Backed-up: chronic constipation in older adults

Backed-up is term used to describe the state of constipation. Eggbound is a Northern British saying for constipation, while FarFromPoopin is a funny slang to describe the condition. However, there is nothing funny about chronic constipation. Chronic constipation affects about 14% of adults around the world. It more commonly affects older adults, women, and non-White populations. Many things can worsen constipation, including not eating enough fiber, diet, lack of physical activity, stress, depression, and certain medications. Very common medications can cause constipation and individuals should be counseled for ways to manage potential constipation or ways to avoid constipation with these medications. Opioids (narcotics) including codeine, oxycodone, morphine, and hydrocodone can cause significant constipation. Patients should be counseled for this side effect and provided options during treatment including added fiber and water intake as well as stool softeners such as docusate to prevent the likelihood of constipation. Other medications known for causing constipation include iron supplements, diltiazem, verapamil, antacids containing aluminum or calcium without magnesium (e.g. Tums, Amphojel), antihistamines for allergies, phenytoin (Dilantin), and gabapentin (Neurontin). Drugs known to slow the motility of the gastrointestinal tract can cause constipation and these include the opioids and the new GLP-1 drugs including semaglutide (Wegovy) and tirzepatide (Zepbound). Researchers published a study in September of 2024 in the journal Frontiers in Pharmacology where they analyzed the top 30 constipation-inducing drugs based on a search of the FDA's adverse event reporting system known as FAERS. FAERS is a voluntary reporting system for side effects to medications and has a searchable public dashboard. When researching the database, the scientists found some additional medications with reports of constipation as a side effect. These included adalimumab (Humira), varenicline (Chantix), semaglutide (Wegovy, Ozempic), alendronate (Fosamax), dulaglutide (Trulicity), duloxetine (Cymbalta), pregabalin (Lyrica), and gabapentin (Neurontin). In addition to medication-induced constipation, a December 2025 study evaluated the impact of diet on the condition. Published in the medical journal Gastroenterology, the researchers evaluated 5 different diets and the occurrence of constipation in individuals eating foods within these diets. These diets included the Mediterranean diet, Western diet, plant-based diet, low-carbohydrate diet, and inflammatory diet. An inflammatory diet consists of a large amount of ultra-processed foods, added sugars, trans fat, and refined carbohydrates. The researchers followed adults 60-75 years of age and observed how their eating habits influenced whether they developed constipation over a two to four-year period. The study results demonstrated the Mediterranean and plant-based diets had a lower risk of constipation. These diets are high in fruits, vegetables, whole grains, and low-fat meats like fish. Those who ate inflammatory and Western diets were at a higher risk of constipation. These diets included processed meats, fried foods, and high-sugar foods. Results of low-carbohydrate diets were unclear, meaning they did not strongly increase or decrease constipation. Individuals looking to lower their risk of constipation should include nuts, vegetables, leafy greens, whole grains, beans, and fruits in their regular diet. These foods help promote healthy gut bacteria and are high in fiber, which improves stool bulk and how often people have bowel movements. It may help to avoid inflammatory and highly processed foods. These include red meats, refined grains, sugary foods, and trans fat. Unlike Mediterranean and plant-based diets, these foods can slow digestion and worsen constipation. Overall, eating a balanced diet including many plant-based and high-fiber foods can help keep the digestive system healthy and reduce constipation. Talk to your pharmacist or healthcare professional, if you have questions about constipation including medications. Ask your pharmacist on how to not be backed-up! If you are unsure where to start, contact your healthcare provider or call ONU Healthwise at (419)-772-3784 for more information! ONU HealthWise does offer the shingles vaccine along with RSV, flu, COVID-19 and other vaccinations. The pharmacy is open at 9 a.m. and closes at 6 p.m. weekdays, while also closing for lunch from 1-2 p.m. Saturdays they are open 10 a.m. to 2 p.m. Please call for more information. Riley McConaghy is a student pharmacist and Karen Kier is a pharmacist, both on behalf of the ONU HealthWise team.