Constipation is a symptom, not a disease. It is defined as having
fewer bowel movements than usual, with a long or hard passing of
Older people are more likely than younger people to
have constipation. But 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. “Regularity” may mean
bowel movements twice a day for some people or just twice a week for
Questions to Ask
Some doctors suggest asking these questions to decide if you are
- 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?
If the answers are yes, you probably do have a problem.
Otherwise, you probably do not.
What Causes Constipation?
Doctors do not always know what causes this problem. Eating a
poor diet, drinking too little, or misusing laxatives can be causes.
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 constipation
if they start eating fewer vegetables, fruits, and whole grains.
These foods are all high in fiber, and, according to some studies,
high fiber diets can help prevent constipation. Eating more high fat
meats, dairy products, and eggs can be another cause of
constipation. So can eating more rich desserts and other sweets high
in refined sugars.
People who live alone may lose interest
in cooking and eating. As a result they start using a lot of
convenience foods. These tend to be low in fiber, so they may help
cause constipation. In addition, bad teeth may cause older people to
choose soft, processed foods that contain little, if any, fiber.
People sometimes do not drink enough fluids, especially if
they are not eating regular meals. Water and other liquids add bulk
to stools, making bowel movements easier.
laxatives and enemas. Many people think of laxatives as the
cure for constipation. But heavy use of laxatives is usually not
necessary and often can be habit forming. The body begins to rely on
the laxatives to bring on bowel movements and, over time, forgets
how to work on its own. For the same reason, if you use enemas often
you may lose normal bowel function. Another side effect of heavy
laxative use is diarrhea.
Overuse of mineral oil-a popular
laxative-may reduce the body’s ability to use vitamins (A, D, E, and
K). Mineral oil may also interact with drugs that prevent blood
clots (anticoagulants), causing undesired side effects.
Other causes of constipation. Lack of
exercise or lengthy bedrest, such as after an accident or illness,
may cause constipation. For people who stay in bed and who suffer
from chronic constipation, medications may be the best solution. But
simply being more active, when possible, is best.
ignore the natural urge to have a bowel movement, they may become
constipated. Some people prefer to have their bowel movements only
at home, but holding a bowel movement can cause ill effects if the
delay is too long.
In some people, constipation may be
caused by abnormalities or a blockage of the intestines. These
disorders may affect the muscles or nerves responsible for normal
bowel movements. A doctor can perform a series of tests to see if a
problem like this is the cause of constipation. If so, the problem
can often be treated.
If you become constipated, first see the doctor to rule out a
more serious problem. If the results show that there is no disease
or blockage, and if your doctor approves, try these remedies:
- Eat 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 be aware that some
people become constipated from drinking large amounts of milk.
- Some doctors recommend 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 the
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. “Regularity” differs from person to person. If your bowel
movements are usually painless and occur regularly (whether two
times a day or three times a week), then you are probably not
More information about constipation is available from the
National Digestive Diseases Information Clearinghouse, Box
Bethesda, MD 20892, (301) 654-3810.
For more information
about health and aging, call or write:
Institute on Aging Information Center
National Institute on Aging
U. S. Department
of Health and Human Services
Public Health Service
Institutes of Health