Failure to regulate bowel activity is one of the most common complaints of older persons and this problem applies even to individuals who are otherwise quite active, consider themselves well, and suffer from very few illnesses. So, why does this occur? Is it a real problem? What can we do about it? This article focuses on changes in intestinal function that can lead to the problems in evacuation that were so disturbing to my mother and her friends.
Bowel Movement Problems
First, what does it mean to have trouble with your bowels? Most older people, whether they are in their 70s or their 80s, or even in their 90s, will begin to complain of some difficulties. So what is the real problem—constipation, diarrhea, or pain or discomfort from having a bowel movement? With additional questioning, "discomfort" often means a feeling that evacuation is not complete. So what is normal? A normal frequency of bowel movement can be anything from three times a week to three times a day, as long as the consistency does not vary widely.
Constipation is better defined as a hard stool. Diarrhea is defined as frequent, loose bowel movements, meaning bowel movements that contain additional water. Medically, diarrhea is judged as producing more than 200 grams of stool per day. The definition of difficulty during defecation is far more subjective and very hard to quantify. When a patient comes in to see the doctor, it is such "difficulty" that often is misinterpreted as constipation.
