Have you noticed that older people seem to be obsessed with being regular? I know it may sound amusing, but the older people get, it seems the more concerns with constipation they have. In fact, constipation is one of the most common ailments in people over age 65, especially women, accounting for most of the 4 million Americans who are affected by it.
While it’s true that a decreased metabolism past age 40 can contribute to constipation, unless you have a specific medical condition that creates constipation, it does NOT have to be a chronic condition of getting older. Allow me to explain about bowel function and constipation.
What Is Constipation?
Constipation is the inability to empty your bowel completely on a regular basis. Normally, the colon absorbs water from food and forms waste matter, or stool. It then moves it to the rectum where it stays until you have a bowel movement. Constipation occurs when the stool is too dry and/or the colon’s muscles contract too slowly.
Types of Constipation
There are basically 3 categories of constipation. They are:
- Functional: Usually caused by incomplete nutritional, water, exercise requirements, or certain food or drugs. Most people will fall into this category, especially women.
- Idiopathic: Unknown, may not respond to traditional treatment. Usually nerve damage or blockages can be involved. Can require manual removal procedures periodically.
- Irritable bowel syndrome: Results from a spastic condition of the muscles of the bowel, moving too much resulting in diarrhea, and then too little resulting in constipation.
What Causes Constipation?
As you can see, functional constipation is the most common type. It also has the widest variety of causes which can happen at any age! The up side of functional constipation is that with some easy lifestyle and nutritional changes, this type of constipation can be remedied fairly easily. Here are some reasons why it occurs:
- Decreased fluids intake – the colon depends on adequate levels of water to create waste that moves properly through your colon. If water is inadequate, stool becomes hard and dry, and becomes impacted in the colon. Daily water intake: divide your weight in half. If you weigh 200 lb, drink 100 oz water daily.
- Too little fiber – always, I stress the importance of the right amount of fiber in your diet. The American Dietetic Association recommends 20-35 grams a day. Guess what most Americans consume? About 5-10 grams a day! Without enough fiber, your colon cannot form solid waste, resulting in either watery diarrhea or pellet-like stool, both of which create uncomfortable and unhealthy bowel emptying.
- Medications – many OTC and prescription drugs can cause constipation because they absorb water from the colon which can result in hard, dry stool. These include: pain pills (especially Vicodin, oxycodone, other narcotics), aluminum or calcium containing antacids, calcium channel type blood pressure pills, Parkinson drugs, antispasmodic drugs, iron pills, diuretics, antiseizure drugs. Ask your doctor if your medication could be contributing to your constipation.
- Lack of exercise – your colon is a muscle like all other muscles of your body and is affected by exercise or the lack of it. Without regular physical activity, colonic muscles can become weak and unable to contract properly. Colonic inertia, or lack of movement, occurs and constipation results. Twenty to thirty minutes a day of actual physical movement, i.e., walking, riding a bike, swimming, golfing, can go a long way to help you stay regular.
- Certain health conditions – thyroid disease, diabetes and metabolic resistance, spinal cord and other nervous system disorders, hypercalcemia (too much blood calcium), lupus, scleroderma. Tumors, intestinal obstructions, surgical scar tissue, diverticulosis, all can create constipation.
Symptoms of Constipation
Most of us know when we’re constipated and just can’t seem to go. We feel:
- Sluggish – from toxins in waste that keep getting released into the blood stream.
- Bloated – you can gain up to 10 lbs from constipation causing your belly to stick out.
- Crampy – impaction of waste can cause painful cramping when it cannot pass easily.
Aging and Constipation
As I mentioned above, as we get older our metabolisms slow down. This can occur as early as age 40. Hormone changes occur in both males and females that can affect metabolism. We start burning fewer calories and we can gain weight.
If we stop getting regular physical activity our muscles can become weak and lose their tone. Remember, the muscles of the colon are like other body muscles. The less active you are, the weaker they become. The key, then, is to boost your metabolism, and your muscle strength, by maintaining optimal nutritional levels, getting regular physical activity that you enjoy, and doing some strength building exercise with weights.
Avoid Constipation At Any Age
As I recommend to my patients, there are many things you can do to prevent/remedy constipation. Doing a few of these together helps ensure that you stay regular at any age!
- Limit saturated fats – animal fats act as a binder that can contribute to constipation.
- Strength training – 20 minutes, 3 x a week will keep your muscles from shrinking and becoming weaker. You can use free weights or weight machine equipment.
- Don’t postpone the urge – many people ignore the initial “urge signal” to have a bowel movement and wait much longer than they should to go. This can lead to constipation.
- Short-term relief – I don’t recommend using laxatives on a continuous basis as your body can become dependent on them. However, there are some excellent over-the-counter (OTC) herbal-based aids such as senna, or Dulcolax, or preparations containing cascara sagrada (such as Dieter’s Tea, bought in health food stores in the tea section) that are very helpful in getting past a bout of constipation.
- Check magnesium levels – as we get older, we can become deficient in magnesium, which can contribute to constipation as well as muscle cramps. 400 mg a day is key.
- De-Stress – life events can cause us to carry a lot of tension in our muscles from stress. The more you can let go of tension, the less trouble you’ll have with constipation.
- Detox – upon arising, squeeze ½ fresh lemon into a cup of hot water (sweeten if you want) and drink down. This not only helps cleanse your bowel, but also helps remove toxins from your liver.
- Olive oil – 1 tablespoon a day can help you stay regular and help your heart!
Constipation can be an uncomfortable and frustrating condition at any age. However, it doesn’t have to be a chronic part of your life just because you’re past age 40! Remember, too, what’s normal for one person may not be normal for you, so it may be counterproductive comparing your habits to someone else.
As long as you are eliminating about 4 times a week, you’re within healthy bowel activity. Following the suggestions outlined here, however, should keep you moving happily along, no matter how many candles you put on your birthday cake!
Mark Rosenberg, M.D.