6 Causes of Constipation in Older Adults

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Constipation is a common problem for older adults, but contrary to popular opinion, it isn't an inevitable part of aging.

In fact, it's a common misperception that only older adults become constipated or that the condition is triggered by age, says Rachel Jantea, MD, an assistant professor of geriatric and palliative medicine with McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and the director of education for the UTHealth Consortium on Aging.

Rather, older people are more likely to have constipation than younger people because they tend take more medications or be less mobile — two major causes of the problem, says Dr. Janea.

And constipation isn't just uncomfortable (although it certainly can be). "If constipation gets bad enough it can cause a bowel obstruction," she says. Also known as a blockage, bowel obstructions can cause tears in the intestinal wall, which can lead to an infection, says the Mayo Clinic.

If you think you might be constipated, talk to your doctor. In the meantime, here are six things that might be triggering your symptoms.

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1. Prescription medications

Medications are one of the biggest contributors to constipation in older adults, says Dr. Jantea. In particular, anti-cholinergic drugs — which are prescribed to help treat Parkinson's, an overactive bladder, depression, and more — are a well-known class of medication that can trigger constipation, says Dr. Jantea.

Another type of medication, called opioids (which are used to treat pain), are also a cause of constipation, she says.

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2. Over-the-counter meds

Just because a medication is available over the counter doesn't mean you won't experience any side effects from taking them. For example, antihistamine medications that contain diphenhydramine can cause constipation in some people, says Dr. Jantea.

"People take these for allergies or to help with sleep, and think there's no issue with them," she says. "But [diphenhydramine] is a hidden ingredient — there's no big red flag that this could be a problem in older adults."

Check the label to see whether your medication contains diphenhydramine; the ingredient is often found in medications that have "P.M." in the name, says Dr. Jantea.

3. Supplements

For some people, iron supplements and calcium supplements cause side effects like constipation, says Dr. Jantea. (Calcium carbonate tends to be the most constipating form of calcium, according to the Mayo Clinic.)

4. A sedentary lifestyle

It's not uncommon for people to become less active with age. But the more you sit (or lie) down, the harder it might be for you to go to the bathroom, says Dr. Jantea.

"Being mobile gets you upright, so that gravity can help you," she says. "It's really hard to move your bowels when you're lying flat." Plus, she adds, "just the act of walking stimulates your body to be metabolically active, and that's going to squeeze your intestines in a way that will help you move your bowels."

5. A lack of fluids

People who don't drink a lot of fluids might have a hard time going to the bathroom. "If you're not drinking very much water, then not very much water makes it through the GI tract into the colon," says Dr. Jantea. "The colon will absorb every drop in there, and what comes out is going to be dry and hard to [pass]."

The National Institute of Aging points out that, with age, people may lose their sense of thirst. The organization tells people not to wait until they feel thirsty to start drinking fluids—instead, try to drink water throughout the day, including between meals, before exercising, and when taking pills.

6. Not eating enough fiber

Fiber is an important part of a healthy diet — not only does it help you feel fuller, longer, according to the U.S. National Library of Medicine, but it also boosts your digestive health and helps ward off constipation. The problem, says Dr. Janea, is that most people in the United States don't eat enough of it.

"When fiber moves through your body and down into the colon, it attracts water into the stool, which helps it bulk up," she explains. "And when the stool is bulked up, it stimulates the colon to move, and lubricates it so that it's easier to pass."

Men and women over the age of 50 should aim to consume 30 and 21 grams of fiber each day, respectively, says the American Academy of Nutrition and Dietetics. You can find fiber in fruits, vegetables, nuts, and beans, she says. If you're having trouble adding fiber to your diet, ask your doctor whether you should take a supplement.

If you're struggling with the symptoms of constipation — such as passing fewer than three stools a week or are straining to go to the bathroom — talk to your doctor about what might be causing the problem, as well as possible solutions.

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