Judging from the popularity of laxatives, a lot of Americans think that regularity is essential for good health. But is this true or is it a myth?
Although grandmothers in many countries have promoted daily bowel movements for generations, there is no evidence that a trip to the bathroom each morning is necessary. Some people do quite well on an intermittent schedule-as infrequently as two or three times a week or as often as a few times a day.
Doctors and patients don’t always agree on what constitutes constipation. Physicians may prefer objective measures like the number of days between bowel movements. But people are often concerned about consistency as much as frequency. They complain about the effort of passing hard “golf balls” or “bricks.”
There is no dearth of advice for people who suffer. Those who are constipated are often urged to drink more water. Unless someone is actually dehydrated, though, drinking extra water does not solve the problem.
Others believe that constipation can be traced to inadequate fiber in the diet. This letter is typical: “Shame on you! You mentioned prescription laxatives for a constipated patient. Many people are not aware of the fiber-deficient western diet and assume they are eating healthfully. You should educate them about eating fruits, nuts and veggies, beans and popcorn, instead of bleached white flour bread and pasta.”
Although fiber is certainly helpful, and we are the first to recommend vegetables, fruits and nuts, people who are chronically constipated eat about the same amount of fiber as those who are not. They simply need more
Fiber can have side effects, though: “I have trouble with chronic constipation. Extra fiber doesn’t help. It just bloats me and causes gas.”
Sometimes constipation can be traced to medication or dietary supplements:
“I know how desperate people feel because I suffered the same problem for years. Those who haven’t cannot imagine the severity of the problem.
“I tried fiber, fluids and more, to no avail. I became convinced it was related to my medication. By a process of trial and error, I narrowed it down to a calcium supplement I had been taking for years. As soon as I stopped taking it, the constipation disappeared and has not returned since.”
Hundreds of prescription and over-the-counter medications can cause constipation. Neither water nor fiber is a guaranteed solution.
We have prepared a Guide with a list of medicines that contribute to constipation and tips to combat it. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. GG-30, P. O. Box 52027, Durham, NC 27717-2027.
One reader found a unique approach: “Antidepressant medication gave me a new lease on life and I felt wonderful, except for the side effect of severe constipation. I tried everything. Nothing helped until I ate fresh pineapple. To my surprise, it worked. I now eat about 1/3 of a fresh pineapple every morning with breakfast.”
Other tried-and-true favorites include bran, ground flaxseed, prunes or psyllium (Metamucil or similar products). No single approach works for all, but with experimentation most people should find relief.