After we ingest food, the peristaltic movement of the intestine pushes it forward to facilitate digestion and absorption. Finally the leftovers are excreted outside the body as faeces. Abnormal bowel movements include constipation and diarrhoea.

Definition of constipation

The bowel opening habit varies with individuals. It can be normal to have bowel movement more than once a day or every two to three days. However, if the faeces are very hard or if there is great difficulty in passing it out, then it is constipation.

Causes of constipation

1. Peristalsis of the intestine in the elderly is usually weakened, hence they are more prone to constipation.
2. Inadequate water or lack of fibre in food, leading to hard faeces.
3. Psychological factors, e.g. using bedpan or commode chair without privacy, a dirty toilet, depression, etc.
4. Drugs such as morphine group pain killers, certain diuretics, calcium tablets.
5. Diseases, e.g. diabetic mellitus, hypothyroidism.

Effect of constipation

Constipation can cause abdominal discomfort or pain, piles and anal fissure. The straining during defaecation can cause a rise in blood pressure, or even precipitate stroke. Chronic constipation can also cause depression.

Prevention and management of constipation

1. Take a high fibre diet with two fruits (e.g. orange, water melon) and vegetable (more than 240 gram) everyday. Choose high fibre cereals such as whole wheat bread, oatmeal and whole grain rice.
2. Drink adequate fluid like water, soup and fruit juice.
3. Do exercise everyday. It can help to increase the peristaltic movement of the intestine. Be relaxed.
4. Lead a regular life and develop a regular bowel habit. Drink some fluid in the morning upon waking to keep the bowel active, or go to the toilet after breakfast.
5. If a bedpan or commode chair is needed, pay attention to safety and privacy. Minimize disturbance.
6. All laxatives have side-effects. They should not be used indiscriminately or depended upon indefinitely. Seek the advice of a doctor.

Constipation is common among the elderly but the above tips can help you to maintain a normal bowel habit. If the bowel habit changes suddenly or if you pass out blood or mucus, it may be the signal of some serious disease of the bowel, e.g. cancer. Consult a doctor immediately.