Food passes through your gut after you eat it. The body takes nutrients and water from the food. Stool, the leftover waste, is moved through your intestines by muscle contractions (squeezing motions). Many things can go wrong with this process.
If you do not drink enough fluid or eat enough fiber, stool may be too hard to pass comfortably. If your diet is irregular and low in calories, that may cause trouble. If you are not physically active, the bowels may move too slowly. Not going to the bathroom when you feel the urge to have a bowel movement can also slow things down.
Medications can affect your bowels. Some pain killers, like Tylenol™ 3, can slow your bowels. Iron and antacids can cause constipation. Some studies suggest that taking laxatives for a long time can cause bowel problems. Ask your doctor about the medications you take.
Certain medical conditions can also cause problems. People with diabetes or an under-active thyroid may have constipation. A stroke or dementia can affect the bowels. Talk to your doctor about whether any of your medical conditions might be associated constipation.
Most people have a bowel movement anywhere from three times a day to three times a week. Everyone is slightly different and not all people need to have a bowel movement every day. Just because you didn’t have a bowel movement today doesn’t mean that you are constipated.
Normal, healthy aging shouldn’t affect the frequency of bowel movements. Being a senior doesn’t mean you will have constipation. If you have fewer bowel movements than you normally do, if it has been more than three days without a bowel movement, or if your bowel movements are uncomfortable, you may be constipated. You may feel that some stool is left over even after finishing. Some people with constipation feel nauseated, have stomach cramps and lose their appetite.
Other symptoms are more worrisome. If you have any of these, check with your doctor.
You can take action to keep your bowels healthy and moving.
Drink plenty of fluids - at least six to eight glasses a day. However, some people might need to be careful with the amount of fluid they drink - for instance, someone who has had heart failure. Ask your doctor whether you have medical problems that might become worse with too much fluid. Fluids include water, juice, soup or other drinks. Limit drinks with caffeine, such as coffee and tea, as they can be dehydrating. Eat regular meals, especially breakfast. Include more fibre in your diet. Add unprocessed wheat bran, legumes, prunes, figs, apricots and unrefined breakfast cereals. Remember to go slowly when adding fiber to your diet to avoid too much gas and bloating. You may have heard that prunes are good laxatives. It’s true - prunes and prune juices contain a natural laxative chemical that stimulates the bowels. Adding them to your diet may help.
Exercise at least thirty minutes a day. A brisk walk can stimulate the bowels. If you can’t exercise due to a medical condition, try to move around more often. Set aside a time to have a bowel movement. The best time is after a meal, especially five to ten minutes after breakfast. Don’t resist the urge to have a bowel movement. It may help to have a schedule. Plan to sit for about fifteen minutes and try to avoid straining. The squatting position is the best. You can also try a footstool in front of the toilet.
Although medications are available, try to avoid self-treatment with laxatives. See your doctor regularly and ask about your bowels if you are concerned.
The best treatment for constipation is prevention. However, what can you do if you are already constipated? Many people, especially seniors, unnecessarily spend money on laxatives. Medication may be needed if you have already tried the other suggestions and they have not helped. It should only be used as a last resort.
First, try using a natural fibre like psyllium. It is the safest and works when taken with lots of fluid. Metamucil™ is a good source. It is the safest and works when taken with lots of fluid. Be aware that psyllium can cause bloating and extra gas. These products help to increase the stool softness and make you go more often. Be patient, as it can take a few days to start working.
Your doctor may also recommend prescription medication. Milk of Magnesia brings water into the bowel and stimulates bowel muscle movement. It should be used with caution by people who have kidney problems. Lactulose, another medication, works in a similar way. It tastes sweet and may sometimes cause people with diabetes to have higher blood glucose readings. These two medications usually work more quickly than fibre - often within a day.
Two commonly used laxatives are stool softeners and stimulant laxatives. Colace™ is one stool softener. It doesn’t push stool through but softens it, making it easier to push out. Stimulant laxatives, either prescription or over-the-counter, are favorites used by seniors and doctors. They are more powerful and work faster, usually within a few hours. Senokot™ directly triggers the muscles in the colon (lower intestine) to squeeze. However, some studies have shown problems with these pills. Over a long period of time, bowel muscles may start to resist the stimulation and become lazy. Taking these pills may make the bowel change or become dependent. Use this type of laxative only for a short time, on the advice of your doctor.
If the bowels are really stuck, a suppository or an enema may be needed. These products are put into the rectum and work from the bottom end. Different types include glycerin suppositories, Dulcolax™ and Fleet™. Although soapsuds and tap water enemas were used in the past, they can cause irritation in the bowel and are not used much now.
Take action to keep your bowels healthy and moving. Healthy living, a good diet and exercise goes a long way in maintaining healthy, active bowels at any age.