What are the recommended initial treatments for constipation in older adults?

The recommended initial treatments for constipation in older adults include dietary modifications such as increasing fiber intake, ensuring adequate fluid intake, and engaging in regular exercise. If these measures are insufficient, bulk-forming laxatives like psyllium or polycarbophil may be used. In some cases, osmotic laxatives such as polyethylene glycol or lactulose are recommended.

For older adults experiencing constipation, the initial approach involves making dietary changes, particularly by increasing fiber intake to 18-20 grams per day, which should be done gradually to avoid bloating and gas. Adequate fluid intake, typically 1.5 to 2 liters per day, is also important. Regular exercise is recommended to promote colonic mobility. If dietary and lifestyle changes are not effective, bulk-forming laxatives such as psyllium or polycarbophil can be introduced, although they require increased fluid intake. Osmotic laxatives like polyethylene glycol or lactulose may be considered, as they help draw fluid into the bowel to facilitate bowel movements. These interventions aim to establish regular, predictable, and comfortable bowel movements without relying heavily on pharmacological treatments.