The Love Of A Good Bowel Movement
Excerpt from ABCNEWS.com
By Peter R. Holt, MD, Columbia University College of Physicians
Yes, no one likes to talk about it, but regularity is very imporant
to health. Read why.
close to twenty years, my mother went out every Tuesday afternoon
to meet three of her friends. I often wondered what they talked
about-probably their husbands, their children, and later their
grandchildren, politics, or good sales. So one evening I asked
her what the conversation had been about on that afternoon. She
looked at me a little oddly, clearly embarrassed, and said, "Well,
I must admit today's conversation focused upon our various approaches
to having a good bowel movement. I'm afraid that this has become
a constant topic of our conversations and we try to get hints
from one another. We're all having trouble."
regulate bowel activity is one of the most common complaints of
older persons and this problem applies even to individuals who
are otherwise quite active, consider themselves well, and suffer
from very few illnesses. So, why does it happen? And what can
we do about it?
and illnesses that affect bowel function
of illnesses and medications affect the normal passage of food
down the intestine, and the passage of fecal material through
the colon to the rectum. There are a number of metabolic and endocrine
disorders that can frustrate your bowel schedule. The most common
is diabetes mellitus, but it can also result from conditions in
which thyroid hormone activity is low, there is excess calcium,
or too little potassium in the blood. Common diseases of the nervous
system that can cause problems in evacuation in the elderly include
Parkinson's disease, and stroke. Neurological illnesses such as
multiple sclerosis rarely cause changes in the intestine themselves,
but they can damage the nerves of the autonomic nervous system
(which controls heart rate, blood pressure, and breathing) that
may alter bowel movement.
are a serious culprit of bowel problems as well. Antihypertensive
drugs, calcium channel-blockers, and anticonvulsants may present
problems. Iron and calcium supplements, both of which may be very
important as supplemental nutrients in the elderly, and aluminum
containing antacid compounds, including sucralfate, may cause
constipation. Also, drugs that are used for the treatment of Parkinson's
disease, antidepressants, and antipsychotic medications are all
common causes of bowel roadblocks.
In order for
your doctor to make an accurate diagnosis, tell him or her how
frequently you have bowel movements. Keep a record for a week
to ten days before your appointment, and record the following:
- What does
the stool look like?
- Are you
straining when you defecate?
- Do you
lose stools either with a little soilage on your underclothes,
or is there severe fecal incontinence?
- Do you
have any pain in the rectum, or any stomach pain? Is this pain
related to defecation?
- Do you
have a history of hemorrhoids or any diseases of the rectum?
- Is there
ever any blood or mucus in your stool?
- How frequently
do you take laxatives? Daily? Weekly? And be prepared to give
a diet history. All these historical points are important in
determining how best to manage the problems you are having,
and to decide whether you need any tests to eliminate the possibility
of serious bowel disease.
easy treatment for your discomfort is to drink eight glasses
of water a day, and add fiber to your diet. High-fiber foods
include many fruits and vegetables, bran cereals, and whole-grain
bread. Management without drugs should be the foundation of
long-term treatment. But when you need to take a drug to treat
your constipation, how should you proceed?
a warning...habitual laxative use can result in distention
of the colon and the rectum and can stop the urge to defecate,
which can result in-you got it-taking even more laxatives.
Everyone must be very careful about this problem.
this caution, you could start by taking an over-the-counter
bulk laxative, which contains psyllium and ispaghula. These
laxatives can absorb a lot of water, which makes it easier
to pass stool. However, taking such laxatives makes the colon
work harder, and can cause pain, discomfort, or excess gas,
so you have to proceed slowly.
bulk laxatives include Milk of Magnesia (magnesium hydroxide)
and saline laxatives. Magnesium salts draw fluid into the
small bowel and cause movement of feces to the rectum. Products
that contain sodium phosphate can also be used to draw fluids
into the small bowel. There also are so-called hyperosmolar
laxatives that include lactulose, which is a sugar that is
not absorbed in the small intestine. Lactulose is broken down
by bacteria in the colon and increases the water content,
thereby making stool passage easier.
types of products don't work, you may need to use stimulant
laxatives, which include senna and phenolphthalein-containing
compounds such as Ex-Lax or Correctol, or bisacodyl (Dulcolax).
These laxatives whip the colon into action, but often result
in your needing more and more of the compound to have an effect.
It is not a good idea to use senna or Dulcolax for more than
seven to ten days.
if you need quick action, it is much better to use suppositories,
either a glycerine suppository or a Dulcolax suppository,
or you could even use an enema. However, overuse of enemas
can create problems as well. The colon can get used to the
enemas and depend on them for any bowel action at all. Occasionally
the lower bowel can be damaged by excessive use of enemas.
are a few ideas that might help ease your bowels and ease
your mind. If simple measures don't work, see your doctor
so that you can rule out more serious causes of your discomfort.
Reference Source 104