Bowels not working how they use to? Exploring the Causes of Age-related Constipation
What causes age-related, simple constipation?
Bowel movements are the endgame of the digestion process and while one might assume digestion begins in the mouth, there is one important (but often forgotten about) preceding step - the senses. The ability to taste and smell forms an important component of the initiation of appetite…getting the ‘juices flowing’, so to speak.[1][2] Many of us have experienced the mouth-watering aroma of a Sunday roast or the drool-worthy tartness of fresh summer berries. Just the thought of tasty food can be enough to release those salivary enzymes.
In our later years, these senses can dull, whether due to age, illness or certain medications.[3] In addition to this, the environment in which food is consumed, or even the food itself, may lose its appeal. This is particularly relevant to those in an aged-care environment or who cook for one.[4] Researchers have proposed that alterations to sensory function may affect food choices in the elderly, which can go on to affect nutrition-related health outcomes, including constipation.[4]
Moving beyond the senses, an age-related decline in function can also impact general gut motility (e.g., swallowing, gastric emptying), digestive secretions (e.g., stomach acid, digestive enzymes, bile) and mucosal barrier function.[5] And, as with most health imbalances, diet and lifestyle factors also have their role to play in gut health, including:
- Medications
- Dehydration
- Nutritional deficit
- Reduced physical activity[6]
All of which can affect the over-all health and function of the bowels making us more predisposed to constipation.
Gut flora and constipation
The composition of the adult gut microbiome can be altered by many of the above listed factors in addition to the ageing process itself.[8] A stable and balanced, naturally occurring gut microbiome favours health at all ages and research has shown that that this concept also applies to those with constipation.[8]
A holistic and preventative approach
There are many available constipation treatments which you can discuss with your health professional, but as the old saying goes, prevention is better than (a constipation) cure. So, in light of this we have put together some simple, holistic strategies that you can implement at home to help improve bowel function and microbial health and reduce constipation symptoms in your later years.
-
Increase your daily fibre
An oldie but a goodie. Fibre is a tried and tested treatment for constipation relief. In addition to providing bulk to the stool, dietary fibre, particularly galacto-oligosaccharides, has shown to increase the growth of indigenous beneficial bacteria, such as Bifidobacterium and Lactobacillus. A good place to start is by increasing fruit and vegetable intake.[7]
-
Drink more water
Don’t be a cactus! Dehydration has been associated with constipation in older populations. Gradually increasing water intake may help to improve colon transit time, particularly when consumed in conjunction with more daily fibre.[8],[9]
-
Enjoy a meal with friends and family
Get your gut excited about food again and enjoy a special meal with loved ones whenever you get the chance. *Make sure you include extra veggies.
_________________________________
If seeking specific advice on supporting your bowel health, talk to your health professional.
[1] Sergi G, Bano G, Pizzato S, Veronese N, Manzato E. Taste loss in the elderly: Possible implications for dietary habits. Critical reviews in food science and nutrition. 2017 Nov 22;57(17):3684-9.
[2] Kitamura, A., Torii, K., Uneyama, H. and Niijima, A., 2010. Role played by afferent signals from olfactory, gustatory and gastrointestinal sensors in regulation of autonomic nerve activity. Biological and Pharmaceutical Bulletin, 33(11), pp.1778-1782.
[3] Whitelock E, Ensaff H. On Your Own: Older Adults' Food Choice and Dietary Habits. Nutrients. 2018 Mar 27;10(4):413. doi: 10.3390/nu10040413. PMID: 29584644; PMCID: PMC5946198.
[4] Sergi G, Bano G, Pizzato S, Veronese N, Manzato E. Taste loss in the elderly: Possible implications for dietary habits. Critical reviews in food science and nutrition. 2017 Nov 22;57(17):3684-9.
[5] Grassi M, Petraccia L, Mennuni G, Fontana M, Scarno A, Sabetta S, Fraioli A. Changes, functional disorders, and diseases in the gastrointestinal tract of elderly. Nutricion hospitalaria. 2011;26(4):659-68.
[6]Martínez-Martínez MI, Calabuig-Tolsá R, Cauli O. The effect of probiotics as a treatment for constipation in elderly people: a systematic review. Archives of gerontology and geriatrics. 2017 Jul 1;71:142-9.
[7] Shah A, Morrison M, Holtmann G. A novel treatment for patients with constipation: Dawn of a new age for translational microbiome research?. Indian Journal of Gastroenterology. 2018 Sep;37(5):388-91.
[8] De Giorgio R, Ruggeri E, Stanghellini V, Eusebi LH, Bazzoli F, Chiarioni G. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC gastroenterology. 2015 Dec;15(1):1-3.
[9] Bouras EP, Tangalos EG. Chronic constipation in the elderly. Gastroenterology Clinics. 2009 Sep 1;38(3):463-80.