Geriatrician Questions Constipation

What is the best way to treat constant constipation in elderly?

My mother is 72 years old and is constantly complaining of constipation. She feels bloated most of the time because of this reason. What is the best way to treat constipation problems in the elderly?

2 Answers

First of all, she should have a work-up to exclude bowel diseases like colon cancer, polyps, etc. Usually, a colonoscopy is done for that. Once it is established that it is just chronic constipation, she can do a number of things. Some examples are: warm prune juice 2-3 times a day, regularly taking Miralax, Sennakot OTC. I suggest that she starts with one remedy and do it regularly. The most common issue with chronic constipation is that patients do not continue the remedy on a daily basis.
Constipation in the elderly is tricky because it's not the same treatment for someone a lot younger. For example, if someone younger takes Metamucil, then they should follow it up with a lot of water. But in the elderly, it's difficult to have a lot of water. So, I suggest prune juice for the elderly. If juice is not preferred, then I suggest 8 prunes throughout the day. I would stay away from iron supplements. Sometimes some medications that are commonly prescribed in the elderly have a side effect of constipation. Sometimes, the thyroid hormone is low and then the person gets constipated. I hope that helps.​