DEAR READER:
To the best of my knowledge there is no harm in this practice. Fiber is a vital part of the diet. It is indigestible and adds bulk to the feces which aids evacuation and proper colon health. It is especially helpful to those who suffer chronic constipation.

If you remain concerned, speak with your primary care physician who can provide more information.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

The mascot for these patients is the zebra because the disease is often misdiagnosed as irritable bowel syndrome, Crohn’s disease, and other bowel ailments. Because of the difficulty in getting a proper diagnosis, the motto is “If you think it’s a horse, think again”.

My husband’s case is unusual because his primary tumor was located around the descending aorta, not the liver, as is typical. The cancer has since spread to his lungs and bones. He is a valiant warrior and tries to live a normal life in spite of the devastating side effects. As far as we know there is no cure. Treatment is usually surgery to reduce the tumors or a drug called Sandostatin. My husband was given Interferon but had to stop because Medicare refused to pay since it is not an approved carcinoid cancer treatment.

We are fortunate to have a support group for this disease only 30 miles away. It has been a lifeline for both us as. Your readers may be interested in more information which can be found online at www.carcinoid.org.

DEAR READER:
Carcinoid cancer is a relatively complex condition. It involves slow growing tumors that can present in nearly any part of the body. The most common sites are the small intestine, appendix, rectum, and more.

Some tumors may even produce hormones that can cause a condition known as Carcinoid Syndrome. The primary symptom is carcinoid crisis that may involve flushing of the face and upper body, diarrhea and asthma-like wheezing.

Early detection and removal of all the tumor tissue may lead to a complete and permanent cure. However, because the tumors are so slow-growing, the onset of symptoms can precede diagnosis by several years. Some tumors may not even be noticed until they have spread and multiplied to painful levels.

There are a few treatment options including surgery, chemotherapy and cancer-specific medication known as somatostatin analogues given by injection. Radiotherapy is used only for tumors that have spread within the skeletal system.

Nutritious high protein diets, vitamin and mineral supplements, anti-diarrheal drugs and more can be used in conjunction with the above treatments, primarily as a means to reduce the severity and frequency of diarrhea.

The Carcinoid Cancer Foundation website has several helpful links as well as information about specialists who are diagnosing and treating Carcinoid patients. I recommend anyone interested in learning more about this condition or who thinks their prior diagnoses (of IBS, Crohn’s, etc.) may be incorrect (because of failure to respond to appropriate treatment), to speak with their physician or gastroenterologist.

Because you mentioned that Carcinoid cancer is often misdiagnosed as benign bowel conditions such as IBS, I am sending you copies of my Health Reports “Constipation and Diarrhea” and “Irritable Bowel Syndrome”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

DEAR READER:
Constipation can be caused by a number of conditions such as a diet low in fiber, inadequate liquid intake, stress, and certain medications. Irritable bowel syndrome can contribute to constipation, as can a lack of exercise.

If you feel you don’t get adequate fiber or liquids in your diet on a regular basis, make it a point to consume more fruits, vegetables and whole grains. Supplement the change with more water, juice or other liquids throughout the day. Incorporate exercise on a regular basis, even if it involves only walking. Each step you take toward a well-rounded diet and working to stay active should reduce your symptoms.

While necessary on occasion, I urge you to avoid laxatives. Their chronic use can damage nerve cells in the colon and block its natural ability to contract.

My “colon cocktail” has been used successfully in several local nursing homes. It consists of equal portions of apple sauce, prune juice and unprocessed bran. The name on the bran container is inconsequential. Mix several tablespoons of each ingredient and allow the mixture to sit in your refrigerator for an hour or so to blend. Then take one or two tablespoons each day for relief. It might be necessary to continue the treatment for up to two weeks for this inexpensive but safe, natural remedy to be fully effective.

To give you this and other related information, I am sending you copies of my Health Reports “Compelling Home Remedies” and “Constipation and Diarrhea“. Other readers who would like copies should send a self-addressed, stamped, number 10 envelope and $2 for each report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

A brief medical history is called for. In September 1995, at the age of 55 I was diagnosed with colo-rectal cancer and surgery was performed to remove the diseased areas. I had 31 radiation treatments and one year of chemotherapy. In August 1996 I was able to return to my teaching position. However, in February 1997, I developed an intestinal blockage due to the radiation treatments and needed surgery. Due to the effects of the surgery and radiation, I was forced to resign. I was diagnosed with radiation enteritis and am now classified as permanently disabled.

The long-term effects of the above treatments began to develop and a gradual loss of independence and freedom followed. I started having frequent, urgent and sudden bowel movements on a daily basis. I continue to have bouts of diarrhea and most frustratingly, I have episodes of fecal incontinence. I have been prescribed Asacol, Colozal, Rowasa, and Cortenema all with little or no relief. The symptoms I’ve described continue to be debilitating and almost paralyzing. I’m now reluctant to leave my house and if I do, it is for very brief periods of time. When doctor appointments are needed, they must always be scheduled late in the day and no food can be consumed until after I return home. I am forced to have people run many errands for me and must request other people to transport my wife to her appointments. Needless to say, attending church services and social gatherings are now an impossibility. In short, I’ve lost almost all independence and freedom of choice.

These many years of living in the way I’ve described have led to a few conclusions. Medical science may have saved my life but it certainly didn’t restore it. I never expected to be the person I was prior to the diagnosis and treatment of cancer, but I didn’t expect to be one step removed from becoming a shut-in either.

I now firmly believe that individuals in the various fields of medical science who develop treatments and therapies for diseases such as cancer also have an equal responsibility to develop ways to deal with the long-term effects of the treatments that are applied. Failure to do so almost gives one the impression they have become the “victim” of a cure, left to fend for themselves now that they are cancer free. I would like to see the treatment for the long-term effects of cancer therapies be as aggressive as the treatment for the disease itself. I wonder if cancer survivors who read about declining death rates for those diagnosed with cancer become curious about the quality of life that may result. Certainly, my experiences tell me that surviving cancer can come at a very high price.

I cannot predict your reaction to my letter and you may or may not offer a reply. That is your choice and I realize you are under no obligation. Nevertheless, I believe that experiences like mine should be made known not so much to be merely critical but to encourage the development of more refined and less debilitating treatments.

DEAR READER:
I have chosen to print your letter in its entirety because you have made many valid points.

As far as science has come in understanding and treating cancer and other serious conditions, it still has that much farther to go to develop treatments that are not as potentially harmful. You have experienced very serious side effects from your life saving procedures. I am not an oncologist and therefore cannot say if the severity of your problem is common as a result of your treatment. I hope it is not.

Physicians have a duty to explain the potential harmful effects of any given treatment as well as the benefits. This simple step can help a patient decide if the risks outweigh the benefits and if they are willing to take that gamble. Thankfully, most treatments are benign and side effects are minimal but as the disease becomes more severe, so do the treatments.

I urge you to speak to your oncologist or gastroenterologist about any new therapies or procedures that may be available to combat the side effects of your radiation and chemotherapy. He or she should be up-to-date on the latest breakthroughs and treatments. For example, you might consider surgical removal of the colon followed by a colostomy bag. This will allow you to function in public in a normal fashion and those around you will be completely unaware.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Obviously the liquid phosphate laxative that I had to take prior to the colonoscopies sure does the trick in regards to cleansing but that is too nasty and harsh for me to do even on occasion.

I have tried taking two Senna tablets which helps but it reports side effects and lazy bowel syndrome. Therefore I usually only take it when absolutely needed. One of your articles referred to your “colon cocktail”. Would you please share with me your recipe or other safe natural cleansers?

DEAR READER:
You appear to have been correctly diagnosed as having IBS with constipation and were given appropriate treatment. You also appear to be responding well and have made suitable lifestyle changes to ensure proper health. The only other suggestion I have regarding lifestyle would be to include daily exercise as this can also aid digestion and evacuation.

As for the bowel cleansers, I am unsure what you have looked at. Laxatives? Enemas? Fiber supplements?

Fiber supplements are excellent for treatment of occasional or frequent constipation. They aid digestion, add bulk to the stool and allow for easier passage through the intestine and colon. The two major types of fiber are in capsule or pill form and the drinkable form which is powder that is mixed with water or juice before ingestion. Fiber is a safe, non-habit forming supplement.

Laxatives and enemas are both appropriate treatment options for occasional constipation. They should not be used for extended periods or on a regular basis as both can be habit forming and cause damage to the colon. With repeated use the bowel can actually “forget” how to function normally, leading to constipation.

My colon cocktail is neither habit forming nor damaging. It is a combination of three foods that when combined act as a mild stimulant. Simply mix equal portions of applesauce, bran and prune juice. The bran adds fiber to the diet and the applesauce and prune juice urge the bowel to return to a normal function. One to two tablespoons taken daily or as needed can provide relief from occasional or frequent constipation.

Constipation once every few months is not harmful. As for your use of Senna tablets, you are correct to use them only if absolutely necessary. Despite the side effect warnings, your judicious use is unlikely to cause a problem. Continue to use them or try one or more of my recommendations.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
In a word, no!

As a general rule, the occasional use of home enemas to combat constipation is safe for most individuals. However, repeated, habitual use can be harmful. They can increase the risk of injury to your anus and rectum. Solutions can cause irritation to the lining of the colon. Individuals with kidney or heart disease are at higher risk for fluid overload or an electrolyte imbalance when using enemas.

Much of normal bodily function is done without thought. The frequent use of enemas can disrupt the normal balance of the colon. The continued process may make it necessary to re-train the colon as to what its purpose is.

We all suffer from constipation on occasion. Rather than rely on an enema, consider adding more fiber and water to your daily diet. Increase your exercise habits, take an occasional over-the-counter laxative or warm prune juice, and attempt to program your body to pass stool on a regular basis.

Unless you suffer from a health problem that has enemas recommended by your physician, let Nature do what she does best — regulate your body. If constipation is a constant issue for you, speak with your physician or seek the opinion of a gastroenterologist.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

About 20 years ago I had gallbladder removal surgery. It caused my bowel movements to be very irregular. While reading an old folk medicine book written by Dr. Jarvis one day, I came across a simple remedy. The doctor told to simply drink a mug of hot water one half hour before breakfast every day.

Figuring it harmless and at worst would fill my bladder a little faster, I decided to try it. I could immediately feel the water emptying my stomach of the contents from the night before. Within just a few days I was completely regulated. It was amazing.

I told my doctor of this simple remedy and he said it was one of the best. When I asked why no one ever mentions it, he responded that most patients, and doctors, feel that it is too easy. I guess in today’s society, medication is king and cheap and easy just isn’t good enough anymore.

DEAR READER:
This is novel remedy I had nearly forgotten about until your letter arrived on my desk. The action of the hot water works to speed sluggish digestion similarly to how warmed apple or prune juices do. Perhaps the key is simply the temperature of the liquid and the time it is consumed.

Other simple remedies include eating prunes, increasing fiber intake by consuming more whole grains or using Metamucil, using stool softeners or laxatives sparingly or using over-the-counter products such as Digestive Advantage for Constipation.

To give you related information, I am sending you copies of my Health Reports “Gallbladder Disease”, “Dr. Gott’s Compelling Home Remedies” and “Constipation and Diarrhea”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

I had suffered for a while with gas, bloating and other symptoms. My internist thought that I was lactose intolerant despite my claims that many milk products did not cause my symptoms. He ordered a colonoscopy which showed I had irritable bowel syndrome.

Shortly after the diagnosis I was reading an article in Prevention magazine that claimed there was an epidemic of IBS and that an additive found in many dairy products might be the cause. The additive is a seaweed product called carrageen.

Interested by this, I decided to check my refrigerator and found that the additive was in many products I had on hand including soy milk, ice cream, sherbet and more. I threw all these items away and started checking labels when I went to get replacements. I have found only two ice creams (Breyers and Hagen-Daaz) that don’t have it. It is also in Popsicles, sour cream, most yogurts, creamy dressings, eggnog, some brands of buttermilk and more.

I feel that our food industry’s additives have impaired the health of many people, especially young children. I hope that this information can help others as it has helped me.

DEAR READER:
I was unfamiliar with the additive but upon research found that is a dried and bleached red marine algae harvested for its valuable polysaccharide which is widely used as a gel, emulsifier and thickening agent. It is primarily used for foods, pharmaceuticals and cosmetics.

I am unaware of a link between carrageen and IBS but that is not to say it is not possible. If eliminating the additive from your diet has improved your symptoms, stick with it. If not, I recommend you try an over-the-counter product called Digestive Advantage IBS. It has helped many of my readers who also suffer from irritable bowel syndrome. IBS with constipation can often be helped by increasing fluid and fiber intakes. Occasional treatment with laxatives and stool softeners is acceptable but should not be used daily to prevent dependence. IBS with diarrhea can usually be controlled by increasing fiber and roughage intakes and using OTCs such as Imodium or Pepto-Bismol.

If you truly have IBS, I recommend you see a gastroenterologist who can give you up-to-date information about available treatments appropriate for you. If you feel you do not have IBS but are simply suffering from a food allergy to carrageen, you should see an allergist. This specialist can test you for various allergies to help pin-point the cause of your symptoms, including any possible lactose intolerance. He or she can also provide appropriate treatment.

To give you related information, I am sending you copies of my Health Reports “Irritable Bowel Syndrome” and “Constipation and Diarrhea”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Hirschsprung’s disease is a condition of the large intestine. It causes problems with passing stool because of missing nerve cells in the intestinal muscles. It is present from birth (congenital) and has no known cause.

Hirschsprung’s occurs in one out of every 5,000 births and ranges from mild to severe. In mild cases, babies often have minimal symptoms and may not be diagnosed until early childhood. Severe cases may lead to bowel obstruction, necessitating emergency surgery. Most cases fall into the moderate category which usually causes constipation or difficulty absorbing nutrients. The condition is five times more common in boys and sometimes is associated with other congenital disorders such as Down syndrome.

Symptoms can occur immediately after birth or may taken several months or years to appear. In infants, symptoms include diarrhea, constipation, gas, failure to have a bowel movement after the first or second day of life or vomiting (especially vomiting green bile). Older children may experience infections of the colon such as entercolitis, inability to gain weight, abdominal swelling and problems absorbing nutrients which leads to weight loss, delayed/slowed growth and diarrhea.

Hirschsprung’s disease develops while the baby is still in the womb. At some point during development of the colon, the nerve bundles that line it, fail to form. This can occur throughout the entire large intestine or just a few centimeters up from the rectum. The longer the affected area, the worse symptoms tend to be. It is not caused by anything the expectant mother has done or not done.

The only known risk factor is if you have one child with the disorder there is a greater risk of another child being born with Hirschsprung’s (because it is inherited, even if the parents do not have the disorder), and especially if that child has Down syndrome or is male.

The only treatment for Hirschsprung’s disease is surgical removal of the affected area of colon. You stated your grandson has already had this surgery. I suspect his fecal leakage is due to the surgery which carries the risk of muscle, rectal and nerve damage. I urge your grandson’s parents to talk to his gastroenterologist about his problem and see if there is anything that can be done. Older individuals can be helped by medication, surgery or surgical implants and since your grandson is only 10, I cannot see him having to spend the rest of his life with this embarrassing side effect. At the appointment to discuss the leakage, Kegel exercises can be brought up as a possible aid. I am not sure they will be effective but they cannot do any harm.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

In August 2007, during a four day stay at my beach house in Mexico, I developed watery diarrhea up to 12 times a day. Four days after returning home I saw my physician and he said I must have picked up a bug in Mexico. I have been going there fore 35 years and have NEVER gotten anything before, but thought there is always a first. He prescribed Cipro for seven days with no results so I was given another seven day round. When that failed to help, I was given Flagyl and had blood work and stool samples taken twice. Everything was negative. He then switched me to another medication but I was still having the watery diarrhea up to eight times a day, mostly during the morning and evening. I started losing weight.

I was then referred to a specialist who continued my last medication and ordered a colonoscopy, despite my having had a normal test two years ago. I went along with it because I was told this physician was the “best”. For various reasons I did not go back to him and never will so I took the results to another physician. He diagnosed me with collagenous colitis but was unsure how I got it. I was told there was no known cure and that I would have to take medication for the rest of my life. Fortunately, I was also told it was not life-threatening. I have lost more than 20 pounds and continue to have watery diarrhea up to six times a day.

I have tried to do my own research on this condition but haven’t come up with anything useful. How do people live with this? When I get up in the morning, it takes at least two or three hours of trips back and forth to the bathroom before it is relatively safe for me to leave. Then after dinner, it is the same thing. Occasionally I have an “attack” in the middle of the day and unless I am immediately near a bathroom, it can be devastating because there is no warning. I want to have a normal life again.

DEAR READER:
Collagenous colitis is an inflammatory condition of the colon that causes chronic watery diarrhea. It is similar to lymphocytic colitis and some researchers believe that they are simply different stages of one disorder. They are often both referred to as microscopic colitis.

Some individuals develop patches of swelling in the colon lining (collagen) while others have swelling along the entire length of the bowel. It is more prevalent in people ages 60-80.

The most common symptom is chronic watery diarrhea that often starts suddenly. This can be consistent or cyclic (occurring in cycles of improvement and worsening) and can cause from three to 20 bowel movements a day. Other symptoms can include abdominal pain/cramps, dehydration, nausea, abdominal bloating, fecal incontinence and modest weight loss.

There is no known cause for either collagenous or lymphocytic colitis. Some researchers believe that toxins released by bacteria or viruses may trigger the inflammation but others have theorized them as autoimmune. Many individuals with the conditions also have one or more of the following conditions: celiac disease, diabetes mellitus, Sjorgen’s syndrome, thyroid problems, CREST syndrome, rheumatoid arthritis, scleroderma and pernicious anemia.

Diagnosis is often made by a gastroenterologist with the aid of blood and stool samples, colonoscopy or flexible sigmoidoscopy and biopsy.

The good news is that most cases resolve on their own in a matter of weeks and do not need treatment. Unfortunately you do not appear to be in the vast majority. Treatment usually includes lifestyle changes such as a low fat diet, cessation of caffeine, lactose, spicy foods and alcohol, and limiting intake of raw fruits and vegetables (which can cause gas and resultant diarrhea). If this fails to help, medication may be necessary. These include over-the-counter Imodium or Pepto-Bismol and prescription Lomotil, Colazal, Azulfidine and others. If medications and lifestyle changes fail to produce improvement, surgery to remove the inflamed areas may be necessary. It is important that the dietary changes are continued to ensure the symptoms do not recur.

I suggest you speak with your gastroenterologist about this. You may also wish to go online and get a copy of the collagenous colitis/lymphocytic colitis information from the Mayo Clinic. It is available at http://www.MayoClinic.com/health/collagenous-colitis/DS00824.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.