WHY IT HAPPENS AND HOW TO GET THINGS MOVING

Let’s talk about something nobody particularly enjoys discussing.

Poop. There. I said it.

After nearly 40 years practicing medicine, I can assure you that constipation is one of the most common complaints doctors hear, especially from older adults.

Maybe you’re going less often than you used to. Maybe you’re straining on the toilet. Or perhaps you feel like you’ve finished, only to realize there’s still more business to attend to.

Here’s the good news: Constipation is common, but it isn’t an inevitable part of getting older. And in many cases, you can improve it without spending a fortune on supplements or fancy digestive products. Let’s get things moving.

First, What Counts as Constipation?

You don’t have to have a bowel movement every day to be healthy. Some people go three times a day. Others go three times a week. Both can be normal.

Constipation generally involves one or more of these problems:

• Having fewer than three bowel movements per week.
• Passing hard, dry, or lumpy stools.
• Straining to have a bowel movement.
• Feeling like your bowels haven’t emptied completely.
• Feeling as though something is blocking the stool.

The important thing is what’s normal for YOU.

If you’ve always gone every other day and feel fine, that’s probably not a problem. But if you suddenly go from daily bowel movements to once every four days, that’s a change worth paying attention to.

Why Does Constipation Become More Common After 50?

Your digestive tract is essentially a long, muscular tube. Muscles in the intestinal wall squeeze in coordinated waves, moving food and waste forward. This process is called peristalsis.

As waste travels through your colon, water is absorbed. The longer stool remains there, the more water gets removed.

The result? Harder, drier stool that’s more difficult to pass.

Aging alone doesn’t necessarily cause major slowing of the colon. However, several things that become more common as we get older can interfere with normal bowel movements.

Less physical activity: Sitting more and moving less may contribute to constipation.

Changes in diet: Smaller meals, fewer fruits and vegetables, and less fiber can make stools harder.

Medications: Many commonly prescribed drugs can slow the bowel.

Medical conditions: Diabetes, hypothyroidism, Parkinson’s disease, and certain nerve or muscle problems can contribute.

Pelvic floor problems: Sometimes the muscles that should relax during a bowel movement don’t coordinate properly.

The good news is that many of these problems can be addressed.

6 Practical Ways to Get Things Moving Again

1. Eat More Fiber — But Don’t Overdo It

Fiber is the part of plant foods your body can’t fully digest. It helps stools retain water, adds bulk, and can make bowel movements easier.

There are two main types.

Soluble fiber absorbs water and forms a gel. You’ll find it in oats, beans, apples, and psyllium.

Insoluble fiber adds bulk and helps move waste through your digestive system. It’s found in whole grains, vegetables, and wheat bran.

Most adults should aim for approximately 25–30 grams of fiber daily, although individual needs vary.

Unfortunately, many Americans eat considerably less.

Dr. Mike’s Fiber Fix

Start with these simple additions:

• Breakfast: Oatmeal with berries.
• Lunch: Whole-grain bread and a piece of fruit.
• Dinner: Add a serving of beans or vegetables.
• Snack: Try a pear or a few prunes.

Your challenge: Add one fiber-rich food each day this week. Increase fiber gradually over a week or two.

Adding a large amount overnight can cause gas, bloating, and abdominal discomfort.

And remember: Fiber isn’t the answer to every type of constipation. If you’re severely bloated or have trouble passing stool, adding more fiber may make things worse.

2. Drink Enough Fluids

Your colon absorbs water from stool. When you don’t drink enough, especially if you’re dehydrated, stool may become harder and more difficult to pass.

Water is an excellent choice, but milk, tea, coffee, and other beverages also contribute to your fluid intake. You don’t need to force yourself to drink eight glasses of water every day. Instead, drink regularly, particularly when increasing fiber intake.

If your doctor has recommended limiting fluids because of heart failure, kidney disease, or another condition, follow that advice.

Dr. Mike’s Take: Drinking extra water beyond your body’s needs isn’t a guaranteed cure for constipation. Correcting dehydration is what matters.

3. Move Your Body Every Day

Your intestines aren’t muscles you can train like your biceps, but regular physical activity can help support normal bowel function.

Walking is a great place to start. Try a 10–15-minute walk after breakfast or dinner.

If walking is difficult, try seated exercises, gentle cycling, or other movement appropriate for your abilities.

You don’t need to run a marathon. In fact, your bowels would probably appreciate it if you simply got off the couch more often.

The research suggests exercise may improve constipation for some people, although the benefit varies.

4. Review Your Medications

This is one of the most overlooked causes of constipation.

Common culprits include:

• Opioid pain medications.
• Iron supplements.
• Calcium supplements.
• Certain antidepressants.
• Some antihistamines and bladder medications.
• Certain blood pressure medications, particularly verapamil.

Even over-the-counter products can contribute.

If constipation began after starting a medication or increasing its dose, talk with your physician or pharmacist. There may be an alternative, a dose adjustment, or a bowel regimen that can help.

Never stop a prescribed medication on your own.

Opioid-related constipation deserves special attention because it often requires medication rather than lifestyle changes alone.

5. Train Your Bowels With Better Bathroom Habits

Your colon naturally becomes more active after eating, especially after breakfast. Take advantage of this built-in reflex.\. Try sitting on the toilet about 15–30 minutes after breakfast. Give yourself five to ten relaxed minutes.

Don’t strain, and don’t sit there scrolling through your phone for half an hour.

Another helpful trick?

Place your feet on a small stool so your knees are slightly higher than your hips.

This position may make stool easier to pass.

And when you feel the urge to go, don’t repeatedly ignore it.

Your bowels are trying to tell you something. Listen to them!

6. Know When a Laxative Makes Sense

Sometimes fiber, fluids, and activity aren’t enough. That’s when an over-the-counter laxative may help.

Different types work in different ways.

Type	What it does
Bulk-forming, such as psyllium	Adds fiber and helps stool retain water.
Osmotic, such as polyethylene glycol (MiraLAX)	Draws water into the bowel to soften stool.
Stimulant, such as senna or bisacodyl	Encourages the colon to contract.

Polyethylene glycol is often a useful option for ongoing constipation and has good evidence supporting its effectiveness.

Stimulant laxatives can be helpful for short-term or rescue treatment. They don’t automatically make your bowel permanently lazy, but frequent use deserves a review of the underlying problem.

Avoid assuming that natural products are always safer. Some herbal laxatives contain powerful stimulant ingredients.

If you need laxatives regularly, discuss an appropriate treatment plan with your healthcare professional, especially if you have kidney disease or take multiple medications.

When Constipation Needs Medical Attention

Don’t automatically blame constipation on getting older.

Make an appointment if you develop new or persistent constipation, particularly if it’s a significant change from your usual pattern.

Seek prompt medical attention if constipation occurs with:

• Blood in your stool or rectal bleeding.
• Unexplained weight loss.
• Persistent abdominal pain.
• A family history of colorectal cancer, particularly if you have new symptoms.

Severe abdominal pain, vomiting, a swollen abdomen, or an inability to pass gas may indicate a bowel obstruction and require urgent evaluation.

Your doctor may review medications, order blood tests, or recommend further evaluation. If you’re overdue for colorectal cancer screening, this is also a good time to discuss it.

Remember, constipation can occasionally signal an underlying medical condition.

Small changes can make a big difference.

Constipation after 50 is common, but you don’t have to accept it as your new normal.

Start with more fiber, adequate fluids, daily movement, and better bathroom habits.

If those changes don’t work, effective treatments are available.

Most importantly, don’t ignore a new or persistent change in your bowel habits.

Your digestive system may be getting older, but that doesn’t mean it has to retire before you do!

Need help getting enough fiber?

Food comes first, but a fiber supplement can help fill the gap when your diet falls short. Increase gradually and drink adequate fluids. Check with your clinician if you have persistent digestive symptoms.

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