G211
Constipation
The most common complaint among older people is constipation. If you have constipation, check with your doctor who often orders thyroid tests and a barium enema to rule out obstruction. Usually these tests are normal and you need to correct your diet. Eat whole grains and stop eating foods made from white flour.
The pain of constipation is usually caused by gas stretching your colon where it has been blocked by hard stool. Food is turned into a soup in your stomach and remains that way until it reaches your colon, where water is absorbed and stool is formed. If you don't drink enough fluid or eat enough fiber, the stool rapidly turns into hard stones.
Eating low-fiber foods, such as bakery products and pastas (breads, rolls, pastries, bagels, pretzels, noodles and spaghetti) causes hard stool, while eating fiber-rich foods, such a fruits, vegetables, whole grains and beans, keeps everything soft. Coffee can cause colonic contractions. You should drink some fluid with each meal, but taking extra fluids does not cause soft stools because any extra water is absorbed from your colon into your bloodstream and just causes you to urinate more. If you drink enough water and eat lots of fiber-rich foods and are still constipated, you may have nerve damage and need to be checked for diabetes. Laxatives can interfere with absorbtion of nutrients and will not solve the problem. The antibiotic, erythromycin (5), the gout medicine, colchicine (6) or the stomach medicine, prevacid can be used to treat constipation that does not respond to dietary changes.
1) Discomfort from gas: DM Owens er al. Arthritis and Rheumatism 1995(Jan);122:107.
2) HW Vaillant. Constipation happens. Journal of General Internal Medicine 12: 1 (JAN 1997):75.
3) M Anti, G Pignataro, A Armuzzi, A Valenti, E Iascone, R Marmo, A Lamazza, AR Pretaroli, V Pace, P Leo, A Castelli, G Gasbarrini. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepato - Gastroenterology 45: 21 (MAY-JUN 1998):727-732.
4) SM Tramonte, MB Brand, CD Mulrow, MG Amato, ME Okeefe, G Ramirez. The treatment of chronic constipation in adults: A systematic review. Journal of General Internal Medicine 12: 1 (JAN 1997):15-24. Both fiber and laxatives modestly improved bowel movement frequency.
5) Erythromycin, a motilin receptor agonist has been shown to have prokinetic effects on the upper gastrointestinal tract and gallbladder. SS Sharma, N Bhargava, SC Mathur. Effect of oral erythromycin on colonic transit in patients with idiopathic constipation - A pilot study. Digestive Diseases and Sciences 40: 11 (NOV 1995):2446-2449.
6) GN Verne, EY Eaker, RH Davis, CA Sninsky. Colchicine is an effective treatment for patients with chronic constipation: An open-label trial. Digestive Diseases and Sciences 42: 9 (SEP 1997):1959-1963. colchicine 0.6 mg three times a day.
7) BD Chung, U Parekh, JH Sellin. Effect of increased fluid intake on stool output in normal healthy volunteers. Journal of
Clinical Gastroenterology 28: 1 (JAN 1999):29-32.
8) PJ Boekema, M Samsom, GPV Henegouwen, AJPM Smout.Coffee
and gastrointestinal function: Facts and fiction - A review.Scandinavian Journal of Gastroenterology, 1999, Vol 34, Suppl.
230, pp 35-39
Checked 2/1/08