Constipation needn’t be a pain in the bum!
This article has been kindly written for Caron Cares by Nutritionist Hazel Pelham and looks at some gentle, effective solutions to the troublesome issue of constipation for elderly people.
This is what Hazel advises.
Constipation is a common problem for older people. Reduced mobility and food choices combined with declining digestive function all play a part. Sometimes the conventional approach of increasing fibre, fluids and the use of laxatives just doesn’t get things moving. I’d like to give some practical suggestions for foods, drinks and supplements that may help.
As well as outlining food and drink options a nutritional approach involves thinking about WHY a problem has developed. Deficiencies, lack of enzymes and acids, food intolerances and eating habits can all play a part.
It’s a problem that’s well worth addressing. Feeling bunged up is not only uncomfortable, it can have a knock on effects such as headaches, raised cholesterol, lack of appetite, poor sleep and increased risk of bowel cancer.
Feeling constipated can also affect lifestyle, many older people become anxious about going out if they haven’t been.
Somehow can nutrition help? I like to take a personal approach with my clients, putting together a programme which is based on their usual food choices. This is particularly important with the elderly as drastic changes are not a good idea.
With this in mind, I’ve outlined a range of ideas. I would then suggest picking out one or two which fall in line with the likes, dislikes and eating habits of the person concerned.
Fluids
This can be a difficult issue. Many older people are reluctant to drink as they worry about extra trips to the toilet. This usually only happens while the body is adjusting to extra fluids. In fact, dehydration can be a cause of needing to pee urgently.
Motivation to drink can be important. Alongside easing constipation drinking more has been shown to increase alertness in the elderly. Increased fluids may also help ease backache and arthritis.
Opportunity is important. Make sure drinks are available next to the bed and chair and with meals. Sports top bottles can be useful for this.
Water is best, improve the taste by letting a jug stand or adding a slice of lemon or lime. Other drinks I recommend for constipation include prune juice, vegetable juice, tropical or pineapple juice and herb teas e.g. liquorice, ginger or fennel.
Foods
Increasing fibre is key, in addition some foods can help stimulate bowel movements. Tweaking the existing diet to include some of the following is the best way. Here are some ideas to choose from.
Breakfast Porridge, high fibre cereal, stewed fruit, apple, pears, banana, ground linseeds, oat bran, nut butters, apricot jam or beans on whole wheat toast. Yoghurt especially rhubarb, prune or cherry.
Meals Soups with vegetables or beans. Sandwiches; use wholemeal bread or add handful of salad, slice of beetroot or a tomato. Include vegetables with cooked meals especially broccoli, carrots and cabbage.
Snacks Fruit cake and fig rolls are good high fibre alternatives for those who like a cake or biscuit. Crackers come in whole wheat varieties. Spreading hummus instead of cheese is another way of boosting fibre.
Remember to go gently with any changes to diet or fluid intake. Here is a wide range of suggestions to make it easy to find one or two changes that appeal.
Wheat Watch
I often find that clients with long-standing constipation have a sensitivity to wheat. I never recommend excluding foods completely but it’s easy to rely on wheat at every meal and snack. Trying some alternatives can often help keep bowels moving. Some wheat-free suggestions might be oat or rice cereal or porridge. Gluten free bread, spelt (still wheat but easier to digest), jacket potatoes or brown rice instead of bread or pasta. Wheat-free biscuits, cakes, crackers, and cereals are available from supermarkets and health food shops.
It’s also worth keeping an eye on salt and sugar intake and these can both have a negative effect.
Super Supplements
Sometimes dietary changes are just not an option. Many elderly people have meals provided or are just very set in their ways. Gentle natural supplements can be an alternative to prescription laxatives.
Consider the following
Floradix Magnesium liquid formula
Ortisan fruit and fibre cubes
Powdered vitamin C, (avoid with blood thinning medications)
Syrup of figs
Psyllium Husk
Obviously try one at a time and I would recommend starting with half the recommended dose. Of these magnesium would be my first suggestion as it’s a very common deficiency in the elderly. Boosting magnesium may also help with fraility, sleep, energy and even swallowing problems. More on this in future articles.
Nutrition Know-How
As a nutritionist I always like to look for a cause behind any symptom. If you’ve tried all the above to no avail it may well be worth considering a one to one session with a nutritionist. Constipation is often the end product of a chain of problems in the digestive tract. Use of antacids, diabetes and history of digestive problems all suggest that specific support for the digestion might be helpful. I work with clients to boost digestive function, balance gut bacteria, deal with deficiencies and improve eating habits.
On the Moved
Finally it’s worth mentioning the importance of moving the body in order to get things moving in the gut. This is a common problem in the elderly and disabled.
It doesn’t have to be a five mile run to make a difference. Seated exercises, tai chi or even knitting all keep the body moving.
Don’t get stuck with constipation
Constipation is problem well worth solving. There are so many knock-on benefits for both mental and physical well being. Go slow, try one or two changes at a time and if in doubt, ask a nutritionist.
Hazel practises in Exmouth, find out more at www.devonnutrion.co.uk
