Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Health Education Fact Sheet

Constipation: Prevention is the key

Did you know that constipation is a frequent health concern for older adults and their care providers?

Many things lead to constipation:

  • Not being able to move around (being confined to a bed or wheelchair, or a general decrease in physical activity);
  • Inadequate amounts of fluids and dietary fiber;
  • Not responding to the urge to have a bowel movement;
  • Using laxatives over a long period of time;
  • Taking medications that cause constipation as a side effect; and
  • Increase in the hormone progesterone in women.

Here are some facts:

  • It is estimated that 30% -50% of older adults living in the community use laxatives regularly.
  • Constipation increases with age.
  • At one time or another almost everyone gets constipated. In most cases, constipation is temporary and not serious.

Fortunately, there are many ways to prevent constipation. Understanding the reasons for constipation is the first step. If you have chronic constipation, talk to your nurse, doctor or nutritionist.

Here are some helpful hints.

  • Drink sufficient fluids. Aim for 1½-2 litres of fluids daily (6 to 8, eight ounce glasses).
  • Reduce caffeinated (coffee, tea, some soft drinks) and alcoholic beverages whenever possible as they actually cause you to lose fluids.
  • Eat adequate dietary fiber in combination with a good fluid intake. Please note that dietary intake of fiber should be gradually increased once you are consistently taking 1½litres of fluid daily. A high fiber diet is not recommended in persons who are immobile (bedridden) or persons who do not drink at least 1½litres of fluids per day. Adequate dietary fibre can be achieved by consuming about 2 to 3 servings of grains and about 5 servings of fruits and vegetables per day. Examples of dietary fiber include wheat bran, whole cereals such as wheat, rice, barley, rye, millets; fruits like mango and guava; and leafy vegetables such as cabbage, lettuce and celery. Fiber supplements in powder, tablet or granular form are also available. Consult your pharmacist.
  • Use routine consistent toileting each day based on your urge to have a bowel movement. Use a squat position to facilitate the bowel movement process.
  • Exercise such as walking (15 to 20 minutes once or twice a day) can stimulate the bowels.
  • If you are unable to walk or are bedridden, there are numerous exercises that you can do. Examples of such exercises include flattening the low back arch by tightening the abdominal muscles (pelvic tilt), rolling bent knees side to side twisting at the waist (low trunk rotation) and single leg lifts. Before starting on an exercise program, consult with a health care professionalc(your doctor or nurse).