Complications In The Elderly
It is reported that the prevalence of constipation increases with age, especially those over the age of 65 years.
Researchers state that chronic constipation can lead to fecal impaction and fecal incontinence. They state that in severe cases, fecal impaction can cause stercoral ulcerations, intestinal obstruction, or bowel perforation. If left untreated, these complications can be life-threatening.
Older people can also experience a lower quality of life due to complications and discomfort from constipation.
Essentials For Older People
The rectum enlarges as people age, and increased storage of stool in the rectum means that older people often need to have larger volumes of stool in their rectum in order to feel the urge to defecate. The increased rectal volume also allows hard stool to become impacted.
Other common factors in older people that lead to constipation include increased use of constipating drugs, a low-fiber diet, coexisting medical conditions , and reduced physical activity. Many older people also have misconceptions about normal bowel habits and use laxatives too often.
What Lab Tests And Other Medical Tests May Be Done To Find The Cause Of My Constipation
Your doctor can order no tests or many types of tests and procedures. The decision of which ones your doctor might order for you depends on your symptoms, medical history, and overall health.
Colonoscopy: A colonoscopy or sigmoidoscopy an internal view of your colon with a scope may be performed. During this procedure, a small sample of tissue may be taken to test for cancer or other problems and any found polyps will be removed.
Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines.
Other bowel function tests: Your doctor may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of x-ray , done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into the rectum .
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How Lifestyle And Diet Can Cause Constipation
If youre constipated, your gut might simply be in sharp disagreement with your lifestyle. Poor diet and lack of physical activity are the most common causes of constipation, so its a good idea to rule these out first before looking into other causes.
Here are some diet- and lifestyle-related factors that can make you constipated:
- a diet heavy in meat and dairy products
- a diet heavy in processed foods, which are high in fat and sugar
- lack of high-fiber foods
- not enough water and other fluids
- too much alcohol or caffeine
- lack of exercise
- ignoring the urge to use the bathroom
Make a few changes to your lifestyle and see if they result in any positive bowel changes. For example:
- Include more high-fiber foods in your meals: fruits, vegetables, whole grains.
- Take a fiber supplement along with a tall glass of water each day.
- Do some form of physical activity for 30 minutes each day, even if its just a long walk.
- Use the bathroom as soon as you have the urge.
- Avoid alcohol and caffeine.
Common Questions About Constipation
Can constipation cause pain?
Sometimes constipation is just plain frustrating. Other times, it can be painful, particularly if youre having to strain. You may experience:
StomachacheConstipation can be accompanied by gas and bloating, so your belly might be the focus of your discomfort. Drinking lots of water can actually help lessen bloating and hydrate stools, making them easier to pass.
CrampingYou might also feel cramping in your bowels. It can be uncomfortable as hard or dry stools slowly make their way through your colon.
Back painBack pain might be caused by a piece of a hard or dry stool that gets stuck in the colon or rectum, adding pressure that can radiate to your lower back. This feels unpleasant, to say the least.
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Whats The Difference Between Ibs
IBS-C and chronic functional constipation share similar symptoms, such as difficulty passing regular stools. However, they also share key differences.
In particular, researchers note that IBS-C tends to cause more abdominal pain and distention, as well as bloating, heartburn, and depression. Chronic FC, on the other hand, tends to be associated with poorer sleep quality.
Why Does Constipation Occur
There are three main physical causes. One of the causes is where the muscles of the intestine and large bowel stop working properly this results in slow movement of contents through the bowel down to the rectum . This is termed slow transit constipation and patients have an infrequent urge to go to the toilet.
Another type of constipation is called obstructed defaecation where the movement of the bowel is normal, but the person experiences symptoms of difficulty with emptying their bowel. Patients may need to strain, and feel they cannot empty. There are some patients who have both slow transit and obstructed defaecation.
Finally, there is constipation-predominant Irritable Bowel Syndrome when the person has difficulty with bowel opening and abdominal pain associated with not going. This type of constipation can be made worse with stress or depression.
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Medical Causes Of Constipation
Constipation is sometimes symptomatic of underlying medical problems, such as:
- Slow transit some people naturally pass motions less often than most people. It seems their bowel pacemaker may be less active. These individuals are more likely to become constipated with minor changes in their routine.
- Anal fissure a tear in the lining of the anus . The person may resist going to the toilet for fear of pain.
- Obstruction the rectum or anus may be partially obstructed by, for example, haemorrhoids or a rectal prolapse.
- Rectocoele the rectum pushes through the weakened rear wall of the vagina when the woman bears down or strains.
- Hernia an abdominal hernia can reduce intra-abdominal pressure, which makes it more difficult to pass a motion.
- Abdominal or gynaecological surgery a combination of change in routine, strange surroundings, post-operative pain and codeine-containing analgesics is a potent cause of constipation and often needs preventive care.
- Irritable bowel syndrome characterised by abdominal pain, bloating, and either constipation or diarrhoea or alternating constipation and diarrhoea.
- Problems of the endocrine system such as hypothyroidism, diabetes or hypopituitarism.
- Tumour pain while trying to pass a stool could be a symptom of rectal cancer.
- Diseases of the central nervous system such as multiple sclerosis, Parkinsons disease or stroke are associated with an increased susceptibility to constipation.
When Should I Call My Doctor
- Constipation is a new problem for you.
- You see blood in your stool.
- You are losing weight unintentionally.
- You have severe pain with bowel movements.
- Your constipation has lasted more than three weeks.
- You have symptoms of outlet dysfunction constipation.
Remember, talk openly and honestly with your doctor about your bowel movements and any questions or concerns you may have. Pooping is something we all should be doing. Constipation may be a temporary situation, a long-term problem or a sign of a more serious condition. Be safe. See your doctor, especially if youve noticed a change in your bowel pattern or if your life is being ruled by your bowels.
Last reviewed by a Cleveland Clinic medical professional on 11/07/2019.
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How Do You Know If Youre Constipated
If you have fewer than three bowel movements in a week, or if going to the bathroom is painful , you might be constipated. Constipation symptoms might also look like needing to go to the bathroom again immediately after a bowel movement or experiencing gas, bloating, or abdominal discomfort.
- Fewer than three bowel movements per week
- Dry, hard stools or excessive straining
- Gas, bloating, and abdominal discomfort
- Feeling like you cant completely empty your bowels
Occasional constipation is usually nothing to be concerned about. In fact, 80% of people will experience constipation symptoms during their lifetime. However, you should consult with your physician if you experience sudden, unexplainable changes to your bowel movements that persist for more than a week or continually return. These could be signs of an underlying condition.
How Common Is Constipation
You are not alone if you have constipation. Constipation is one of the most frequent gastrointestinal complaints in the United States. At least 2.5 million people see their doctor each year due to constipation.
People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated . These include:
- Older age. Older people tend to be less active, have a slower metabolism and less muscle contraction strength along their digestive tract than when they were younger.
- Being a woman, especially while you are pregnant and after childbirth. Changes in a womans hormones make them more prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool.
- Not eating enough high-fiber foods. High-fiber foods keep food moving through the digestive system.
- Taking certain medications .
- Having certain neurological and digestive disorders .
Needing Help To Have A Bowel Movement
If you find yourself pressing down on your stomach or shifting positions in order to help yourself poop, or even using your fingers to help extract stool from your bowel, that’s definitely a sign of constipation. If you’re going as far as to use your hands, you’re probably closer to the “extreme” side of constipation, says Dr. Maser, which is still not entirely uncommon.
What Else Can Cause Bloating
Constipation isnt the only bloating cause. There are many contributing factors that can lead to a buildup of excess gas in your digestive tract. These include:
- Intestinal bacteria. Sometimes bacteria cant break down all the excess carbohydrates in the stomach and small intestine. When the undigested carbohydrates reach the large intestine, the bacteria located there release excess air.
- Medical conditions. Several medical conditions can increase the occurrence of bloating. These include irritable bowel syndrome, gastroesophageal reflux disease, lactose intolerance, and celiac disease.
- Swallowing excess air. Swallowing too much air by chewing gum, drinking carbonated drinks, eating or drinking very quickly, or even wearing loose-fitting dentures can increase the amount of air building up in your gastrointestinal tract.
In addition to these bloating causes, there are many foods known to contribute to bloating:
While you dont need to avoid all of these foods , avoiding consuming an excess of them can help.
You can also try reducing your intake of certain groupings to see if your symptoms improve.
You should talk with your doctor or other healthcare provider about your constipation and constipation-related bloating if you have the following symptoms:
- frequent bouts of constipation
- sudden changes in constipation symptoms
- unexplained weight loss
Your healthcare provider will be able to recommend different treatments that can help you address your specific symptoms.
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What To Eat When Suffering From Constipation
Digestive health is a key factor in your endeavor to prevent constipation. Therefore, your food should comprise:-
- High-fiber diet (dried figs, pinto beans, oat bran, kidney beans
- Fresh fruits and vegetables containing soluble fiber
- Whole grains and whole wheat bread, which contain insoluble fiber
- Drink plenty of water
What Are The Causes Of Constipation
Medicines: Over the counter or prescription medicines often carry a side effect of constipation. If symptoms began after starting one of these drugs, ask your doctor to see if there are any alternatives. Please see Guts UK information on Opioid Induced Constipation for more information.
Emotion: there is a strong connection between feelings and how the gut works. This is called the gut brain connection, the gut and brain talk to each other, normal signals involve feeling hungry or getting butterflies Sometimes the brain and gut overshare information. Being upset or depressed can make the bowel slow down or speed up. Emotional upsets, even in childhood, may result in functional constipation many years later.
Disturbed eating behaviour: eating disorders and sustained periods of erratic eating can result in constipation, even if eating behaviour returns to normal.
Ignoring the natural urges to open bowels: ignoring bowel urges because of an aversion to public toilets or time or social constraints can result in changes to both how the bowel muscles work and the pattern of bowel opening.
Excessive straining: this can be because of difficulty co-ordinating the muscles that empty the bowel.
Irregular mealtimes reduced liquid intake and reduced physical activity: these can all worsen symptoms in people with a tendency towards constipation.
Pain, or fear of pain, on passing stools.
- Bleeding in the stool
- or rectal pain
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The Poop Is Dry And Hard Or Lumpy
In most cases, the texture of a normal poop is soft and firm. It is also easy to pass during bowel movements. The color also should be brown.
If you experience changes in your poop, primarily in texture, for over two weeks, you are experiencing constipation. When you are constipated, much water is absorbed from the poop, making it hard and lumpy.
What You Can Do About Constipation Symptoms
The most effective thing you can do to help with any constipation symptoms is to have a complete bowel movement and then work on habits that might help prevent you from getting constipated again in the future.
To relieve your current constipation, a big glass of water or a cup of coffee can help get your system moving, Dr. Bedford says. “Caffeine itself will stimulate abdominal muscles and squeezing and may help people to eliminate,” he explains. Exercise can also help.
If these things don’t work, over-the-counter laxatives are an option. Both Dr. Bedford and Dr. Maser recommended using laxatives when you’re constipated, but to use them sparingly. They both suggested that osmotic agents, like Miralax, can be effective. These types of laxatives help keep water in the stool, which makes them easier to pass. Other options include stimulant laxatives, lubricants, and enemas.
But it’s important not to overuse laxatives, as they can actually make constipation worse when used too frequently. Stimulant laxatives in particular can cause dependency over time, Dr. Maser says.
After you’ve successfully gotten your system moving again, try incorporating some gut-healthy lifestyle changes into your routine, like eating more fruits, vegetables, and whole grains high in fiber.
In addition to fiber, drink plenty of water, get regular exercise, and only take laxatives sparingly, preferably when recommended by a doctor.
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A Feeling Of Blockage In Your Rectum That Prevents Bowel Movement
You release the stool with ease and comfort in normal bowel movement, unlike when constipated. For individuals suffering chronic constipation, there is a feeling of blockage that hinders the passage of the poop.
The rectum feels like a barrier that blocks the stool from passing out, and the hard stools result in the slow movement.
When Should I See My Doctor
Commonly, diet and lifestyle factors cause or contribute to constipation. However, in some cases there may be an underlying problem.
Occasionally, constipation can be a sign of an underlying condition such as bowel cancer. In such cases, there are likely to be other symptoms. These may include a recent change in bowel habits, weight loss, bleeding from the rectum or blood in stools, or abdominal pain, cramping or bloating.
If you have any of these symptoms, see your doctor. Also see your doctor if you have severe constipation or constipation that is not getting better with simple lifestyle changes.
To make the diagnosis, your doctor will ask you about:
- your symptoms
- any medical conditions you have
- medicines you are taking
Your doctor may also do a physical examination. This may include:
- feeling your abdominal area
- gently examining your anus and rectum using a gloved finger
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What Causes Constipation
Since constipation may be a sign that there is something more serious wrong, it is important to figure out why you are constipated. Some common causes include:
- Dehydration When you dont drink enough water, your stool is dry and hard, making it more difficult to pass.
- Diet A healthy diet is important for good digestion. You can have constipation from eating processed foods and not getting enough fruits and vegetables.
- Exercise If you dont get up and move around enough it can slow the passage of your stool through your body, allowing it to harden.
- Medication and supplements Many prescriptions and supplements can contribute to constipation.
- Digestion issues Other digestive conditions, like irritable bowel syndrome , can cause constipation. By treating these conditions, you will also address the symptom of constipation.
- Health conditions Diabetes, lupus, and thyroid issues also cause constipation.
When To See A Doctor
Not in all instances will you need the doctors attention because of constipation. Having hard stool once in a while may not supply sufficient evidence youre suffering from constipation.
Here are some cases that may make guarantee your visit for a health check-up:-
- When you have constipation for the first time. You havent experienced dry stools before
- When your daily diet composes of high-fiber foods and still get constipated
- Another known medical condition
- Your bowel movements are fewer than three times a week
- You are losing weight without your intention
- Fever in children
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