Constipation is a very common problem in older adults, as gut function and its responses slow down with age. Many medications that are commonly used and necessary for older adults can also have side effects that include constipation, such as calcium or iron supplements, painkillers, antidepressants, and Parkinson’s medications. Additionally, various medical conditions that affect older adults can contribute to constipation, including Parkinson’s disease, hypothyroidism, elevated blood calcium levels, and being immobilized in bed.
Before using laxatives, ensure you make the following lifestyle changes:

• Drink adequate water—at least 4 to 6 glasses daily.
• Consume foods higher in fiber, such as fruits and vegetables. A blended smoothie may help those who have difficulty chewing.
• Try to establish a regular time for bowel movements, usually after breakfast and some light walking, to stimulate the urge to defecate. Exercise and increased physical activity also help regulate bowel movements.

If all of the above measures have been implemented and laxatives are still required, consult your doctor about the appropriate laxatives for your medical conditions. The safest options to start with are bulk-forming fiber laxatives; however, they must be taken with adequate water and may not be suitable for those who do not drink enough fluids. Other safer laxatives include stool softeners such as lactulose or milk of magnesia, though the latter should not be taken by individuals with chronic kidney disease. Stimulant laxatives, such as senna or bisacodyl, can be effective but may lead to dependence and habituation. Many older adults use enemas and suppositories regularly for bowel movements, but frequent use can cause dependence and changes to the colon lining. When constipation cannot be managed by lifestyle changes and increased fiber alone, it is advisable to consult your doctor or pharmacist for guidance on appropriate laxative treatment.
 

Older adults may experience diarrhea due to gastrointestinal infections, as a side effect of their medications, or from taking excessive laxatives for constipation. They are also at a higher risk of dehydration and electrolyte loss from diarrhea. Therefore, it is important to maintain hydration with fluids and electrolytes. If they are also vomiting and cannot keep fluids down, they may require intravenous fluid rehydration.

When experiencing diarrhea, replace lost fluids by gradually consuming an electrolyte solution. Food does not need to be taken in the short term if water, sugar, and electrolytes are provided. When resuming food intake, avoid any foods that are high in fiber, fat, or spice.

If diarrhea is prolonged, or if the patient becomes increasingly fatigued or confused, seek urgent medical attention.
 

Bloating, indigestion, and acid reflux are common symptoms in older adults, as the stomach takes longer to digest food, the esophageal sphincter is looser, and some medications can increase stomach acidity.
The following steps can help reduce these symptoms:

• Avoid eating large meals late at night or going to bed shortly after eating. 
• Avoid alcohol, caffeinated and carbonated drinks, and smoking, all of which increase stomach acidity. 
• Reduce the intake of spicy, heavy, or fatty foods that are difficult to digest. 
• Remain upright for up to two hours after a meal, or sleep with a more elevated pillow.