The colon plays a fundamental role in your well-being, as it absorbs nutrients and liquids from food, and helps the body get rid of what it does not need. But when problems arise, you may be reluctant to seek help.
“A lot of people shy away from these topics, but they shouldn’t,” says Dr. Kyle Staller, a specialist in diseases of the gastrointestinal tract at the College of Medicine from Harvard. “Many of these seemingly embarrassing health conditions have solutions.” However, some can indicate serious diseases, such as colorectal cancer, and should be treated.
The following are some common problems and strategies to solve.
“I don’t go to the bathroom enough”
Up to half of people over 65 years suffer from constipation chronic, that is, they evacuate less than 3 times a week continuously. Regardless of your age, if you suffer from chronic constipation, see your doctor, who may want to examine you for contributing problems such as anal fissures or hemorrhoids.
Your doctor may also check whether the rectum and anal sphincter muscles work well to move stool. “In women, constipation can be due to weakening and damage to the pelvic floor muscles or nerves as they age, especially if they have had vaginal deliveries or changes in pelvic anatomy after a hysterectomy,” says Dr. Carol A. Burke , a gastroenterologist at the Cleveland Clinic. Pelvic floor physiotherapy can help.
Review your usual medications with your doctor. Ibuprofen (Advil, Motrin, and generics), antacids with calcium or aluminum, iron supplements, and antihistamines can promote constipation. So can some antidepressants and calcium channel blockers for high blood pressure. Switching to a different class of medication may provide some relief. The following lifestyle changes may also help:
Eat fiber.
- Older adults should consume between 25 and 30 grams a day, focusing on soluble fiber (in fruits and vegetables) and psyllium (psyllium), which is found in cereals and added to some breads and cereal bars, says the Dr. Brian Lacy, a gastroenterologist at the Mayo Clinic in Jacksonville, Florida. (He checks for psyllium, psyllium seed husk, or psyllium husk in the ingredients box.) Kiwi can be especially helpful. A study published in The American Journal of Gastroenterology found that consuming two of these ingredients daily relieved constipation as much as prunes or 12 grams of psyllium, with less swelling.
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Have had polyps (potentially cancerous growths on the lining of the colon) removed. The American Society of Colon and Rectal Surgeons advises having a colonoscopy every 1 to 5 years, depending on the size and number of polyps.
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A benign polyp could not be completely removed. You will need another one in 3 or 6 months to try to eliminate it again.
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You have had surgery for cancer colorectal. You will need a colonoscopy within a year.
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You have inflammatory bowel disease. You will need a colonoscopy every 1 to 2 years.
Have a schedule. “The GI tract rests at night and tends to wake up early in the morning,” says Lacy, “so getting up at the same time, drinking coffee or tea, eating breakfast, and then having some time scheduled to go to the bathroom often helps it to function more regularly.”
Stay active. Although research is limited, “we see less constipation in active people,” says Dr. William Chey, a gastroenterologist at the University of Michigan. “Exercise awakens all the muscles, including those of the colon.” Need help while you wait for these strategies to take effect? Lacy recommends short-term daily use of a laxative such as polyethylene glycol (Miralax and generics) between dinner and bedtime.
“I go too many times”
Around the 10 % of people older than 60 years old declare to have chronic diarrhoea, that is, at least 3 loose stools per day for more than 4 weeks. It is important to see a doctor for this problem, as it can lead to dehydration or malnutrition.
Your doctor will want to check for autoimmune diseases such as Crohn’s disease and ulcerative colitis. Since these conditions can develop if your immune system attacks your digestive tract, you may be prescribed medications to suppress your immune system.
Another possible cause is overflow diarrhea, in which waste matter accumulates in the colon and liquid stool leaks around the harder stool, says Dr. Michelle Hughes, a gastroenterologist and adjunct professor at Yale School of Medicine. That requires a visit to the doctor and the use of laxatives to solve the problem.
Some older adults may experience more significant stool leakage — known as fecal incontinence — due to nerve damage caused by type 2 diabetes, a back injury, or surgery, or for women, damage to the pelvic muscles and nerves caused by vaginal deliveries years before, says Burke. It is usually treated with a course of antidiarrheal medication such as loperamide (Imodium), pelvic physical therapy, and regular use of a psyllium fiber supplement.
“I have gas all the time”
Lactose intolerance (problems digesting the natural milk sugar in dairy products) and Bacterial overgrowth in the small intestine (which connects to the colon) can cause excess gas and uncomfortable bloating. For some people, regular use of proton pump inhibitors for heartburn (such as Nexium and Prilosec) may also be a factor in heartburn.
Not sure why? You could try lactose-free dairy products or opt for milk supplemented with lactase (an enzyme that helps break down the milk sugar, lactose). If that doesn’t make a difference, consider removing other common gas producers one at a time. These include fructose (in juices, sports and energy drinks, soft drinks, and fresh fruit); legumes, cruciferous vegetables such as broccoli or cabbage; and fructans (onions, peppers, asparagus).
If avoiding them doesn’t work for you, see your doctor, advises Chey, to be tested for a condition such as irritable bowel syndrome. Working with a nutritionist to follow a low-FODMAP diet, which involves eliminating dairy, wheat, and certain fruits and vegetables, may offer a solution.
“I can’t stand the colonoscopy prep”
Since the intestines must be empty for a colonoscopy, you may be advised to drink up to a gallon of preparation (water mixed with a laxative) the day before. If this is challenging, Lacy advises that patients follow a clear liquid diet for two days beforehand, adding a teaspoon of the laxative polyethylene glycol to each 8-ounce glass of fluid consumed. This helps reduce the workload on the GI tract and kick-starts colonic emptying, so you may need less of the prep liquid. Plus, “you can mix the brew with ginger ale, 7UP, apple juice, lemonade…any clear liquid you fancy,” he says, noting that varying flavors can make the brew more enjoyable to drink.
Also, ask about a prep that requires less total fluid, or if you can split the prep, consuming half the night before and the rest 4 hours before your colonoscopy. (If it is an exam in the afternoon, you can drink all the preparation the morning of the procedure).
When is it necessary to have a colonoscopy?
To learn more about when to have your first colonoscopy — a common test for signs of colorectal cancer — see our previous article. But if you’ve already had at least one colonoscopy, most people don’t need another one for 10 years. The exceptions:
Tell your doctor right away if you have potential symptoms of colorectal cancer, such as blood in your stool, a sudden change in bowel habits, or unexplained weight loss. If you are over 75 years old, ask if you should continue with colorectal cancer screening.
Editor’s Note: This article also appeared in the April issue of 2022 of Consumer Reports On Health.
Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. Copyright © 2022, Consumer Reports, Inc.
Consumer Reports has no financial relationship with the advertisers on this site. Consumer Reports is an independent, nonprofit organization that works with consumers to create a fair, safe, and healthy world. CR does not endorse products or services and does not accept advertising. Copyright © 2022, Consumer Reports, Inc.
2022