Doctors and nurses specializing in gastrointestinal (GI) problems agree that constipation is a leading hardship for older adults.
Kris Mauk PhD – President of the Association of Rehabilitation Nurses (ARN) – outlined top tips for a healthy bowel program.
1. Implement a high fiber diet – 25 to 35 grams of fiber per day found in:
• Root vegetables
• Fruits
• Fruit Juices, especially prune and apple juice
• Legumes
• Nuts
2. Drink eight glasses of fluid per day – especially water.
3. Use the bathroom within the first 15 minutes after breakfast when the gastric colic reflex is the strongest. Food for breakfast stimulates the reflex of the beginning of a bowel movement.
4. Never suppress the urge to go.
5. Stay active, especially walking. A sedentary lifestyle of TV and eating leads to less active bowels.
6. If the natural approach fails, use a safe laxative to add extra fiber to the bowel. Pain medication used by older adults often slows down bowel function and can lead to prolonged periods of constipation.
Mauk’s recommendations can be found on SeniorCareCentral.
Types of Fiber
Dr. Ed Levine, a gastroenterologist from Bridgeport CT, said constipation in older adults develops from a reduction of metabolism. The muscle function of the colon decreases over time leading to difficulties in digestion and bowel discharge.
Dr. Levine believes too much focus has been placed on increasing fluid intake. “It’s more important to boost fiber intake in the diet.” He classified fiber as:
• Soluble Fiber – bran cereals and whole wheat grains
• Insoluble Fiber – Fruits, salads and vegetables
Levine recommended focusing on an uptake in insoluble fiber because it draws water from the intestinal tract. “That’s how fiber works,” he said. “It helps bulk up stool.” He agreed with Maun that laxatives are effective combined with a good diet.
Constipation for the Mature Traveler
Travel constipation can arise when older adults visit family over major holidays – Thanksgiving and Christmas. “One-half of the population is prone to constipation during travel,” he said. “Older people can experience even greater difficulties.”
Long drives or plane rides upset schedules and regular diets. Different settings and foods, dehydration, and rushing can disturb the gastrointestinal tract.
Levine recommends increasing water and insoluble fiber before prolonged travel. He and his wife have created GoodtoGo for mature travelers.
All Things in Moderation
Dr. Richard Desi, a specialist in digestive diseases at Mercy Medical Center in Baltimore, MD, considers the Western diet to be fiber-deficient – even traditional oatmeal. “Look at the package for fiber content” said Desi.
According to Desi, everyone has anecdotal information about foods that constipate them. “But there’s no trend. Medical science can’t point to any one food that constipates.” Some people can eat poorly with no gastro-intestinal complications. Others are very health conscience but are beset with GI problems.
Moderation for the festive season is Desi’s solution.