A reader asks: I’m 75, relatively fit and healthy for my age, but have been constipated for three months. I haven’t changed my eating or exercise habits – I’m a size 14, eat plenty of fibre and walk a couple of miles twice a day. I don’t feel ill or have any pain and while taking DulcoEase or Dulcolax helps, I wish things were as they used to be. Do you have any advice?
Dr Rosemary Leonard replies: The muscles in the bowel can become weaker with increasing age, and this can lead to a tendency to harder stools and constipation.
Another common cause of constipation in older people are medications – these can include painkillers containing codeine or other opiates, anti-inflammatories like ibuprofen, some drugs used to treat high blood pressure and heart conditions, iron or calcium supplements, some anti-depressants and proton pump inhibitors used for indigestion and excess stomach acid.
It can also sometimes be a sign of an underlying medical condition, such as an underactive thyroid.
In some older people lack of dietary fibre is to blame, and taking a stool bulking agent, such as lactulose or DulcoEase can help with this, and they are safe to use long term.
Dulcolax is different, as it stimulates the bowel muscle, and this can lead to the bowel emptying completely. This means there may be no bowel movement for a day or so, which some mistake for constipation – but taking another dose merely continues this issue, so it is very important these types of laxatives are only taken occasionally.
However, constipation starting for no obvious reason, even if there is no pain or discomfort, should always be investigated as it may be a sign of something more serious, such as bowel cancer. I don’t want to alarm you, but please, make an appointment to talk or see your doctor as soon as possible.
● If you have a health question for Dr Leonard, email her in confidence at [email protected]. She regrets she cannot enter into personal correspondence or reply to everyone
