Constipation in the Elderly: Causes and Treatments

Close to a third of elderly Americans suffer from chronic constipation, a condition that will affect most individuals at some point. It has been labeled as a condition of modern life, one aggravated by an addiction to fast food and reliance on medications. However, there are many underlying causes, some of which are less obvious than others.

Causes of Constipation in the Elderly

Constipation can be a sign of something more serious, covering everything from cancer to metabolic diseases like diabetes. Usually, however, the causes are innocuous, easily diagnosed, and just as easily remedied. 

They include:

Opiates and Opioids

The United States is in the midst of an opioid epidemic right now. In fact, experts have been saying those words for several years, and the issue is showing no signs of stopping. These highly addictive drugs are readily prescribed, and while healthcare experts are using a little more caution these days, that caution doesn’t apply to elderly patients.

If you walk into a room of over-60s and announce that you have back pain, you’ll be greeted with a cacophony of rattling pill bottles as opioids are thrust into your face. They’re common. It seems like all seniors have been prescribed them at some point and many are on them long-term.

This is a problem for many reasons, but for the context of this article it’s a problem because opiates and opioids cause constipation. These drugs are often used to treat severe diarrhea for this very reason. They shut the body down and make it difficult to pass anything, even with relatively mild doses.

Many users don’t even realize this and may blame their diet or activity levels.

Speak with your doctor about treating opioid-induced constipation. They can prescribe fiber supplements or laxatives designed to introduce water into the bowel. They will also advise you to follow some of the treatment options described below.

Other Medications

While opioids are one of the most common causes of medication-induced constipation, other drugs have the same effect, including drugs in the following classes:

  • Anti-Anxiety Medications 
  • Antidepressants
  • Calcium Channel Blockers
  • Diuretics
  • Sedatives


Your body needs water for optimal function, and this includes your bowel. The more dehydrated you are, the dryer your stools will become, making it hard for them to move through your bowel.

Chronic dehydration can cause chronic constipation, delaying the passage of your stools and causing a gridlock of sorts. If the problem persists, your stools may become impacted, leading to a blockage and a host of serious complications.

As you get older, the signals that trigger thirst become less effective. When you combine this with mobility issues, swallowing problems, and medications, dehydration becomes a very real and common threat.

Lack of Fiber

Low fiber consumption has been linked to a host of illnesses and diseases, including heart disease, bowel cancer, and even diabetes. 

In the United States, as little as 5% of the population eats enough fiber. These things could be purely coincidental, but the research suggests that getting enough fiber could significantly improve your health and increase your lifespan.

Constipation is one of the many problems caused by a low-fiber diet. 

Fiber is the roughage that helps everything to move slowly and it comes in two forms: soluble and insoluble. 

This refers to whether or not the fiber dissolves in water. Soluble fiber, which does dissolve in water, helps to slow digestion down, facilitate digestion, and may also help to regulate blood sugar. Insoluble fiber works by adding bulk to the stool and also helps to draw water into the bowel.

Both types of fiber are commonly found in fruits and vegetables and are required to maintain proper digestion. It’s important, however, that you drink lots of water to facilitate the passage of the fiber.

Some fiber supplements will give you a large dose of soluble fiber, but if you’re consuming this while dehydrated, you may cause more problems than you fix.

Treatments for Constipation in the Elderly

In the section above, we highlighted some of the specific causes and possible solutions of constipation, but there are more solutions out there and these often apply regardless of the cause.

  • Water: Drink plenty of fluids throughout the day. It’s very difficult to drink too much water (although it is possible, so don’t overdo it), but it’s easy to not drink enough.
  • Fiber: Eat a diet rich in fruits and vegetables. Whole foods like these are rich in fiber, water, and nutrients, and can improve your digestive health. Beans and greens are a great source of fiber, as are fruits like apples and bananas.
  • Exercise: A little exercise goes a long way and could help to stimulate activity in your bowel. The more inactive you are, the greater the risk of constipation becomes.
  • Medications: There are a host of different medications available for constipation. These include medications designed to introduce water or fiber, and medications designed to stimulate the bowel.
  • Healthy Bacteria: It may help to introduce some healthy bacteria into your gut. Some sufferers find relief after introducing fermented foods into their diet, including things like kefir and sauerkraut.
  • Natural Laxatives: Incorporating a few natural laxatives into your diet may help to alleviate constipation. These include healthy oils, rhubarb (contains sennosides), and prunes.
  • Maintaining a Ritual: It helps to establish a ritual and to defecate at specific times every day. It can seem counterproductive, but if you sit down and try during a specific time every day, you can make it a habit.

If you find that you’re struggling with constipation on a regular basis and you can’t seem to find consistent relief, you should speak with your physician. Constipation can be harmless and easy to treat, but as noted above, it can also be a sign of something much more serious. If it persists, it can be very difficult to live with.

In addition, it’s important not to become too reliant on over-the-counter medications, especially when they are being consumed without guidance from your doctor.

Bulk laxatives, which are designed to introduce fiber, are generally well-tolerated long-term. That said, if you’re using spasmodic laxatives, your body may become reliant on them, which means you may struggle to have a bowel movement without them and develop a tolerance.