Dr. Gott: Let nature, food take its course

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Dear Dr. Gott: I have had a problem with severe constipation for many years. I have taken different laxatives and have been on milk of magnesia for a long time. I took a large dose of it last night and the night before, to no avail. I use Fleet enemas and suppositories, and strain with all my might to get any kind of action.

Dear reader: Constipation is a persistent decrease in the frequency and ease of bowel movements. On a temporary basis, this is nothing to worry about. Long term, it should be investigated.

You do not indicate how often you actually have a bowel movement. Every person has a slightly different pattern. For some, it’s once a day, three times a day or even once every three days. Do you include adequate fiber and sufficient fluids in your diet? Or is your diet high in animal fats and refined sugars? Have you had your thyroid gland checked? A sluggish thyroid can cause chronic constipation.

The habitual use of laxatives can be dangerous. As with addictive drugs, doses of laxatives over time must be increased to produce the effect needed. Eventually, the intestines can become unresponsive to the drugs altogether, and cease to become effective.

Constipation can be a symptom of a more serious problem, such as medication interactions, hormonal disturbances, thyroid disorders and more. It can also lead to hemorrhoids from straining and fissures caused by hard stool stretching the sphincter muscle. With that in mind, I recommend you make an appointment with your primary-care physician, who hasn’t listened to you thus far, to demand help, or request a referral to a gastroenterologist. Ask to be checked for the obvious possibilities mentioned. If nothing is found, your concerns should be put to rest at least.

While waiting for the appointment, bypass all the over-the-counter drugs you have. Instead, add fiber and plenty of fruits and vegetables to your diet, and increase the amount of fluids you consume daily. Consider warm prune or apple juice with breakfast or try my colon cocktail (equal portions of bran, applesauce and prune juice, 1 to 2 tablespoons taken daily). Exercise regularly to the capability you feel comfortable with.

Perhaps this translates to a walk around the block after work. Allow your body to get back on track without the aid of outside forces. You might be amazed at the results.

• Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.

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