Preventing Constipation for Dementia

Regular bowel movements are crucially important for people living with dementia. Constipation (only 3-5 bowel movements a week) can not only lead to needless pain, increased irritability, difficulty sleeping, agitation, and reduced appetite, but can actually make dementia worse.

When the digestive tract is not moving food fast enough, gut bacteria can become imbalanced and trigger danger alarms throughout the body, including in the brain, which can accelerate cognitive decline.

People with dementia are especially susceptible to constipation due to many factors, including:

• Chronic stress
• Low energy
• Not chewing food as thoroughly
• Difficulty communicating need for assistance or intervention
• Difficulty getting to the bathroom
• Difficulty sensing the feeling of having to have a bowel movement

Ways You Can Help

Aim for 1-2 bowel movements a day. It is much easier to prevent constipation than to resolve it after it begins.

Laxatives can force the bowels to move if constipation is already present. However, this will not resolve the underlying causes, and regular use of laxatives has been linked to higher risk of dementia.

To reduce the risk of becoming constipated in the first place, the following prevention strategies can help restore the relaxed, wave-like muscle motions that move matter through the digestive tract (peristalsis).

Dietary & Nutritional Support

• Drink coffee The old adage is true: coffee does indeed make you poop. Do not forget milk and sugar to prevent the counterproductive jitters and stress response from plain black coffee.

• Eat fruits and fruit juices daily Prune juice is an old standby, but orange juice and grape juice also work well.

• Take MCT oil One teaspoon with meals can ease bowel movements by providing easy energy. This can be increased to two teaspoons if well tolerated. Add to food or beverages only after cooking. Do not cook with MCT oil.

• Eat raw carrots Eating shredded carrots has been found to increase stool output.

• Salt your food Adequate salt intake ensures a hydrated body, which reduces chance of constipation. Unless you have been directed by your physician to be on a low-salt diet, do not be afraid to add salt to your food.

• Drink bone broth (or eat jello) Bone broth and jello contain glycine, which promotes relaxation of the gut. Both can be eaten daily.

Positioning & Movement

• Use a "Squatty Potty" Raising the knees above the hips while on the toilet makes it easier to pass stool. You can use a dedicated Squatty Potty or any sturdy footstool.

• Gentle movement Encourage walking or standing hourly while awake. This promotes circulation and gentle movement of the gut.

• Go at the right times Plan a bathroom trip within a half hour of waking and a half hour after a heavy meal. It is easier to pass stool at these times.

Gut Relaxation & Warmth

• Avoid eating while watching TV or while in a hurry Stress activates the sympathetic nervous system, which slows down the digestive system.

• Apply heat If a bath is too difficult, placing a hot water bottle on the tummy for 15-30 minutes each day relaxes the gut and promotes healthy circulation.

• Take warm baths Aim for a 20-30 minute bath with Epsom salt, 2-3 times per week, as this can help relax the gut.

Recipe: Homemade Digestive Broth Using Instant Pot Pressure Cooker

Ingredients

• 3lb beef bones (knuckles, feet, oxtail, or other bone)
• 1 large bunch Swiss chard, spinach, or beet greens
• 1 Tablespoon salt

Instructions

1. Place bones and salt in the pressure cooker pot. Fill with water to the fill line.
2. Seal the valve and cook on high pressure for 90 minutes.
3. Allow at least 20-30 minutes for the pressure to naturally release before removing the lid.
4. Use tongs to remove the bones from the pot, leaving the broth in the pressure cooker.
5. Roughly chop the greens and add them to the broth in the pot.
6. Use the low saute function on the pressure cooker to simmer the greens in the broth uncovered for 30 minutes.
7. Pour broth through a sieve into a clean food safe storage container. Discard leftover bones and exhausted greens.
8. Store broth in the fridge. Skim the tallow fat off the cold broth before serving for easier digestion.
9. Serve warm.

Serving size: 1 cup broth
Recipe yield: 3 quarts (about 12 servings)

Recipe: Homemade Digestive Jello

Ingredients

• 1 Tablespoon unflavored gelatin
• 1/4 cup cold water
• 1 3/4 cups grape juice
• Pinch salt
• 1.5 tsp sugar (or to taste)

Instructions

1. Sprinkle 1 tablespoon unflavored gelatin over 1/4 cup cold water; set aside to bloom.
2. Heat 1 3/4 cups grape juice, stir in 1 pinch salt and 1.5 tsp sugar.
3. Pour the hot juice over the gelatin and cold water mixture, stir until completely dissolved.
4. Chill in the fridge until set (about 2 hours).

Serving size: 1/2 cup
Yield: 4 servings

Recipe: Digestive Carrot Salad

Ingredients

• 1 medium to large carrot, shredded
• 1 teaspoon melted coconut oil or MCT oil
• 1 teaspoon distilled white vinegar
• pinch salt

Instructions

1. Peel and shred carrot with a grater.
2. Mix the shredded carrot with the coconut oil, vinegar, and salt.
3. Enjoy with meals or as a snack to promote bowel regularity.

Serving size: As desired
Recipe yield: 1 serving