Constipation is the most common gastroenterological symptom treated by physicians — as many as 2.9 million patients seek help annually. Last week I appeared on a local TV program and described a natural cocktail to ease constipation. Within days, I received hundreds of e-mails and telephone calls seeking the recipe. Clearly, this topic deserves some discussion!
While I don't want to keep you in suspense, I must first provide information on constipation — a term that has varied meanings. Constipation is defined as fewer than three spontaneous bowel movements weekly. Constipation may also exist if stools are too hard, too small, if there is an excessive need to strain or the sense that even after a movement there is incomplete emptying of the bowel.
Constipation becomes more common as we grow older, with as many as a third of all individuals over age 65 complaining of constipation. The number increases to well over 50 percent at age 80. Often no cause can be found, but a diet containing inadequate fiber and too few calories are major contributing factors. The problem is made worse by lack of exercise and trying, on numerous occasions, to suppress a bowel movement because it occurs at an inconvenient time. Usually bowel movements are stimulated by eating a big meal, the so-called "gastro-colic" reflex. Suppressing this urge can lead to constipation.
I have a patient who refuses to use any bathroom but her home. She tells me that on occasion she has to leave an event and speed home to relieve herself. Needless to say, this is not a good practice, and she now has constipation.
Finally, there are numerous medications that lead to constipation. Common culprits include antacids containing aluminum, calcium channel blockers used for high blood pressure, many antidepressants and drugs used to treat pain.
The first approach to constipation is a careful history and physical examination; blood tests may be needed, and illnesses such as thyroid problems, diabetes, irritable bowel syndrome and cancer must be excluded.
In most cases, no cause is identified. The best possible treatment is to regularize and obtain normal bowel movements naturally. This includes eating a diet rich in fruits and vegetables or cereals. The bulk content of your diet can be increased by taking psyllium (Metamucil) or methylcellulose (Fibercon). The dose for both is 1 tablespoon up to three times daily in a full glass of water. Never suppress a bowel movement if you have the urge to go.
Unfortunately, finding the best natural method to end constipation is no easy chore. Recently, I had a patient who believed she was so constipated that only a "Molotov" cocktail would be powerful enough to clear her bowel. For years, my mother has constantly criticized my medical prowess, as I was unable to provide her relief. Eventually, I turned to a fellow geriatrician, Dr. Jerry Malott, who gave me a powerful recipe to ease constipation. I immediately prescribed the "Malott" cocktail to my patient and my mother. Since then both of them have been regular and, according to my mother, life is "as smooth as silk."
The recipe is as follows: At any health food store buy 8 ounces each of flax, sesame and peeled sunflower seeds. Mix them equally. Take 1 tablespoon up to three times daily alone or in cereal, fruit, salad or any other appropriate foods. The Malott cocktail provides fiber, your daily requirements of the omega-3 fatty acids and naturally occurring vitamin E (which is the only form that is beneficial for your health).
While this cocktail helps many people, the cure rate is nowhere near 100 percent. If these recommendations all fail, a laxative may be needed. The most gentle is one that increases the water content of the stool, such as Miralax or Glycolax. If this fails, consider milk of magnesia, senna (Exlax, Senokot) or bisacodyl (Correctol, Dulcolax). However, there are problems with these stimulants. Overuse can lead to a vicious cycle of constipation followed by diarrhea and to metabolic changes that can be dangerous.
Remember that newly developed constipation can be the harbinger of a serious illness. Always see your doctor. If nothing serious is present, stay natural if at all possible. Here, the Malott cocktail can prove most helpful.
Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. Dr. David Lipschitz' e-mail address is [email protected] More information is available at www.drdavidhealth.com.