Ask Dr. Christina: I Didn’t Know That Chronic Constipation Can Kill!

Dear Dr. Christina,

My grandmother, who was 92 years of age, was one productive woman who was alert and loved life. She lived independently and loved to read, cook for the family, and go for walks with her walker. 

I am writing to you because it pained me to see how she died and to learn how her death could have been prevented. She really did not have any medical issues, other than aging and suffering from chronic constipation all her life. She was one of those stubborn women who used laxatives or gave herself enemas to make herself have a bowel moment daily.

If I would have known what I know now, I would have been more alert to her bowel movements and paid more attention to her constipation. I just thought this was an aging issue and never gave it any thought.

You see, due to the loss of another family member, my grandmother went to live with my sister in another state and no one really checked in on her. Because of her pride and her desire to be independent, my grandmother never complained. One day, she began to have abdominal pain and was struggling to have a bowel movement. She began having diarrhea, which my family members were grateful for, for at least she was having a bowel movement. Instead, she had what I have since learned was a fecal impaction (this is a large lump of stool that got stuck in her rectum and caused her to have a sudden condition of overflow diarrhea).

Inside of three months, she finally could not stand the bloating, nausea, vomiting, and the abdominal pain. She was finally taken to her family doctor. A CT scan of her abdomen was done which revealed that her entire large colon was huge and full of stool. The doctors tried enemas and digital removal of her impaction, but nothing worked. The doctors told us she was too fragile to undergo a major surgery, and she died of a perforation of her bowel and a painful death. She was such a good woman and didn’t deserve to die in such a horrible way.

I feel so guilty about all this. Had I just paid more attention to her bowel movements and her constipation, it could have been so different.



Dear Sally,

I am so sorry for the tragic loss of your grandmother.  Constipation is a very common problem for the elderly.  As a matter of fact, constipation can occur at any age – and be just as life threatening.

This topic is sometimes hard for people to speak about, and oftentimes jokes are made about it. Once these jokes get old, the main topic of discussion turns to how many times a week you go to the bathroom. Many people don’t want to talk about it and feel embarrassed in these types of conversations. What they don’t know is that constipation affects everyone, regardless of your status in life. For example, famous people such as Elvis Presley and John Wayne suffered from chronic constipation.

Some people have a bowel movement three times a day, or once a day, and, for, some every three days. The longer the stool stays inside you, the more it becomes harder and more difficult to evacuate. You will experience more staining from your stool or incomplete evacuation.

You are right, Sally: having a fecal impaction can indeed confuse the issue, due to the fact of your grandmother having had long-term constipation and suddenly experiencing overflow diarrhea, which makes you think that perhaps constipation is no longer the issue.

What are some causes of constipation and fecal impaction?

1)  Inadequate water intake

2)  Decrease fiber intake

3)  Consuming a lot of sweets and large amounts of dairy

4)  Decrease in exercise

5)  Stress

6)  Hypothyroidism

7)  Overuse of laxatives that weaken our muscles

8)  Depression

9)  Neurological problems

10)  Colon cancer

What are some of the symptoms of constipation and fecal impaction?

1)  Infrequent bowel movements

2)  Swollen or bloated abdomen

3)  Abdominal pain

4)  Nausea/Vomiting

5)  Unusual Gas

At various times, the question has been asked: “Can constipation kill you?”

The answer is yes, especially if you are elderly and/or if you have a heart condition.

1)  Having constipation can cause you to strain and overexert yourself. Holding your breath can cause you to lower your blood pressure and cause fatal heart arrhythmias.

2)  Overdistention of your bowel can cause a bowel perforation.

What are some things that can help with constipation?

1)  Drink water

2)  Eat fiber and fibrous foods

3)  Exercise

4)  Decrease stress

5)  Take magnesium citrate and calcium with orange juice

Your letter has enlightened so many people to an issue that we consider to be a condition that is so benign, but yet it can steal a loved one’s life. In some way, you and your grandmother have left us with information that we must not take lightly. We must spread the word of not taking for granted even the simplest of matters such as a bowel movement, which is essential for each individual’s good health and vitality.

Your letter has brought to our attention how we must monitor a subject that many want to avoid and ignore.

I honor you for writing to me to help others from suffering from a topic that people tend to shun and shy away from, and to raise a vigilant awareness of, not only for our elderly but to all those who suffer from this common complaint. Whether it is because you are taking pain medication, if you are sedentary, or if you are experiencing constipation for other reasons, pay attention to your condition, keep a daily journal of your bowel movements, and maintain an open dialogue with your doctor and loved ones. After all, your life may depend on it.

I send you my fond thoughts, Sally, for you and of your grandmother, and my gratitude for the lives you will save as a result of you speaking out.

Dr. Christina

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