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What Can I Do About My Constipation?
This uncomfortable condition becomes more common with age and can have serious health consequences. Here’s how to tackle it
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I’m constantly constipated. What can I do about it?
Constipation is one of those problems people often put up with for far too long because they assume it’s simply an unavoidable part of getting older. While the condition becomes more common with age, that doesn’t mean it’s something you have to accept. In most cases, there are several things you can do to improve it, and if those aren’t enough, there are effective medical treatments.
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One of the biggest reasons constipation becomes more common as we age has to do with water. Your colon naturally pulls water out of stool. If you’re not drinking enough fluids, it pulls out even more, leaving the stool hard, dry and more difficult to pass. Many older adults intentionally drink less because they’re worried about frequent trips to the bathroom or bladder leakage, but that strategy often backfires by making constipation worse.
That’s why my first recommendation is almost always to increase your fluid intake. Water is wonderful, but it isn’t your only option. Fruits and vegetables can contain a great deal of water, too, so adding more of them to your meals is a good plan.
Which brings me to fiber. Edible fiber helps stool retain water, making it softer and easier to move through our digestive tract. Whole grains, beans, lentils, fruits, nuts, seeds and vegetables are all excellent sources. If your diet is low in fiber, increase it gradually over a week or two. (For ideas on how to do this, see 25 Easy Ways to Get More Fiber Into Your Diet.) Adding too much too quickly can leave you feeling bloated and uncomfortable.
If food alone isn’t enough, a fiber supplement may help. Among the options available, psyllium has some of the strongest evidence supporting its effectiveness.
Movement is another powerful remedy we often underestimate. Your digestive tract responds to activity. I often say, “If you’re moving, your bowels are moving.” Even a brisk walk can stimulate the intestines. I recently suggested to a patient that she have a cup of hot tea or coffee, eat some fruit and then go for a morning walk. She later told me it worked like a charm. Yoga, stretching, gardening or any activity that gets you moving will keep your digestive system active.
What’s more, research shows that constipation may be a marker of overall physical health in later life. A 2021 study of around 1,200 community-dwelling older adults found that constipation was associated with slow gait speed and sarcopenia, or age-related loss of muscle mass and strength. The researchers concluded that muscle loss is common in older people with constipation. It’s possible that those who are constipated also don’t tend to move or exercise much. That’s another reminder that regular movement benefits far more than just our heart and muscles; it helps keep our digestive system working as well.
It’s also important to ask yourself whether this has been a lifelong issue or whether it’s something new. If you’ve struggled with constipation for years, hydration, fiber and exercise are usually the best places to start. But if your bowel habits have changed recently, don’t ignore it. A new pattern of constipation deserves a conversation with your health care provider. While constipation is usually not serious, it can occasionally be a sign of an underlying medical condition that warrants attention.
Your doctor will likely review your medications. Many can contribute to constipation, including certain blood pressure medications, narcotic pain medicines and some antihistamines. Sometimes simply adjusting a medication can make a remarkable difference. Other conditions, such as an underactive thyroid, can also slow the bowels.
If you’ve tried these strategies and you’re still struggling, don’t suffer in silence. Today’s prescription treatments are much more sophisticated than the harsh laxatives you may remember. Some work by increasing the amount of fluid in the stool, making bowel movements easier and more comfortable.
The most important point I’d like you to remember is this: Constipation is common, but it isn’t something you have to live with. Left untreated, it can lead to bloating, abdominal pain, nausea, emotional distress and, in severe cases, stool becoming so impacted that hospitalization is required. The good news is that with the right combination of health habits, a careful review of your medications and, when necessary, newer prescription treatments, most folks can find relief and get back to feeling fine.
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