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Pooping is something everyone does but few talk about. As you age, you may experience changes in your bowel habits that may concern you.
“If something changes one month to another, it can sometimes be a sign of problems that are not part of natural aging,” says gastroenterologist Mark Pimentel, professor of medicine at Cedars-Sinai Medical Center in Los Angeles.
What’s normal, what’s not?
Take a peep after you poop. The shape and color of your bowel movements can tell you a lot about how your digestive system is working and your health. Everyone is different, so knowing what’s normal and what’s typical for you can help you spot the signals that you need to alter your diet or check in with your doctor.
A loglike or snakelike shape that’s easy to pass is ideal, says Matthew Fuglestad, assistant professor of surgery in the Division of Colon and Rectal Surgery at the University of Nebraska Medical Center in Omaha. It can look dry and slightly cracked, or smooth and soft, and it’s okay if it comes out in a few pieces.
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If your stool looks like individual pebbles or a log made up of pebbles, you may be constipated, especially if you have trouble passing it. Pencil-thin stools once in a while are normal but may be a sign of constipation or a bowel blockage if they occur frequently. Bloblike shapes may indicate that you aren’t eating enough fiber to firm things up, while fluffy pieces or watery stool means you may have diarrhea. It could be from something you ate, but if your stool is frequently fluffy or watery, see your doctor.
Light brown to dark brown stool is a sign that everything is normal. Differences in color can depend on what you’ve eaten but can also be a sign of a problem. For example, beets, cranberries and tomatoes can turn stool red, and black stool can be the result of taking iron supplements or medications with bismuth (the active ingredient in Pepto Bismol). But both red and black, tarry stools can be a sign of bleeding in the digestive tract.
Occasional changes in color or texture are typically nothing to worry about, but if they persist, or if they’re accompanied by unintended weight loss or rectal bleeding, see a doctor at once to rule out colon cancer or another problem.
Cures for constipation
Constipation is a common problem in older adults — 1 in 3 people over age 60 experience it. For some, it’s an occasional nuisance, but many suffer from chronic constipation.
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Temporary shifts in your lifestyle, such as travel, variations in your diet or physical activity (say, if an injury has kept you off your feet), can trigger constipation. But aging itself can lead to bowel muscle changes that slow down the passage of stool or blunt the urge to empty the bowel. And some medications that older adults commonly take — for example, opiates, certain antidepressants and blood pressure meds like calcium channel blockers — can also be a cause. (It may not be possible to alter your meds, but there are probably other ways to relieve your symptoms.)
Temporary constipation will usually resolve on its own once you get back into your routine. But if you’re often constipated, it’s important to address it. Constipation doesn’t just cause discomfort — it can also signal a more serious concern. For example, it could be caused by a thyroid problem. And a 2023 Nature Scientific Reports study involving 541,000 people age 60 and older found that constipation was linked with a 96 percent higher risk of hypertension and a 58 percent increased risk of heart attack and other cardiovascular events.
Constipation isn’t always about how often you go — typical regularity ranges from once every three days to as often as three times a day. More reliable signs include frequent hard or lumpy stools, straining to go and spending more than five minutes on the commode, and not feeling emptied after you have a bowel movement, says Reezwana Chowdhury, an assistant professor of medicine at Johns Hopkins Medicine in Lutherville, Md. In those cases, try these strategies:
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Keep a targeted food log. Fuglestad recommends noting which foods exacerbate your symptoms. In some cases, something as simple as eliminating or limiting a food can be really beneficial, he says. For example, constipation can be a symptom of lactose intolerance (though diarrhea is a more common reaction).
Check your fiber intake. Most of us don’t get the daily value for fiber, which ranges from 22 to 34 grams depending on age and sex. (A small pear or medium sweet potato has about four grams, a slice of whole-wheat bread has two grams, and a cup of lentil soup has eight grams.) Increasing your intake can bulk up and soften stool, helping to move it along and out. To avoid overwhelming your GI tract, gradually over a few weeks add more fruits, vegetables, nuts, seeds, whole grains, beans and lentils, being sure to drink plenty of water as well.
However, fiber isn’t always the answer, Pimentel warns. If you’re straining a lot or if your constipation is medication-related, increasing fiber can produce gas and bloating without moving stool, making you more uncomfortable.
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Stay hydrated. “The amount of water you take in is very important in terms of having soft, well-formed bowel movements,” Chowdhury says. Not all of it needs to come from drinking water, though. Other beverages count. Plus, fruits and vegetables have water, so in addition to providing fiber, they can help keep you hydrated.
Try these foods. Prunes contain sorbitol, a natural sweetener that has a laxative effect. Kiwifruit may help boost healthy gut bacteria, which can speed up stool transit time. For the same reason, kefir, a fermented drink, and yogurt may also help improve symptoms.
Move more. Exercise is thought to help speed the rate of stool’s passage through the gut. Any kind of moderate exercise is beneficial, Pimentel says.
Use laxatives the right way. When lifestyle changes aren’t enough to relieve constipation, you can try a laxative. Fiber supplements (like Metamucil or Citrucel) are a good option. They can help soften and bulk up your stools safely. (If you’re often constipated, you may be able to use one indefinitely, but check with your doctor.) You can expect results in 12 to 72 hours; if not, try an osmotic laxative, which attracts water into the intestines. It usually causes a bowel movement in two to four days. One of the most effective and least likely to cause cramping and gas is polyethylene glycol, or PEG (MiraLax).
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If these steps don’t help, see your doctor. Not only are there a slew of prescription medicines, Chowdhury says, but tests can be done to pinpoint your specific issue, so you can get things moving comfortably again.
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