Constipation and gut health
Why constipation is more common in later life
Constipation is more common over 65 years of age, the NHS tells us, however “sometimes there’s no obvious reason.” However, if you’ve changed your diet, made lifestyle changes, or begun taking new medications these could all be responsible too. Sometimes, fears around continence, especially when outside of the home mean that older people don’t drink enough fluids or eat enough fibre in their diet, which can lead to changes in bodily functions. While rare, constipation can also point to more serious causes such as bowel cancer, so it’s always worth having a chat with a healthcare professional if things don’t improve.
Common causes
There are many reasons for constipation, the majority of which can be amended or changed to try and improve symptoms.
Not drinking enough
This can be because they don’t want to use too many pads because of the cost or are worried that they can’t get to the toilet in time due to mobility issues. It could also be that they find water bland or are worried about choking.
Diet and fibre
It can be hard to eat a balanced diet, especially when there are concerns around swallowing or continence. Older people may be worried that fibre-rich foods are harder to chew or swallow, causing fears around choking.
Reduced mobility
As we get older, mobility is sometimes reduced and activity slows. The temptation to spend longer sitting down – perhaps due to pain while moving – means that the body’s systems can become more sluggish.
Medication side effects
Opioid medications in particular, can cause constipation. These include codeine, tramadol, morphine, buprenorphine, tapentadol and fentanyl. According to Guts UK, they can often have side effects on the gut.
Ignoring the urge to go
Whether it’s because of a lack of mobility, or because they are not recognising the signs of needing to go to the toilet, some older people may ignore the urge to go. They may also be concerned about pain or discomfort.
Medical conditions
Medical conditions can also affect the nerve endings that regulate continence. Conditions such as Parkinsons disease, multiple sclerosis, or dementia can mean someone cannot manage their toileting.
Signs to look out for
It’s important to ensure that older people are supported with their continence needs, especially if they are unable to communicate traditionally. Caregivers should look for symptoms of constipation and related discomfort.
Signs in someone with dementia or who cannot tell you
If someone is living with advanced dementia and is non-verbal, it’s unlikely they’ll be able to communicate constipation. Caregivers should always note changes in appetite, and differences in routine, as any of which can affect the toileting process.
Several functions need to work together to ensure successful toileting, including feeling the urge, recognising what it means, and getting to the toilet in time. As UK Dementia Information says, “Dementia can affect any link in this chain.”
Practical ways to help at home
If you are providing care for a loved one, it can be difficult to know when they want to go to the toilet. They may use pads; however, some older people are understandably very private about their toilet habits, wanting instead to maintain their independence and keep such details personal.
Food and fluids
While a balanced diet should always be eaten, containing adequate fibre to keep constipation at bay, some people are worried about eating too much fibre in case it causes loose stools or diarrhoea. Therefore, gradually increasing fibre in the diet so that affects on bowel habits can be monitored is the best way to approach it. Drinking plenty of water – or other fluids if water isn’t enjoyed – while avoiding alcohol, is also important.
Movement
Movement and staying active is important at any age, but especially as we age. This is because bones can weaken and muscles can waste if they are not used, and lack of movement can cause constipation. Fears around falling or joint pain can prevent movement but encouraging them to be as active as they can be, within their limitations, will help avoid constipation. Suggest chair exercises such as yoga or Pilates, at first.
Routine and privacy
A break in routine may be all it takes to interrupt regular toileting. Being away from home and in a strange place may mean the person doesn’t want to go to the toilet, perhaps if they’re staying with a loved one or having a spell in hospital. Many people don’t go to the toilet as often if they’re on holiday or eating an unfamiliar diet either. The temptation to eat an unhealthier diet when we’re out of our routine at home may also risk constipation.
Laxatives and when they are appropriate
The NHS recommends that lifestyle changes are attempted before laxatives are tried, but it’s recognised that this may not be suitable for everyone. If lifestyle and diet changes have been attempted but they haven’t helped, laxatives may be recommended by a healthcare professional. Laxative are designed to ease symptoms of someone who is having difficulty passing waste. They can also help if certain conditions necessitate softer pools to be passed. Your GP may prescribe laxatives if you are taking medication that makes defecation more difficult as a side effect. They may also be used if an empty bowel is required before a medical procedure.
When to contact a GP
Contacting a GP is especially important when older people are feeling unwell. This is because they may have lower resistance to conditions, and may take longer to recover from illnesses after they’re diagnosed.
Symptoms that need urgent attention
Contacting a GP or calling 111 for advice is essential if constipation hasn’t responded to treatment or is accompanied by other symptoms, such as bloating, losing weight without trying, blood in the stools, feeling tired all the time, stomach pain, or high fever. If opioid painkillers are being taken this should also be discussed with the GP.
Impaction and overflow
If constipation is allowed to go on for too long a condition called faecal impaction can develop. Waste builds up in the last part of the large intestine (rectum) and can cause diarrhoea, which leaks through the build-up of solid waste. A healthcare professional may need to remove some of build-up manually or administer medication to help.
Dignified personal care from Helping Hands
We promote our customers’ dignity and independence above all else. If you or a loved one is living with constipation it can be extremely uncomfortable and make you not want to leave your home. This can have a knock-on effect on every aspect of your life.
Discreet personal care at home
Our carers will support your personal care, on both a visiting or live-in care basis. This means you get to dictate your routine and what works best for you. Regardless of how often your carer is there, they will undertake your personal care discreetly, ensuring you get to live as comfortably as possible in the home you love.
Nurse-led support
We are unique in private home care companies for having our own team of clinical nurses on staff. They manage all of our clinical care packages where people are living with complex care conditions that have an impact on their continence. Wherever you live in England and Wales, we’ll have a team of professionals near you.
Arranging support with our team
Arranging support with Helping Hands is so easy. Contacting our friendly customer care advisors – by phone, online, or via our webchat service – or requesting a callback for a time that suits you better, means that you’ll be in the very best hands from day one. You can also pop into your nearest branch and chat face-to-face with the local team.
FAQs
Constipation can be more common in later life due to increased amounts of medications being taken, less regular activity being undertaken, and a decrease in food and drink consumption.
Definitely. Even moving about the house will help the body to be less sluggish, which will also assist the bowel to work as it should. Any level of activity is better than none at all.
If more symptoms have developed, or constipation hasn’t responded to treatment, medical advice should be sought. If the person shows symptoms of increasing pain or are taking opioid painkillers the GP or 111 should be consulted.
If someone doesn’t communicate in a traditional way it can be harder to recognise when they are in discomfort or pain. Using hand gestures, pointing to the area, or picture cards may illicit a response, but prevention is always better than cure. The Alzheimer’s Society has tips on their website to help someone living with dementia to avoid constipation.
Yes, Helping Hands are fully regulated by the Care Quality Commission and Care Inspectorate Wales to undertake personal care for our customers. Our carers are all directly employed by us which means we provide them with exceptional training and qualifications, so you and your loved ones will be reassured by who’s coming into your home.
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How we wrote this page
This page has been produced referencing key insights and data from external experts, trusted medical sources and our team of in-house specialists. We have worked hard to ensure that all information is as accurate as possible and reflects current consensus at the time of writing and reviewing.