Oct. 9, 2007

AMARILLO – Constipation is a serious problem at any age but may be more so in older adults, said a Texas Cooperative Extension specialist.

Constipation can account for some of the cases of delirium in older adults, causing symptoms similar to those of Alzheimer's disease, said Andrew B. Crocker, Extension gerontology specialist.

Nearly everyone becomes constipated at one time or another, Crocker said. But older adults may have more bouts due to lack of exercise, diets low in fiber, not drinking enough liquids and taking more prescription medications.

Most of the time it is not serious, he said. However, sometimes it can cause agitation, aggression and combativeness in older adults.

Normally, waste products are moved through the intestines by muscle contractions, Crocker said. In the large intestine, most of the water and salt in this mixture are reabsorbed. If too much water is absorbed or if the waste moves too slowly, constipation may occur.

"You may also experience constipation if the muscles you use to move your bowels are not coordinated," he said.

Heath providers are not always sure what causes constipation, Crocker said. Some of the causes are:

Diet – People may become constipated if they do not eat enough high-fiber foods like vegetables, fruits and whole grains. Eating a lot of high-fat meats, dairy products, eggs, rich desserts and sugary sweets also may cause constipation. Also, sometimes people do not drink enough water and other fluids to help them stay regular.

Laxatives – Many people think of laxatives as a cure for constipation. But if laxatives are used too often, they can cause the body to forget how to work on its own. Heavy use of laxatives may not be needed and may cause diarrhea. Enemas can have the same effect.

Lack of exercise – Inactivity or long periods in bed, such as after an accident or illness, may cause constipation. Health providers sometimes suggest medicine for people who stay in bed and suffer from chronic constipation, but being more active, if possible, is a better option.

Holding back bowel movements – People can become constipated if they ignore their urge to have a bowel movement. Some people prefer to have bowel movements only at home; but holding in a bowel movement can cause constipation if the delay is too long.

Medical conditions – Some problems, like stroke, diabetes or a blockage in the intestines, may cause constipation, as well as a condition called irritable-bowel syndrome. These disorders may affect the muscles or nerves used for normal bowel movements.

Medications – Some medicines may lead to constipation. These include some drugs used to treat depression, antacids containing aluminum or calcium, some allergy medicines, some high blood pressure drugs and some drugs used to treat Parkinson's disease.

"If you think you may be constipated, talk to your health provider to rule out a more serious problem," Crocker said.

If tests show no disease or blockage – and if a health provider approves – he suggested trying these changes:

-- Add fiber to the diet by eating more fresh fruits, vegetables and more whole-grain cereals and breads. Dried fruit such as apricots, prunes and figs are high in fiber. Add small amounts of unprocessed bran to baked goods, cereals and fruit. This may cause bloating and gas for a few weeks. Make diet changes slowly to allow the system to adapt.

-- Be sure to get enough fluids. Drinking lots of water and juices helps some people get back to regular bowel movements.

-- Stay active. This is important for overall health too.

For more information, visit the National Institutes of Health – National Digestive Diseases Information Clearinghouse: http://digestive.niddk.nih.gov .