Constipation is a widespread issue for older adults, with estimates suggesting that 15% to 30% of individuals over 60 experience this condition. This gastrointestinal disorder involves difficult, infrequent, or incomplete bowel movements, often accompanied by symptoms like bloating and abdominal pain. The impact of constipation on an older person’s quality of life can be significant, affecting general health and well-being. Probiotics have emerged as a popular option for supporting gut health and alleviating constipation symptoms.
Why Constipation is Common in the Elderly
As individuals age, the movement of stool through the colon can slow down, a condition known as slow transit constipation. This is linked to degenerative changes in the colonic smooth muscle cells, a reduction in the neurons within the gut wall, and weakened pelvic floor muscles. These changes can lead to difficulties in effectively evacuating stool.
Dietary habits and fluid intake play a role in bowel regularity. Older adults may consume diets low in fiber due to dental problems, difficulty chewing, or a decreased interest in food. Inadequate fluid consumption can contribute to hard, difficult-to-pass stools, while reduced physical activity also negatively affects bowel function.
The use of multiple medications (polypharmacy) is a contributor to constipation. A number of commonly prescribed drugs have constipation as a known side effect, including certain antidepressants, calcium channel blockers, diuretics, and opioids. Chronic health conditions such as diabetes, Parkinson’s disease, and other neurological disorders can also disrupt normal bowel function.
How Probiotics Can Influence Gut Health and Motility
Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The primary mechanism involves modulating the gut microbiota, the community of microorganisms residing in the digestive tract. An imbalance in this community can contribute to digestive problems, and probiotics can help restore a more favorable composition.
Probiotics achieve this in part by producing short-chain fatty acids (SCFAs), such as butyrate, propionate, and acetate, through the fermentation of dietary fibers. These SCFAs help to lower the pH of the colon, which can stimulate peristalsis—the wave-like muscle contractions that move stool through the intestines.
This stimulation of gut motility decreases colonic transit time, the duration it takes for food to travel through the colon. By speeding up this process, probiotics can help increase the frequency of bowel movements. They also influence the consistency of the stool itself, making it softer and easier to pass.
Selecting Effective Probiotic Strains for Seniors
The effects of probiotics are strain-specific, meaning not all are equally effective for constipation. Strains of Bifidobacterium lactis, such as HN019 and BB-12, have been studied for their ability to increase bowel movement frequency.
Other strains with supportive evidence include Lactobacillus casei Shirota, which has been shown to improve stool consistency and relieve constipation symptoms. Lactobacillus plantarum 299v has been investigated for its role in improving symptoms like abdominal pain and bloating. When selecting a probiotic supplement, the concentration of live organisms, measured in colony-forming units (CFU), is an important consideration, with many clinical trials using dosages in the billions.
Probiotics are available in various forms, including capsules, powders, and as components of fermented foods like yogurt and kefir. The best choice may depend on individual preference and dietary habits. Look for products that specify the exact strains they contain and are backed by scientific research.
Safe Administration and Monitoring of Probiotics in Older Adults
When an older adult begins taking probiotics, it is recommended to start with a lower dose and gradually increase it. This approach allows the digestive system to adapt and can minimize potential side effects. Some individuals may experience temporary gas or bloating when first introducing probiotics, which subsides as the body adjusts. Follow package instructions, as some products are best taken with food while others are designed for an empty stomach.
While probiotics are considered safe for most healthy older adults, there are safety considerations. For individuals who are severely immunocompromised or critically ill, the use of live microorganisms could pose a risk of infection.
Before starting any new supplement, including probiotics, seniors should consult with a healthcare provider. A doctor or pharmacist can review their current medications and health conditions to identify any potential interactions or contraindications. They can also provide guidance on monitoring the effectiveness of the probiotic and determine when it might be necessary to explore other treatment options if constipation does not improve.