What is constipation?
In short Constipation means infrequent, hard, or difficult-to-pass stools, often with straining or the feeling of incomplete emptying. In older adults, it’s common and usually improves with steady habits and, when needed, safe laxatives.
Targets: comfortable, regular bowel movements (your personal “normal”), minimal straining, and prevention of complications like hemorrhoids or fissures.
When to seek urgent help
- Severe abdominal pain, vomiting, or inability to pass gas or stool
- Unexpected blood in stool or black, tarry stools
- Unintentional weight loss, fever, or new anemia
- Sudden change in bowel habit after age 50
These could signal blockage or other serious conditions. Seek care promptly.
Common symptoms
- Hard, dry, or lumpy stools
- Straining or pain with bowel movements
- Feeling of incomplete emptying
- Fewer than 3 bowel movements per week
- Bloating, lower abdominal discomfort
Related topics
- Hydration & Drinks
- Daily Living Routines
- Fiber-Rich Recipes
- When to Call a Doctor
Common causes & medicines
Lifestyle & medical
- Low fiber, low fluids, limited physical activity
- Ignoring the urge, irregular routines (travel, hospitalization)
- Diabetes, hypothyroidism, Parkinson’s disease, prior stroke
- Pelvic floor dysfunction (trouble coordinating muscles)
Medicines that can constipate
- Opioids (pain medicines)
- Iron supplements, some antacids, calcium supplements
- Some antidepressants, anticholinergics, Parkinson’s meds
- Some blood pressure medicines (e.g., calcium channel blockers)
Never stop a prescribed medicine on your own—ask for alternatives or bowel plans.
Evaluation & simple tests
- History & exam (diet, medicines, routine, red flags)
- Basic labs in some cases (blood count, thyroid, glucose, calcium)
- Stool tests or colon cancer screening per age/risk and local guidance
- Specialized tests only when needed (anorectal manometry, transit studies)
Plans are tailored to symptoms, risks, and age-appropriate screening.
Bowel routine (step-by-step)
Daily rhythm
- Pick a regular time (often 20–30 minutes after breakfast)
- Sit with feet supported (small footstool), lean forward, relax belly
- Practice slow belly breathing; avoid straining
- If no urge in 10–15 minutes, try again later—consistency wins
Gentle stimulators
- Warm drink in the morning
- Short walk after meals
- Abdominal massage clockwise if comfortable
Laxatives: options & safety
Common options (examples)
- Bulk-forming: psyllium/ispaghula (add slowly; needs fluids)
- Osmotic: polyethylene glycol (PEG), lactulose
- Stool softener: docusate
- Stimulant: senna or bisacodyl (often bedtime, short courses or as part of a plan)
- Suppository/enema: for occasional rescue if oral steps fail
Fiber, fluids, movement
Fiber goals
- Increase gradually (oats, fruit, vegetables, beans/lentils, whole grains)
- Consider psyllium if diet alone isn’t enough
- If you follow a special diet (kidney/diabetes), choose fiber within those limits
Fluids & movement
- Steady sips through the day unless on a fluid restriction
- Limit dehydrating drinks if they bother you
- Daily light walking; gentle core/hip exercises support bowel movement
Special situations
Travel & routine changes
- Pack your fiber and any usual laxatives
- Keep mealtimes and morning bathroom time similar if possible
Hemorrhoids & fissures
- Prevent straining; use stool softeners as needed
- Warm sitz baths can soothe; seek care for bleeding or severe pain
Pelvic floor dysfunction
- Symptoms: prolonged straining, feeling blocked
- Ask about pelvic floor therapy (biofeedback) if suspected
When to see your clinician
- Constipation lasts > 3 weeks despite steady routine
- Needs frequent rescue measures or severe bloating/pain
- New symptoms after a medicine change
- Any red flags (bleeding, weight loss, anemia, vomiting)
Questions to ask
- What’s the likely cause of my constipation?
- Which fiber amount and laxatives are right for me?
- Can any of my medicines be adjusted?
- Do I need tests or age-appropriate cancer screening now?
- What’s a safe “rescue” plan if I go several days without a BM?
Quick answers
How much fiber should I aim for?
Many adults do well increasing gradually toward 20–30 g/day from foods and/or psyllium—adjust for your medical conditions.
Are stimulant laxatives safe?
They can be used safely as part of a plan (often short courses or intermittent). Long-term daily use needs clinician guidance.
What about probiotics?
Some people find them helpful, but results vary. Diet, fluids, movement, and fiber are the foundation.
Can iron tablets cause constipation?
Yes. Ask whether the dose, type, or schedule can be adjusted—or whether alternatives are suitable for you.
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