Dr. Gott Fighting constipation

Dear Dr. Gott: I was so happy to see your colon-cocktail ingredients in print, as I have a real problem with constipation. Do you have other ways to stop this annoyance?

Dear Reader: The gastrointestinal tract slows as we age, with dietary and lifestyle changes often being to blame. For example, it is often far easier to eat a frozen dinner or a prepared meal that may be nutritious but that may lack the necessary fiber to keep you regular. Or your previous, faster pace of daily living might be slowed, so you don’t exercise as much as you once did. Both scenarios can lead to constipation. Perhaps a diet that includes fruits and vegetables, whole grains and unprocessed bran, an increase in the amount of fluids you consume daily and moderate exercise will get you back on track quickly. Try to consume between 20 and 35 grams of fiber each day, but begin slowly. You may find a piece of fruit each day is sufficient to keep you regular. To overdo it too quickly is to turn constipation into diarrhea, and you don’t want that to happen. Be sure to avoid foods high in sugar and fat, such as ice cream and cheese, that can aggravate constipation.

Be sure to take sufficient time when you feel the urge to defecate. Being rushed and thinking you may be forced to strain will definitely have a negative impact on the result. The longer you delay, the more water will be absorbed from your stool, and the harder it becomes.

If your problem persists, visit your physician or a gastroenterologist to ensure nothing else, such as a blockage, is going on. Have you had any testing along those lines? For example, noninvasive procedures are available to determine how well food passes through the digestive system. You might choose to speak with your physician about them.

While you don’t mention any medical issues in your brief letter, you could have undiagnosed irritable bowel syndrome, might be overusing laxatives, have diverticulosis, be on specific medications such as those to combat hypertension and depression, or you may have hypothyroidism or hemorrhoids. The possibilities are almost limitless.

For the record, my colon cocktail may take up to two weeks to become fully effective, so you might wish to do it on a permanent basis. Beyond that, consider drinking 4 ounces of warm prune or apple juice daily. You also might do well with a simple stool softener, fiber supplement or an osmotic to help fluids move through your colon. There are several over-the-counter products such as magnesium citrate that might do the trick. I’m sure that your local pharmacy will have a large supply from which to choose. You might even ask your pharmacist his or her opinion regarding which product might meet your needs best.

Avoid using laxatives on a regular basis. Habitual use of them can cause the colon to become dependent. As with any drug, even over-the-counter ones, their use can involve increasing the dosage time after time until the colon relies completely on an outside source to allow it to function. Laxatives should be taken only under a physician’s supervision.