes along with aging. It’s things like less physical activity, which helps the bowels move more regularly. It’s the medications many older adults take,” explains Dr. Stanley Rosenberg, assistant professor of medicine at Harvard Medical School and gastroenterologist at Beth Israel Deaconess Medical Center.
Constipation causes
One of the biggest factors in constipation is diet. Eating high-fiber foods, such as raw fruits and vegetables and whole grains, helps to keep you regular. Drinking enough fluid is essential too. “The fiber holds the water in the bowel so it can mix with the stool and make it softer,” Dr. Rosenberg says.
If you’re getting plenty of fiber and fluids and you’re still not regular, one of these constipation causes may be to blame:
medicines such as narcotic pain relievers, antidepressants, aluminum-containing antacids, blood pressure medications, drugs for Parkinson’s disease, and iron supplements
lack of exercise
regularly ignoring the urge to have a bowel movement
- diseases such as diabetes or an underactive thyroid gland (hypothyroidism).
Getting going again
Laxatives may seem like the quickest and simplest solution, but they’re not a good idea, says Dr. Rosenberg. “If people go right to stimulant laxatives, there is a risk that they’ll become physically dependent on them,” he cautions.
Before taking any laxative, try these diet and lifestyle tips for managing constipation:
Stay hydrated. Drink at least four to six glasses of fluids a day. Water and fruit juices are best for preventing constipation. Limit caffeinated beverages such as soda and coffee, which can actually leach more fluid from your body.
Bulk up on fiber. Try to get at least 25 grams of fiber daily from your diet. Good food sources include Brussels sprouts, apples, figs, bran cereal, and black beans.
Get on a daily schedule. The longer stool sits in your intestines, the harder it becomes, and the more difficult it is to push out. “That’s why having a regular bowel habit is important,” Dr. Rosenberg says. Because the emptying reflex works best after a meal, “I tell my patients to eat a good breakfast, and after breakfast go into the bathroom and sit there for 10 minutes. See if you get the urge.”
Try not to strain. It could lead to hemorrhoids, anal fissures (tears in the skin around the anus), or rectal prolapse (when part of the intestinal lining pushes out through the anal opening). Add more fiber and fluid to your diet, or try a stool softener to make bowel movements easier.
If you simply can’t go and you want to try a laxative, start with the osmotic type (such as MiraLax or Geri Care). “The osmotic laxatives are reasonably harmless and they work pretty well,” Dr. Rosenberg says. They work gently by pulling water into your intestines, making the stool softer and easier to pass. A recent study in the Canadian Medical Association Journal found osmotics to be the most effective type of laxative in older adults.
If you’ve tried everything and you still aren’t regular, see your doctor, who can evaluate you for a medical problem. Call your doctor right away if you have any symptoms of a bowel obstruction, which can include abdominal pain, vomiting, a swollen belly, or the complete inability to have a bowel movement.