1.) Constipation

From: Helen Dynda (olddad66@runestone.net)
Wed Dec 19 16:28:57 2001


1.) Constipation

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Chronic constipation is the number one gastrointestinal complaint in the United States, particularly among the elderly. Constipation accounts for more than 2.5 million physician visits a year and is among the most frequent reasons for patient self-medication.

The American Family Physician journal reported in 1998 that constipation affects as many as 26% of elderly men and 34% of elderly women. Constipation is one of those health problems that has been related to diminished perception of quality of life. The good news is that there are conventional and alternative treatments that can provide immediate relief. Common Symptoms

Most individuals with uncontrolled constipation develop a variety of symptoms, ranging from large bowel pain, rectal discomfort, abdominal fullness, nausea, anorexia, and a general feeling of malaise. These people feel like they never completely evacuate their bowels. Severe chronic constipation may be accompanied by fecal impaction resulting in severe diarrhea, ulceration of the colon, and intestinal obstruction.

Fiber is Not the Solution for Most People

Conventional and alternative physicians often recommend fiber supplements to prevent constipation. Yet published studies show that a significant number of chronically constipated people do not find relief from fiber supplements.

An example of fiber not working was a trial that showed that 80% of patients with slow transit and 63% of patients with a disorder of defecation did not respond to dietary fiber treatment. In 85% of patients without these disorders, fiber was effective. This study showed that slow gastrointestinal transit and/or a disorder of defecation may explain a poor outcome of dietary fiber therapy in some patients with chronic constipation and why nutritional laxative therapy may be important.

Another example of fiber not working was a trial with 73 consecutive constipated children whose mean fiber intake was the same as in healthy controls, although energy and fluid intakes were lower. The conclusion was that the amount of dietary fibers played no role in chronic constipation. Dietary advice did not change the mean fiber content of the diet. In addition, changes in fiber intakes had no effect on colonic transit time or cure.

Still another study evaluated whether laxatives and fiber therapies improve symptoms and bowel movement frequency in adults with chronic constipation. Fiber and laxatives decreased abdominal pain and improved stool consistency compared with a placebo. The conclusions were that both fiber and laxatives modestly improved bowel movement frequency in adults with chronic constipation. The results of this study showed that there was inadequate evidence to establish whether fiber was superior to laxatives, or if one laxative class was superior to another. Clearly, fiber is not the solution to chronic constipation for many people, despite endless TV commercials and physician recommendations that tout the benefits of fiber.

Aggressive Alternative Therapies

Dietary modifications can help some people, but many people's constipation is caused by insufficient peristalsis, which means there is not enough colon contractile activity to completely evacuate the bowel. However, there are specific nutrients that, if taken at the right time, can induce healthy colon peristaltic action without producing side effects. While pharmaceutical laxatives have been linked to the development of cancer, nutritional laxatives have many health benefits.

Nutrients that induce healthy colon peristalsis work best when taken on an empty stomach. One combination is 4 to 8 grams of vitamin C powder and 1500 mg of magnesium oxide powder taken with the juice of a freshly squeezed grapefruit. A convenient product sold by several vitamin companies is a buffered vitamin C powder product that contains magnesium and potassium salts mixed with ascorbic acid. Depending on the individual, a few teaspoons, or in some cases, 1 to 2 tablespoons of this buffered vitamin C powder produces a powerful but safe laxative effect within 45 minutes. This therapy has to be carefully individually adjusted so it will not cause day-long diarrhea.

Most Americans suffer from a deficiency of magnesium, and the use of a magnesium laxative several times a week could prove beneficial for cardiovascular health. However, chronic use of very high doses (over 3000 mg every day) of magnesium could allow excessive magnesium into the bloodstream, and this could affect kidney function.

Vitamin B5 (pantothenic acid) in a dose of 2000 to 3000 mg on an empty stomach will produce a rapid evacuation of bowel contents. Vitamin B5 powder tastes terrible, but there are many health benefits attributed to this vitamin in addition to its ability to stimulate peristalsis.

One way of taking vitamin B5 and other peristalsis-inducing nutrients is to use a multi-nutrient formula called Powermaker II developed by Durk Pearson and Sandy Shaw and sold by many supplement companies. This decent-tasting powder contains vitamin B5, vitamin C, choline, and arginine, all of which induce significant peristaltic action when 1 to 2 tablespoons are taken on an empty stomach.

Nutritional laxatives such as magnesium, ascorbic acid, and pantothenic acid are becoming more popular in those afflicted with constipation that is resistant to fiber therapies.

Some Lifestyle Changes That May Help

There are number of factors that can contribute to constipation, including not eating enough fiber, not drinking enough water, not getting enough exercise, improper laxative use, hypercalcemia, inflammatory bowel disorders, neuromuscular disorders (e.g., scleroderma, dermatoamyocytes), and acute diverticulitis. Additionally, taking antacids containing aluminum or calcium as well reactions to taking medications (e.g., painkillers containing codeine, antidepressants, antiparkinsonism drugs, and diuretics) may cause constipation. In many people, anxiety, depression, and grief may also precipitate constipation. Even pregnancy can cause constipation.

Aging itself may increase the incidence of constipation. As a person ages, the colon wall thickens. When this thickening is combined with a lifetime diet low in fiber, constipation can result.

Constipation can also contribute to loss of bladder control by weakening the pelvic floor muscles due to straining. A full bowel pressing on the bladder and causing it to empty prematurely or blocking the outflow of urine is another common effect of constipation. People with bladder control problems often don't drink enough for fear of wetting, which can result in constipation, causing further discomfort and anxiety.

Diet can have a significant effect on constipation. People may become constipated if they start eating fewer vegetables, fruits, and whole grains. Eating more high-fat meats, dairy products, and eggs can be another cause of constipation. So can eating more rich desserts and other sweets high in refined sugars.

Unfortunately, many elderly people who live alone may lose interest in cooking and eating. As a result they start using a lot of convenience foods. These foods tend to be low in fiber, so they may contribute to constipation. In addition, bad teeth may cause older people to choose soft, processed foods that contain little, if any, fiber.

People sometimes do not drink enough fluids, especially if they are not eating regular meals. Water and other liquids add bulk to stools, making bowel movements easier.

Despite all of the above known causes, many people suffer chronic constipation because of a sluggish bowel (insufficient peristalsis) and need to follow aggressive interventions to properly evacuate their colon on a regular basis.

What the Europeans are Doing

The most popular digestive aid sold in Europe is called Digest RC. This product was introduced in Europe over 45 years ago, and today over 100 million doses of the product are sold annually, primarily in Eastern Europe.

The mechanism of action of the formula is to stimulate peristalsis of the intestines, speed digestion of fats, and prevent stagnation of food in the digestive tract. The benefits the user finds are a reduction in esophageal acid reflux, alleviation of the feeling of fullness and bloating after eating, decreased digestive tract tension, alkalinization of the gastric content, constipation relief, and normalized elimination.


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