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Constipation in the Elderly – Diagnosis, Causes, Types, and Management

Constipation is one of the common challenges or problems the elderly (typically over 60 years) often complain about. In fact, older adults are about 5-times more prone to constipation than younger adults. Let’s talk about some of its causes.

Common Causes of Constipation in the Elderly

Among the common causes of constipation in the elderly are lack of adequate fluids in their diet, the use of medicines or drugs to fix one or more other existing medical conditions, lack of exercise, and the major one is poor bowel habits.

Besides, there is also one psychological angle to this. Many of the older adults overthink or are pretty much concerned about their bowel movements and, thus, constipation becomes an imaginary ailment.

Some widowed or single older adults do not show much interest in eating and end up consuming convenience food, in a state of extreme hunger, which is often low in fiber. Another reason for meal irregularities could be the loss of teeth.

Types of Constipation in the Elderly

When it comes to types of constipation, the following is the list you can refer to:

1. Normal transit constipation

This type of constipation is very common among older individuals. In this case, they experience difficulty during their bowel evacuation due to the affected rate of passing stool through their colon. Such individuals also have ISB (irritable bowel syndrome) during constipation. The abdominal pain differentiates chronic constipation from IBS.

2. Slow-transit constipation

This type of condition during constipation is common in older women. These women experience reduced or infrequent bowel movements, restricted urgency, or straining to defecate in addition to slow colonic movements.

3. Pelvic floor dysfunction

This is more of a problem with the muscles of the person’s pelvic floor or sometimes around the anus. Individuals suffering from this condition usually have a poor ability to coordinate these muscles at the time of defecation. As a result, they have a feeling of incomplete evacuation along with slow transit colon.

Diagnosis of Constipation in the Elderly

The diagnosis of constipation begins with a detailed examination of both the history and current health of an individual. A case of drug-induced constipation could be a result of prolonged inactivity and completely changed diet and daily fluid intake, which might be a result of medical history.

Besides, conditions like worsening of constipation, baffling weight loss, blood in the stools, fever, nausea, reduced/loss of appetite, vomiting, and even apparent family history of colon cancer or inflammatory bowel disease in older adults (age over 50 years) need careful evaluation.

The patient has to undergo a set of general examinations for evaluation of the presence of some other causes of constipation. These other causes often affect other parts of the body due to the inclusion of the following:

  • A heart condition, i.e. heart attack
  • Diabetes mellitus
  • Hypokalemia (low potassium in the blood)
  • Hyperparathyroidism (overactive parathyroid glands)
  • Hypercalcemia (increased calcium in the blood)
  • Hypermagnesemia (increased magnesium in the blood)
  • Hypothyroidism (underactive thyroid)

Managing Constipation in the Elderly

The primary aim of managing chronic constipation in older individuals is to restore normal bowel movements, ensure painless passage of soft, formed stool for a minimum of 3 times a week and make life better with zero or minimal side effects.

With the increasing age, older individuals should bring in some lifestyle changes, including regular physical activities, eating healthy and balanced meals, which include adequate fluids and sufficient fibers. In the meantime, they should cut down on their everyday tea, coffee, and alcohol intake as much as possible, and drink a few extra glasses of water for each cup of tea, coffee, or alcohol.

Add more and more sources of soluble fiber, such as oats, beans, green vegetables, lentils, rice bran, chia seeds, and flax seeds, etc. in everyday meals to reduce the chances of constipation.


Older people often fear of constipation and become pretty much dependent on stimulant laxatives. Once an individual becomes habitual of laxatives, their natural mechanism of bowel movement fails to work without such drugs. Adding fiber-rich vegetables, green salads, and necessary supplements to their everyday diet can help prevent the chances of constipation in older individuals.

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