constipation G211
Gabe Mirkin, M.D.

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 a cancer or other
obstruction or diabetic nerve damage. Usually these tests are
normal and you need to correct your diet. Eat whole grains and
stop eating foods made from white flour. Exercise and try to empty
your colon soon after eating breakfast.

PHYSIOLOGY: After you eat, the pyloric sphincter at the end of the
stomach closes, and food is not allowed to pass into your small
intestine until is converted to a liquid soup. Some food is
absorbed, but most of the liquid soup passes to your colon, where
fluid is rapidly absorbed. The longer stool remains in your colon,
the more water is absorbed, the harder stool becomes, and the more
difficult it is to pass.

are made up of combinations of sugars. Before any carbohydrate can
be absorbed, it must first be broken down into single sugars that
are almost always absorbed before they reach your colon. Only
single sugars can be absorbed. Dried skins of fruits contain fiber
that your body cannot break down, and sugars imbedded so deeply in
the fiber that these sugars cannot be absorbed in the small
intestines. So, when these sugars reach the colon, bacteria
ferment them rapidly and break them into 1) small particles that
draw large amounts of fluids into the colon, and 2) gas that
dilates the colon and pushes stool toward the opening.

TREATMENT: To prevent or treat constipation, the goal is to move
everything from your colon as soon as possible because the longer
it stays, the harder it becomes.

Exercise every day . Exercise causes giant contractions of the
colon which push food out. The longer and harder you exercise, the
greater the movement of food toward the outside.

Drink plenty of fluid because dehydration increases the rate
that fluid is absorbed from your colon.

Avoid constipating foods: low-fiber foods such as flour and
sugar water; and high-fat foods such as cheese, eggs, and meats.

Eat lots of high-fiber foods that hold extra water in your
colon: vegetables, whole grains, beans, nuts.

Foods particularly effective for pushing food onward include
dried fruit, such as prunes, apricots, cranberries or apples.

Try to empty your colon less than a half hour after eating. It's
called the gastro-colic reflex. When food reaches your stomach,
the stomach is stretched, sending a message along nerves from the
stomach to cause the colon to contract and push foods forward. The
longer stool remains in your colon, the drier and harder it
becomes. So you want to empty your colon as soon as it fills.

Updated 4/2/13