Posted on 01/21/2005 8:36:54 PM PST by neverdem
Despite the barrage of television commercials that insist otherwise, a diet low in fiber is usually not the cause of constipation, and taking fiber supplements is probably not the cure, according to a new study.
In fact, a fiber supplement can actually make symptoms worse in some patients, particularly the most severely afflicted. A review study published in the January issue of The American Journal of Gastroenterology suggests that many other common beliefs about constipation are also little more than durable myths.
According to the American College of Gastroenterology, constipation is the reason for at least 2.5 million doctor visits annually in the United States, and ACNielsen, the marketing information company, reports that Americans spent more than $700 million last year on over-the-counter laxative medicines. Yet much of the advice they got - including many suggestions from doctors - was probably not helpful.
Fiber is far from a panacea. In one study, fewer than half of the patients with self-described constipation had any response to added fiber, and studies comparing people with chronic constipation to comparison groups without the condition show no difference in their dietary fiber intake.
At best, a diet low in fiber may be a contributory factor in a minority of patients, and fiber supplements may help them, the reviewers, led by Dr. Stefan Müller-Lissner, a professor of medicine at Humboldt University in Berlin, found.
Drinking more liquid is often recommended, but studies show it does not work. Although it may seem that adding water to hard stools will soften them, adding liquid does not accomplish this, nor does it relieve constipation.
If fiber and liquids do not help much, will increasing exercise? The studies say no.
Despite its other benefits, exercise is largely ineffective in preventing constipation. It seems to help in the elderly if it is part of a broader program, but it does not work in young, severely constipated patients. While workouts like marathons can increase gut activity, moderately increased exercise in healthy people has no discernible effect on bowel function.
What really works for constipation? "I do start with a trial of dietary fiber," Dr. Müller-Lissner said. "Prunes and other fruits may be effective, although bloating can occur as a side effect."
If those measures do not work, Dr. Müller-Lissner recommends laxatives. In addition to the fiber additives, there are three other types: stool softeners (Colace, for example); saline laxatives like milk of magnesia; and stimulant laxatives, including Dulcolax, Correctol, and others. "I prescribe macrogol," the active ingredient in Colace and many other brands, he said.
He added, "If this is ineffective or not tolerated, I switch to bisacodyl" in Correctol and other stimulants, "or a related compound."
These drugs are not harmful in normal dosages, Dr. Müller-Lissner said. Some experts believe that stimulant laxatives that amplify bowel motility can increase the risk for colorectal cancer, but the evidence is weak. Chronic constipation is itself associated with an increased risk of the cancer, but no evidence supports a belief that laxatives used in recommended doses increase the risk.
Other doctors suspect that the drugs have a host of adverse side effects - that they can be psychologically habit-forming, that they cause physical physical dependence, that they lead to "rebound" constipation, or that they damage the nerves and muscles that control the bowel. But studies have found no evidence.
Dr. Müller-Lissner says he believes that what constitutes a normal frequency of bowel movements is up to the patient. "The statistical range of normality is from three stools a day to three stools a week," he said. "But in clinical terms, this is irrelevant. If there is no organic disease underlying the constipation, a low stool frequency by itself does no harm. The only motivation for treatment is the patient's complaint."
Boiled peanuts are the answer.A friend went to the drag race at Rockingham N.C., said a bunch of yankees sitting behind him discovered boiled peanuts, spent all day running back and forth to the concession stand buying them. The next day he said they were back, but this time they spent most of the day running back and forth to the crapper.
My dream/nitemare was to see Pat Schroeder, rep from CO, on SNL doing that "Colon Blow" commercial spoof with that usual, constipated look on her face!!!
pineapple is the best - along with black coffee.
ROFL!
A low-fat, high veggie and fruit diet means you'll never have a problem. Oatmeal is great too, the real stuff you cook, not instant. Why do you think the old fellow on the Quaker box is smiling?
Indeed it does. One's digestive tract is all about what goes in through the mouth.
Old timey remedies still work: bran cereal/muffins, prunes, yogurt (with the live bacillus) ...these are all mild and
Yes indeed. A small bowl of real oatmeal with an apple cooked in, a dash of cinnamon, topped with live bacillus yogurt is yummy too. Forget salads, but cooked veggies with lunch and dinner work too. I like the Zone Diet idea of 3 or 4 ounces of low-fat protein at each meal, with the rest of your plate covered with veggies. Get your fats from fish oil, cod liver oil, and olive oil only. Fats in butter, cream, beef tend to promote constipation imo.
Indeed it does. One's digestive tract is all about what goes in through the mouth.
Old timey remedies still work: bran cereal/muffins, prunes, yogurt (with the live bacillus) ...these are all mild and
Yes indeed. A small bowl of real oatmeal with an apple cooked in, a dash of cinnamon, topped with live bacillus yogurt is yummy too. Forget salads, but cooked veggies with lunch and dinner work too. I like the Zone Diet idea of 3 or 4 ounces of low-fat protein at each meal, with the rest of your plate covered with veggies. Get your fats from fish oil, cod liver oil, and olive oil only. Fats in butter, cream, beef tend to promote constipation imo.
Ah, transit time. Sounds like public transportation. LOL. I worked at an ad agency where our client was trying to sell a disgusting gloppy fiber concoction. We learned all about transit time, much to our dismay. We'd come in every morning and ask, "How's your transit time?"
Do you know that natives in Africa have no more than a 12-hour transit time, and very low cancer rates while in the USA transit time is 24-36 hours or more? Africans in the studies eat very high fiber diets.
Well, there you have it.
Robinul, amongst others, works for IBS, and spastic bile ducts...it's an atropine derivative...I have a standing prescription for it because of my bile duct, but it works well on the IBS I get sometimes...
Considering what spews from the NYT on a daily basis, it is clear that the Times has more than enough fiber in their diet.
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