My grandfather complains constantly of constipation. His doctor gives him Colace and Milk of Magnesia but it really isn’t helping. What’s best for seniors?
It often seems to others that most seniors have bowels that are either ‘locked shut’ or ‘blocked open’. Constipation is common. Below is a list of things which contribute to it along with successful treatments.
What causes constipation?
- Inactivity. Therefore, the more active you are, the better for your bowels.
- Lack of hydration. Drinking more fluids [specifically water] will increase stool bulk and softness.
- Diet. For most people, the more fiber in your diet, the better: this refers to vegetables, fruits, and whole grains. Minimize simplez starches [white bread, donuts, cakes, etc].
- Medications. Numerous drugs contribute to constipation: pain killers, especially narcotics [like hydrocordone [Lorcet]); nerve pills, such as lorazepam [Ativan]; overactive bladder pills [like ‘Detrol’]; some blood pressure pills, such as the calcium channel blockers (diltiazem [Cardizem], amlodipine [Norvasc]); basically, any drug which slows things down, makes constipation worse.
- Follow the suggestions above regarding diet, water intake, exercise, etc. when possible.
- If you must take a narcotic (pain pill), then also take 1 or 2 senna every night. Narcotics ‘paralyze’ the large bowel so that it won’t contract [push stool down] and just taking a stool ‘softener’ only creates a large ball of mush which your bowel can’t push out; you need the stimulant, like senna [Senokot] or bisacodyl [Dulcolax]; if stools become loose, then reduce the dose. Studies show that the combination of senna and colace is no better—it only increases revenue for the drug company. Unless your stools are rock hard, there is no need to take the ‘softener’.
- Polyethylene glycol 3350 [Miralax] is safe and effective. Take 1 scoop [17 grams] in a cup of water or juice every day or every other day. It increases bulk and stimulates the colon.
- Prunes are good ‘natural’ laxatives, either juice or canned.
- If all else fails, use grandma’s final solution: castor oil. Start with 1 tbsp in prune juice and increase up to 4 tbsp daily until effective. [PS. Don’t take it at bedtime!]