Dr. Marie's Guide to Preventing and Treating Constipation


If you're not always "regular," you're definitely not alone. ThirdAge's resident women's health expert, Marie (Dr. Marie) Savard M.D., says that women are much more likely to suffer from constipation than men are. The reason is that the contractions of the digestive tract -- a process called peristalsis -- are slower in females. Dr. Marie also points out that women are especially prone to "holiday constipation," a phenomenon brought on by changes in diet, long plane or car rides, and the "safe toilet syndrome" in which people "hold it" for too long when they're away from home.

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The good news, though, is that preventing and treating constipation is almost always simple and rarely requires a doctor visit. Here's what Dr. Marie recommends:

Fill Up on Fiber Hard stools and the need to strain are the result of a diet that doesn't have enough bulk. "Your colon is a muscle," Dr. Marie says. "It needs a daily workout. Plenty of fiber stretches the muscle so that you get a good evacuation after which the muscle will spring back into place." She adds that chronic constipation can make the colon lose its elasticity, thus creating a vicious cycle.

Stay Hydrated You need 1 1/2 to 2 quarts of fluid a day. Water is the best, but research shows that other liquids count as well. In fact, coffee - even decaf - acts as a stimulant that can speed peristalsis. Stay away from sugary soft drinks, however. They are a major contributing factor to obesity and with it a host of health problems including Diabetes 2.

Live an Active Lifestyle Dr. Marie says that being sedentary is a top cause of constipation. You've heard this before but it bears repeating: If you sit at a desk all day, take breaks during which you stand up, stretch, and walk around. You also need regular exercise, of course, but this simple ploy alone will help to keep your system functioning efficiently. Similarly, don't sit constantly when you're traveling for many hours. On a plane, get up as soon as the "Fasten Seat Belt" sign goes off and walk up and down the aisle for a little while. The same goes for train rides, and you don't even have to wait for permission to unbuckle yourself! During car trips, make fairly frequent rest stops so you can get out and move around - and perhaps enjoy some scenery in the bargain.

Try OTC Remedies If you do become constipated, Dr. Marie says that using dietary fiber supplements such as Metamucil, or "osmotic laxatives" such as Milk of Magnesia, or stool softeners such as Ex-Lax, can help. Other possibilities are glycerin suppositories and an old-fashioned enema. She cautions, though, that these products and procedures don't have the phytonutrients and antioxidants that are abundant in high fiber foods. Those components can help protect against cancer and slow the effects of aging so make every effort to eat your share of whole grains, nuts, and lentils. Resort to constipation treatments only as an emergency measure.

Finally, Dr. Marie offers some caveats:

Mineral Oil Is Not a Safe Laxative

This previously popular remedy can be aspirated into the lungs and is considered very dangerous.

See Your Doctor If the Problem Persists

You may have an underlying medical condition such as fibroids, an underactive thyroid gland, nerve damage in the gastrointestinal tract caused by Diabetes 2, diverticular disease, or even colon cancer. Also, you could be having an adverse reaction to prescription or OTC drugs such as antidepressants, painkillers, diuretics, calcium channel blockers, antihistamines, cough medicines with codeine, antacids containing aluminum, and iron tablets.

Be Wary of the New Prescription Medications for Constipation

"Why be a guinea pig?" Dr. Marie says. "In 2006 the FDA approved Amitiza, but I suspect that the direct-to-consumer advertising budget far exceeds the research budget for this drug. Also because of studies done in 2007, Tegaserod is no longer approved for older women or anyone with risk factors for heart disease."

Now you're all set to head into the holiday season and the new year ahead knowing how to avoid or treat one of the most common of all nuisance ailments. Here at ThirdAge, we're glad we have Dr. Marie to give us frank advice about constipation and other conditions that people so often suffer in silence!

Marie Savard, M.D. is a nationally known internist, women's health expert, advocate for patient empowerment, and Medical Contributor to ABC' "Good Morning America." News. She is the author most recently of "Ask Dr. Marie." Please visit www.drsavard.com.

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