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Integrative medicine: Fiber is just one key to regularity

By Drs. Kay Judge and Maxine Barish-Wreden, McClatchy Newspapers, Source: MCT News Service

This is an embarrassing problem: I only have a bowel movement every other day. How can I be more regular? I usually have to drink a laxative tea to go daily.

This is not embarrassing at all for us to answer. But it's a red-faced question we get asked frequently, so thanks for asking.

Constipation is defined as going fewer than three times a week. Other signs include straining, hard stools, a sensation of incomplete evacuation and a sense of blockage or obstruction.

It is actually normal for some people to go every other day, so if you don't have any other signs of digestive upset, we wouldn't recommend actively treating it to increase the frequency – especially with laxatives, including special teas.

However, about 4 million Americans do suffer from chronic constipation, and more than $150 million is spent yearly by Americans on laxatives. What may be some reasons?

_Not getting enough fiber. The average American eats only 5 to 14 grams of fiber daily, as opposed to the 20 to 35 grams recommended by the American Dietetic Association.

_Not exercising enough. Lack of physical activity is a surprisingly common cause of constipation in the elderly. (Time to do those sit-ups!)

_Not drinking enough water. Water adds fluid to the colon and makes bowel movement easier. Conversely, caffeinated beverages and alcohol may dehydrate the body.

_Certain medications can aggravate constipation. Common culprits include pain medications (narcotics), antacids that contain aluminum and calcium, blood pressure medications (calcium channel blockers), diuretics and iron supplements.

_Not listening to the body. Ignoring the urge can lead to chronic constipation.

_Taking laxatives. These can impair the colon's ability to have regular movements.

Some of our favorite natural remedies for constipation, therefore, are pretty straightforward. Drink plenty of water, exercise daily and practice regularity in the times you go to the bathroom. You can also try to get to a goal of 25 to 35 grams of fiber a day through bran, beans, whole grains, fresh fruit and veggies. Some foods that are pretty high in fiber include raspberries, pears, barley, split peas, lentils, black beans and artichokes.

As always, if any other medical symptoms occur along with the constipation – such as abdominal pain or blood in the stools – seek the advice of a doctor.

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(Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter Downtown Integrative Medicine program in Sacramento, Calif. Have a question related to alternative medicine? E-mail adrenaline@sacbee.com.)

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(c) 2010, The Sacramento Bee (Sacramento, Calif.).

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Distributed by McClatchy-Tribune Information Services.