Published: August 23, 2010
Highlights from the August Issue of Mayo Clinic Health Letter
ROCHESTER, Minn. - (BUSINESS WIRE) - Here are highlights from the August issue of Mayo Clinic Health Letter.
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Getting the Facts on Constipation
While sometimes the solution is simple, for example, short-term use of a
laxative or eating more fiber, relieving constipation sometimes can be
more difficult. For many older adults, constipation is a chronic problem
that requires an individualized treatment plan.
The August issue of Mayo Clinic Health Letter sorts myth from fact on a
health concern that affects virtually everyone at some point --
constipation.
Myth: An absence of daily bowel movements indicates constipation.
Fact: Constipation is most accurately defined as the infrequent or
difficult passing of stool. Normal bowel movement frequency in adults
can range from three times a day to three times a week.
Myth: Constipation causes the body to absorb toxins from stools.
Fact: Not true. This belief causes some people to unnecessarily take
laxatives when a daily bowel movement doesn't occur. Others try colon
cleansing to remove supposed toxins. These practices aren't helpful and
may be harmful.
Myth: An unhealthy diet causes constipation.
Fact: A low-fiber diet may contribute to constipation, but chronic
constipation often involves other factors. Constipation can be a
complication of another disease or condition, or a side effect from a
drug or supplement. In women, constipation can be caused by pelvic floor
dysfunction -- a lack of coordination of the complex muscular actions
that allow bowel movements. This condition is most common in those who
have had surgery of the rectum or anus or who have given birth vaginally.
Myth: Laxatives shouldn't be used long term.
Fact: New studies indicate that long-term laxative use prescribed by a
physician can be safe and effective for some forms of constipation.
Because side effects may occur, laxatives should be taken under a
physician's supervision.
Myth: Laxatives and surgery are the only two ways to treat chronic
constipation.
Fact: There are many treatment options and many of them depend on a
patient's circumstances. Laxative medications are an option, as well as
treating any underlying diseases or adjusting medications that could be
contributing to the condition. Surgery is used rarely and as a last
resort.
In recent years, pelvic floor rehabilitation (biofeedback therapy) has
worked well for women with constipation due to pelvic floor dysfunction.
Biofeedback involves using sensors to detect contractions and relaxation
of the muscles used for bowel movements. Working with a therapist,
patients relearn how to control and coordinate the necessary muscles for
a bowel movement.
When constipation involves new symptoms, is associated with bleeding,
significant abdominal pain or nausea, the advice is to seek prompt
medical care.
Stress Management, Diet Changes Improve Irritable Bowel Syndrome
Symptoms
When persistent cramping, abdominal pain, bloating, gas, diarrhea and
constipation are causing distress and frequent bathroom trips, the next
stop should be a visit to the doctor. These symptoms, commonly caused by
irritable bowel syndrome (IBS), often can be minimized with diet and
lifestyle changes.
In the August issue, Mayo Clinic Health Letter outlines what occurs in
IBS and how this usually chronic condition is managed.
The walls of the intestines are lined with layers of muscles that
contract and relax in a coordinated rhythm as they move food from the
stomach through the intestinal tract and to the rectum. With IBS, the
contractions may be stronger and last longer than normal, causing
bloating and diarrhea. Sometimes, the opposite occurs. Slow food passage
causes hard, dry stools.
What causes IBS is not clear, so treatment typically focuses on avoiding
triggers and on symptom relief. Mild signs and symptoms may be
controlled by managing stress; many people's symptoms are aggravated by
stress symptoms. Diet changes also are helpful. Chocolate, milk and
alcohol might cause constipation or diarrhea. Carbonated beverages and
some fruits or vegetables may lead to bloating or discomfort.
When symptoms are moderate to severe, a doctor may recommend fiber
supplements or anti-diarrheal medications. Some people with diarrhea may
benefit from anticholinergic medications to relieve painful bowel
spasms. However, the same medication can worsen symptoms for people with
constipation. Low-dose antidepressant medications may be appropriate,
because they inhibit the activity of neurons that control intestinal
muscles.
Seeking a doctor's care is important when experiencing chronic bowel
symptoms. Because there are no physical signs to definitively diagnose
IBS, diagnosis is often a process of elimination. And cramping,
diarrhea, constipation and other bowel symptoms also can indicate more
serious conditions such as ulcerative colitis or Crohn's disease, forms
of inflammatory bowel disease, or colon cancer.
Staying Intimate Later in Life
Many older adults -- ages 65 to 85 -- remain sexually active and
consider sexuality an important part of their lives. But with age,
sexuality also can be challenging. The August issue of Mayo Clinic
Health Letter looks at some of the challenges and solutions to
cultivating sexual desire later in life.
For men and women, medical conditions that affect general health and
well-being can interfere with sexuality. Diabetes, high blood pressure
and high cholesterol can affect the cardiovascular system, and adequate
blood circulation figures strongly in arousal during sexual activities.
Conditions affecting joint health, such as osteoarthritis and rheumatoid
arthritis, may impair movement or cause pain. A decrease in sexual drive
(libido) is common in older adults.
For women, changes in body shape that occur naturally can affect
feelings of desirability. Decreased estrogen levels result in thinning
of vaginal tissues and less natural vaginal lubrication. These changes
may reduce sexual desire because of pain or discomfort during sexual
stimulation. With age, orgasms typically become more muted.
For men, testosterone levels gradually decrease over time, meaning
erections may take longer to achieve and may not be as firm. Erectile
dysfunction becomes more common as men age.
But the desire for emotional intimacy defies age; the focus on a
physical relationship can shift increasingly to an emotional one. This
change tends to bring older adults together for satisfying sexual
intimacy even if arousal and orgasm aren't the same as they once were.
While the clock can't be turned back, Mayo Clinic Health Letter
describes ways to enhance sexual experiences later in life:
Communication: Partners need to talk openly about any physical
difficulties as well as changes in sexual function or sexual enjoyment.
Women's options: Nonprescription products can help with vaginal dryness
due to menopause. Options include a nonprescription, water-based
moisturizer (Replens) or non-glycerin lubricants such as System Jo H20
or Slippery Stuff. Vaginal estrogen, available by prescription, is
another option.
Men's options: Drugs such as sildenafil (Viagra), tadalafil (Cialis) and
vardenafil (Levitra) are available to treat erectile dysfunction.
However, they don't affect libido.
Other medications: Antidepressants, opiate-type drugs used for pain
relief, and high blood pressure medications may affect sexual function
negatively. A doctor may be able to offer other treatment options.
Exercise: Regular exercise can improve energy levels and also helps
stimulate blood flow to the genitals.
Counseling: A trained therapist can offer education, suggestions, and
tailored interventions to help address sexual concerns.
Mayo Clinic Health Letter is an eight-page monthly newsletter of
reliable, accurate and practical information on today's health and
medical news. To subscribe, please call 1-800-333-9037 (toll-free),
extension 9771, or visit www.HealthLetter.MayoClinic.com.
Mayo Clinic
Emily Hiatt
507-284-5005 (days)
507-284-2511
(evenings)
newsbureau@mayo.edu
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