Everyone gets constipated from time to time. If you’ve ever been constipated, you know how uncomfortable it can be. Can you imagine being in that state all the time? Constipation in elderly people is a very common condition as it develops much more often in older age. Experts estimate that two-thirds of people over the age of 65 experience constipation.
Though occasional constipation can come and go without serious consequences at any age, chronic constipation requires medical attention to discover its causes so that it can be managed and prevented from repeatedly occurring in the future.
Many people think they are constipated if they don’t have a bowel movement every day. However, constipation is most often defined as having fewer than three bowel movements a week. Furthermore, chronic constipation in elderly people manifests as infrequent bowel movements or difficult passage of stool that lasts for at least several weeks.
While we can usually identify an underlying cause, there are instances when we cannot determine what causes an older adult to be constipated. Fortunately, there are ways to prevent and treat constipation even when we can’t determine what caused it.
Signs and Symptoms of Constipation in the Elderly
In order to diagnose constipation, two or more of the symptoms we’ll list need to be present. The first one, obviously, being infrequent defecation. Ideally, you should have a bowel movement every day, but one every 2–3 days is also perfectly normal, that is, if it is not always accompanied by the following signs and symptoms:
- Hard and lumpy stool
- Straining during defecation
- The sense of incomplete evacuation
- The need to “help” the stool come out
A quick way to assess if your stool is normal is to take a look at the Bristol stool scale. It can reveal mild or severe constipation in elderly people and even show whether they lack fiber in their diet.
Other associated signs and symptoms can include:
- Pain in the abdomen
- Feeling of fullness
- Lack of appetite
Irritability can be a symptom of constipation in elderly dementia patients
Complications of Chronic Constipation
If left untreated for a long time, constipation can lead to a number of complications, including the following:
Fecal impaction (stool that can’t be evacuated): The longer it stays in the colon, the drier and harder the stool gets. Eventually, it gets stuck and becomes impossible to evacuate without treatment.
Hemorrhoids (swollen veins around the anus): Long-term straining during defecation can lead to hemorrhoids, which can also further become complicated by bleeding.
Anal fissures (tears in the skin of the anus): Large and hard stools can even lead to tears in the anus.
Rectal prolapse (intestines protruding through the anus): One of the most severe complications can occur when the rectum protrudes outside due to straining.
Causes of Constipation in Elderly People
A number of issues can cause chronic constipation—from those that make the stool move too slowly to those that prevent it from being eliminated effectively, leading to hard and dry stool. Here are all the potential causes of chronic constipation:
Blockages in the colon or rectum: These can include anal fissures, bowel obstructions, narrowing of the colon (stricture), the rectum bulging through the back wall of the vagina (rectocele), and finally colon cancer, rectal cancer, and other abdominal cancers that press on the colon.
Issues with nerves that cause muscles in the colon and rectum to contract: The causes of constipation in seniors among these types of conditions can include a stroke, spinal cord injury, Parkinson’s disease, autonomic neuropathy, and multiple sclerosis.
Problems with the muscles involved in stool elimination: These can be brought on by anismus (the inability to relax the pelvic muscles, which allows a bowel movement), dyssynergia (the lack of coordination between pelvic muscles in providing proper relaxation and contraction), and weakened pelvic muscles.
Conditions that affect hormones: Finally, conditions that lead to an imbalance of hormones that control the amount of fluids in the body like diabetes, hyperparathyroidism, hypothyroidism, and even pregnancy can also lead to constipation.
No less important than the specific causes are the risk factors that can be responsible for constipation in older adults. The first two of the following risk factors are clearly unmodifiable. But you can make changes to the others in order to decrease your risk of becoming constipated:
- Being older than 65
- Being female
- Not getting enough dietary fiber
- Physical inactivity
- Having mental health issues like depression or an eating disorder
Taking medications that cause constipation in the elderly, which include certain sedatives, antihistamines, muscle relaxants, anti-nausea medications, narcotics, antidepressants, diuretics, and calcium and iron supplements.
Types of Constipation Among the Elderly
Normal transit constipation: The most common type, in which the stool passes at a normal rate, but patients have trouble evacuating the stool. It is commonly associated with irritable bowel syndrome (IBS). However, IBS patients experience a lot more abdominal pain and discomfort.
Slow-transit constipation: This type is more common in women. Bowel movements are slow and infrequent, there’s limited urgency, and patients strain to defecate, which can lead to various elderly constipation complications.
Dysfunction of the pelvic floor: Some elements of slow-transit are present here as well. There are also problems with the muscles of the pelvic floor and around the anus (problems with the anal sphincter). Patients have trouble coordinating muscles during defecation, and they have a feeling of incomplete evacuation.
How to prevent constipation:
Add enough fibre to your diet. Eat fruit, vegetables, wholewheat & whole grain products everyday.
Drink enough water. One should drink between 1.5 litre and 2 litres of water per day. Reduce coffee, soda and alcohol consumption.
Never ignore an urge. When you prevent a bowel movement from happening you can confuse your body and this can increase chances of constipation.
Get your body moving. Exercise can do wonders for people suffering from constipation as it helps improve digestion.
Use ozonated oils. Ozonated oils, neutralises excessive acids in the body, neutralises the side effects from drugs that can cause constipation and Ozone balances out the metabolic rate in the body.
Treating constipation with ozonated oil
Researchers have found that the microscopic organisms that live in the gut may be connected to constipation. A study in SpringerPlus shows many people with ongoing constipation have differences in their gut bacteria when compared to healthy individuals.
The bacteria in the gut aid the function of the digestive system by helping to break down food and absorbing nutrients. When they are out of balance, problems such as constipation and diarrhea may occur.
Although the possible link between ozonated oils, bacteria and constipation requires more research, a study in the International Journal of Food Microbiology found that ozonated oils hold antibacterial properties.
Part of the oil's function in the plant is to protect it from unwanted bacteria and fungi, which researchers believe could benefit the human digestive system as well.
Ozonated olive oil is a stimulant laxative. According to the American Academy of Family Physicians, stimulant laxatives cause the bowel to move, squeeze, and contract harder than they usually would.
This means that when a person drinks the oil, it stimulates the bowel to move more. This increased motion encourages the stool to pass through the intestine and out of the rectum.
Although ozonated olive oil can relieve constipation, it can also cause nausea and vomiting as a side effect.