a wellness perspective

by Diane K. Newman, RNC, MSN, CRNP, FAAN

There are certain matters absolutely fundamental to good health and the enjoyment of life that are infrequently addressed in the media, in health lectures, or in polite conversation. An example might be the nature of well bowel movements. It has been my experience that most people are reluctant to listen to or expound upon certain fundamentals you'd think everyone would find interesting but which, in fact, are both shunned from conversations and little understood. Case in point—bowel movements.

I thought about this the other day when reviewing a few scholarly journal articles provided by Diane K. Newman, the director of the Incontinence Center at SeekWellness.com. Diane deals everyday with matters related to the output side of nutrition, including constipation and the very nature of normal bowel movements. She has a wealth of knowledge about this field. I think anyone interested in optimal self-management would benefit from more facts related to this area. Don’t you agree? No harm in a little more knowledge, right?

Do you know what constitutes constipation? This might amaze you—it’s less than three stools per week! Can you imagine? Unless one is on an extended fast, this seems almost impossible to endure, but that’s what the scientists who track such things have established as the definition of constipation. You may have thought you were constipated on occasions, when in fact you never came close to being really constipated, in the official sense of the word. Here are a few additional facts about the other end of the nutrition cycle that might be enlightening, if not quite suitable for dinner table conversation.

17% of the adult population will experience constipation at some point in their lives, unfortunately not before they are potty trained.
Some experts in the area of incontinence include difficulties related to defecation as part of the syndrome; terms used to describe these problems are straining at stool, painful defecation, dry hard stools, small stools and incomplete or infrequent stool evacuation.
The prevalence of constipation increases with age. No surprise there—what malfunction does not occur more frequently with aging? Older adults (particularly over age 60) are five times more likely than younger adults to report problems with constipation.
Constipation is more common in women than men, in non-whites than whites, and in those with lower family income and education.
Constipation is a symptom, not a disease, though it can, if prolonged, lead to urinary retention and incontinence.
A bowel movement is not necessary every day though personally I find a daily “experience” highly fulfilling if not out and out pleasurable. But, I’ll refrain from a lyrical soliloquy on the matter at this point.
Laxatives, enemas and other invasive procedures are hazardous; side effects such as cramping, bloating, dehydration, diarrhea, anal irritation and fecal incontinence should be taken seriously as clues to back off. Laxatives can be habit-forming, which will interfere with the effective functioning of the colon.

For healthy bowels, drink lots of water (at least eight glasses daily, more if you have ready access to bathrooms) and prune juice now and then, exercise vigorously nearly every day, eat lots of fiber including ample fruits, vegetables and whole grains, maintain upper body strength, work on your sense of humor, seek more meaning and purpose in life (as a distraction from the fact that you might be slightly overdue, so to speak) and be careful about the use of medications or other drugs. A few of these tips (upper body strength, seeking added meaning) have nothing to do with the output side of nutrition, but they help you look and live better, which in its own round-about way will contribute to good and regular bowel movements.

Here’s one such distraction:

A 75 year-old woman went to the doctor for a check-up. The doctor told her she needed more activity and recommended sex three times a week.
She said to the doctor: "Please, tell my husband."
The doctor goes out in the waiting room and tells the husband that his wife needs to have sex three times a week.
The 80 year old husband replies: "Which days?"
The doctor says, "How about Monday, Wednesday and Friday."
The husband says, "I can bring her Monday and Wednesday, but on Fridays she'll have to take the bus."

There’s a great deal more to be learned about incontinence and the like, so visit the Incontinence Center and get the details from the real experts like Diane Newman. As for my take on the topic, there’s no better time or place to look on the bright side of life than when having a meaningful experience, if you catch my drift. Be well.

Posted November 2006
Last Updated February 2007