AlzU Blog

The ABC’s of Constipation/Tips for Caregivers-Part I

As we age, many systems of the body begin to slow down, including the elimination system.  Most seniors have experienced constipation from time to time, but there are many factors that can make constipation even more of a challenge. But what is constipation and what’s the best way to treat it?

Some people may describe constipation as having infrequent stools, to others it means hard stools with difficulty and straining, or a sense of incomplete emptying after a bowel movement.  Medically speaking, constipation is a result of less than 3 bowel movements per week-on a regular basis.

Depending on the symptoms and cause, the treatment for constipation can differ quite a bit.  A common factor in constipation is side effects of various medications such as Vicodin, a common narcotic pain medication that slows down peristalsis (mobility of the bowel in moving food and eliminating waste). 

                  Common causes of constipation

Dehydration-adequate fluid intake and hydration levels are necessary to move the food through the intestinal system adding fluid to the colon and bulk to the stool-making it easier to pass.

Alzheimer’s disease (AD)- individuals with AD who are less active and may not drink enough fluids are prone to constipation.  Some sources report that constipation can lead to increased levels of confusion and agitation in the later stages of Alzheimer’s disease, severe constipation (resulting in fecal impaction) could even lead to sudden and extreme acceleration in dementia in folks with AD.  Certain medications given to treat AD may also cause constipation-see “medications” category below. 

Depression-causes the GI system to function improperly as a result of changes in neurotransmitters (serotonin and norepinephrine)-leading to lower nerve excitation.  This can lead to constipation.  It’s important to note that depression may result in periods of intermittent constipation and diarrhea.

Stroke-a stroke in and of itself does not necessarily cause constipation, however, the resulting combination of lack of physical activity, not drinking enough liquids and certain medications given to treat stroke, often times causes constipation.

Diseases of the nervous system-such as muscular sclerosis and Parkinson’s disease can affect the nerves that are necessary to control muscles in the colon and rectum to contract and move stool through the intestines.

Lack of exercise and overall physical activity-it’s not been scientifically proven exactly why lack of activity leads to constipation, but it’s well known factor in bedridden patients after an accident or illness.

Medications-various types of medications can cause constipation such as Narcotic pain medications like codeine (Tylenol #3), oxycodone (Percocet), and hydromorphone (Dilaudid), Antidepressants such as Elavil and Tofranil, Anticonvulsants such as Dilantin and Tegretol, Iron supplements, Calcium channel blocking drugs such as Cardizem and Procardia, and Aluminum-containing antacids.  The drug Namenda (used to treat moderate to severe AD) is also known to cause constipation.

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