When I was a resident, it felt like every clinic day included a little old lady worried about constipation. Over time, I saw how serious it could be—bowel obstructions, ulcerations, hospital stays. About 1 in 4 older adults living in the community has chronic constipation, and rates in care facilities are even higher. Yet roughly two-thirds never mention it to their family doctor. This overview explains why it happens and practical ways to get things moving again.

As we age, the gut slows down. Conditions such as diabetes, Parkinson’s disease, and stroke can reduce nerve signals and blood flow to the intestines. Many common medications—opioid painkillers, antidepressants, antacids containing aluminum, some blood pressure pills, and Parkinson’s medications—also slow the bowel.

Constipation is typically defined as fewer than three spontaneous bowel movements per week, often with hard stool or straining. It’s considered chronic when symptoms last for at least six months.

Diet and hydration play a major role. Typical North American diets are low in fiber, fluids, and fermented foods, and high in sugar. Thirst signals also weaken with age, and some people deliberately cut back on fluids to avoid frequent bathroom trips. The gut microbiome, which links the brain and gut, depends on fiber and fermented foods to thrive. High sugar intake can worsen diabetes and damage the enteric nervous system—the “brain” of the gut.

Activity level matters too. Less walking or being bedbound allows the bowel to become sluggish. Structural issues such as pelvic floor dysfunction, prior abdominal or pelvic surgery, hemorrhoids, or rectoceles can add mechanical barriers. Habits like ignoring the urge to go, irregular bathroom times, or a lack of privacy further compound the problem. Women are about three times more likely than men to experience constipation, partly due to hormonal changes and childbirth.

If symptoms persist despite lifestyle changes for a couple of weeks, it’s worth speaking with a health professional. There is no need to suffer in silence, and early attention can prevent more serious complications.

4. Create a Bathroom Routine

Use a regular window after meals—often breakfast—when the natural gastrocolic reflex is strongest. Sit unhurried for 10–15 minutes, and use a footstool to elevate the feet slightly and improve the angle of the rectum. Privacy and comfort are important; rushing often backfires.

5. Review Medications

Opioid pain medications are well-known causes of constipation, but other drugs such as some antidepressants, antihistamines, and antispasmodics can contribute. Ask your doctor or pharmacist to review your medication list and consider alternatives or bowel regimens when needed.

People often reach for over the counter laxatives such as senna or bisacodyl. Be aware that these products should only be used for a limited period of time, around 2 weeks. People can become dependent upon them to have a bowel movement.

Constipation is not an inevitable part of getting older. For many people, targeted changes in diet, fluids, movement, toilet habits, and medications can make a meaningful difference. Starting with one or two changes—such as more water and a brief daily walk—can be enough to begin improving comfort and confidence. Open, honest conversations with healthcare providers are essential; they can rule out serious causes and tailor a safe, effective plan. Doctor house calls make these conversations easier since patients are more relaxed in their own environment and more likely to open up about symptoms they might otherwise brush aside. Contact Beyond Neighbours if you or your family member would be interested in joining our house call clinic.