Constipation in Seniors: Causes and Concerns - Gastroenterology and Hepatology

Q: Constipation in Seniors: Causes and Concerns

Hello： If you are still able to have bowel movements, it cannot be classified as a bowel obstruction. <br>However, if your bowel habits have significantly changed during this time, it is indeed important to consider the possibility of colorectal cancer. <br>It would be advisable

My mother has a bowel issue - constipation?

Hello, doctor.
My mother is 74 years old, and she has not had a normal bowel movement for almost 12 days.
In the past 11 days, she has only had bowel movements on 2 days, both of which were constipated.
The first bowel movement was somewhat thin, yellow-brown in color, and not very substantial in volume.
The second bowel movement was about the size of a small thumb, also yellow-brown, and consisted of only 1 to 2 small pieces.
My mother takes a stool softener every night (prescribed by her hypertension doctor).
During these 11 days, she has occasionally experienced cramping abdominal pain, followed by excessive flatulence or the sensation of stool being stuck at the rectum, along with significant abdominal bloating that makes it difficult for her to eat.
In the past two weeks, she has been taking cold medication, and when she asked her doctor if the constipation could be related to the medication, the doctor said that cold medications do not cause constipation.
She eats green vegetables for all three meals, but due to her recent cold, she has not been eating fruits, such as bananas (which she says help her with bowel movements).
I would like to ask the doctor if my mother's condition could potentially be related to colon cancer or bowel obstruction?

Lai Xiaojie, 30~39 year old female. Ask Date: 2019/11/29

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you are still able to have bowel movements, it cannot be classified as a bowel obstruction.
However, if your bowel habits have significantly changed during this time, it is indeed important to consider the possibility of colorectal cancer.
It would be advisable to consult a gastroenterologist or a colorectal surgeon to get their opinion.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2019/11/29

More Info

Constipation in seniors is a common issue that can arise due to various factors, including dietary habits, medication side effects, and underlying health conditions. In your mother's case, the fact that she has not had a normal bowel movement for nearly 12 days is concerning and warrants further investigation.

Firstly, it's important to understand that constipation is defined as having fewer than three bowel movements per week, and it can be accompanied by symptoms such as abdominal pain, bloating, and discomfort. In older adults, constipation can be particularly problematic due to changes in the gastrointestinal system, decreased physical activity, and potential medication side effects.

In your mother's situation, there are several factors to consider:
1. Dietary Intake: While you mentioned that she consumes green vegetables, it is crucial to ensure she is also getting enough fiber from a variety of sources, including fruits, whole grains, and legumes. Fruits like bananas can help promote bowel movements, but if she is not eating them regularly, this could contribute to her constipation. Additionally, hydration is essential; seniors often do not drink enough fluids, which can exacerbate constipation.

2. Medication Effects: Although her doctor indicated that the cold medication she took is not likely to cause constipation, it is essential to review all medications she is currently taking. Some medications, especially those for hypertension, pain relief, and certain antidepressants, can lead to constipation as a side effect. If she is taking a softener, it may not be sufficient if her diet lacks fiber or if she is dehydrated.

3. Physical Activity: Regular physical activity can stimulate bowel function. If your mother has been less active due to her cold or other health issues, this could contribute to her constipation. Encouraging gentle exercises, such as walking, can be beneficial.

4. Underlying Health Conditions: While the concern about colorectal cancer and bowel obstruction is valid, especially given her age and the symptoms you described, it is essential to approach this with caution. Symptoms such as severe abdominal pain, bloating, and changes in bowel habits can indicate more serious conditions. However, these symptoms can also arise from less severe issues like functional constipation or medication side effects.

Given the duration and severity of her symptoms, it is advisable to seek further medical evaluation. A healthcare provider may recommend:
- A thorough assessment: This could include a physical examination and possibly imaging studies or lab tests to rule out any serious conditions such as bowel obstruction or malignancy.

- Adjusting medications: If her current medications are contributing to her constipation, her doctor may consider alternatives or additional treatments.

- Dietary modifications: A nutritionist can help create a balanced diet plan that includes adequate fiber and hydration.

- Laxatives or stool softeners: If over-the-counter options are not effective, her doctor may prescribe stronger laxatives or other treatments.

In conclusion, while constipation can be a common issue in older adults, the symptoms your mother is experiencing should not be ignored, especially given the duration of her condition. It is crucial to consult with her healthcare provider for a comprehensive evaluation and tailored treatment plan. Early intervention can help prevent complications and improve her quality of life.

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