First, Kellogg’s All-Bran Bran Buds can help fight constipation. Second, for minor sinus congestion, facial massage can help. For serious congestion, try chiropractic massage.

DEAR READER: Thank you for the suggestions. Bran is a part of my colon cocktail and is a great way to add fiber to the diet, thus preventing constipation.

As for your massage suggestions, I assume it works similarly to acupressure, which can relieve symptoms for some patients.

We try different things every few days but are running out of ideas. Your information has been so valuable. I read your column every day in our local newspaper. Any suggestions?

DEAR READER: For readers who may not fully understand multiple sclerosis, this disorder occurs when the body’s immune system attacks itself, destroying the protective sheath that covers the nerves. This may result in deterioration of the nerves over time and, unfortunately, the condition isn’t reversible. However, there are a number of things your son can do to remain active both mentally and physically.

Symptoms can occur at any age but are most common in people between the ages of 20 and 40. Women are more susceptible than men. Family history plays a large role, as well. For example, if a parent or sibling has the disorder, the other children of the affected parent or the siblings of the affected individual have up to a 3 percent chance of also developing it. This compares with one-tenth of a percent without a family history. Patients may have tremors, weakness or numbness in one or more limbs, occurring on one side of the body at a time, double vision, fatigue and more. In the beginning stages, there may be partial or complete remission that can reverse suddenly.

Bowel and bladder difficulties and depression are common in those with MS. I suggest he speak with his physician regarding the use of warm prune juice daily or my “colon cocktail,” which consists of equal parts prune juice, applesauce and bran. The specifics can be found in my Health Report “Compelling Home Remedies” and is one I have found to be effective when treating patients in nursing homes.

Your son should be eating a more healthful diet with fiber. Poor diet is linked to constipation, and diets low in fiber are known to increase the possibility for producing stools that can be difficult to pass. Because his diet is so limited, he should begin slowly — perhaps with whole-grain cereals and breads. He should drink plenty of fluids daily. Gradually add fresh fruits and vegetables, broiled fish and/or chicken and other appealing foods.

Many medications carry the unwanted side effect of constipation. He should speak with his prescribing physician to determine whether any of his drugs are contributing to his problem. If so, he should request another drug be ordered in its/their place.

His depression must be addressed. I don’t know how limited your son is in terms of walking, riding a stationary bike, listening to the radio, working on model cars or airplanes, having a stamp collection or using the Internet. It’s hard to make recommendations without knowing his age, general health and physical status, etc., but something between speaking with a therapist, a trip to the local park or a rousing game of checkers or chess with a friend on a regular basis might be just what the doctor ordered. He should also contact the MS Society to find the nearest support group.

As mentioned above, I am sending you a copy of my Health Report “Compelling Home Remedies.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: If you are suffering from occasional constipation, I don’t believe this method will harm you. However, you should inform your doctor. Perhaps your constipation is caused by something other than your medication, such as improper diet or a rectocele. Increase your fluid and fiber consumption to add bulk and moisture to your stool. This alone may resolve your problem. If you continue to have difficulties, a change in medication may be in order.

To provide 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 No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Pudendal nerve entrapment occurs when a nerve in the pelvic area becomes compressed or trapped. It can be the result of post-surgical scarring, pregnancy or trauma. Activities such as riding a bicycle are known to trigger the condition.

Symptoms include pain when sitting that is reduced or eliminated by standing, lying down or when on a toilet seat; paresthesias in the buttock and genital areas; urinary hesitancy and/or urgency; constipation; impotence; sexual dysfunction; and a great deal more.

Treatment varies depending on the underlying cause and how long symptoms have been present. If you are a cyclist, that prolonged activity should be reduced. There are a number of medications — nerve stabilizers, antidepressants or anticonvulsants — that might reduce or alleviate the pain. When all else fails, treatments such as corticosteroid injections or nerve blocks may be appropriate.
Speak with your physician who knows your history and can recommend appropriate advice or medication. Then, if and when conservative measures fail, request referral to a top-notch surgeon for the problem.

To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

It’s odd that I write because I have an ileostomy and have exactly the opposite problem. I take tincture of opium, which slows my bowels down and lessens the amount of fluids I lose. Our bodies are amazing, and it’s good to educate ourselves about them with as much knowledge as we can.

My friend doesn’t have a computer, so if you send the information on, he can either read it in our local paper or I will forward it to him. Thank you.

DEAR READER: My colon cocktail consists of equal portions of unprocessed bran, applesauce and prune juice. Mix the three ingredients together, and place them in your refrigerator for at least an hour to blend. Then take 1 to 2 tablespoons daily, more if necessary, for relief. The remedy may take up to two weeks to be fully effective, but the ingredients are safe and natural.

DEAR READER: I believe the recipe you are looking for is that of my colon cocktail. It consists of equal portions of applesauce, prune juice and bran. One to 2 tablespoons taken daily in the morning should relieve symptoms of constipation. I often advise that it be made in small batches in order to keep it fresh because it does not have a long shelf life. It must also be stored in the refrigerator.

Other home remedies include a mug of warm water a half-hour before breakfast each morning, warm apple juice, prune juice (warm or cold), whole prunes, powdered fiber drink mixes and even consuming more raw fruits and vegetables that are high in fiber.

To provide 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 No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: The three ingredients, known as a colon cocktail, are applesauce, prune juice and unprocessed bran. Mix equal portions in a small bowl, and refrigerate for at least one hour to blend. Then take 1 to 2 tablespoons or more, if needed, each day for relief. Refrigerate any unused portions in a sealed container. The remedy may take up to two weeks to be fully effective.

To provide related information, I am sending you a copy of my Health Report “Compelling Home Remedies.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

I hope you can share this with your readers and perhaps improve the quality of life of someone out there. It has been wonderful for me.

DEAR READER: IBS is a malfunction of motility of the colon. Stress, medications, specific foods, caffeine, alcohol and gas contribute to symptoms that include abdominal pain, flatulence and diarrhea/constipation. The medication you have been prescribed can cause identical symptoms.

Colesevelam (WelChol) reduces the amount of cholesterol and specific fatty substances in the blood. It is sometimes prescribed with other cholesterol-lowering statin drugs toward this goal. This drug binds bile acids in the intestines to form a product that is ultimately released from the body. It is also prescribed for some type 2 diabetics to control blood-sugar levels. Drugs that have been manufactured and marketed for one purpose are often used for other, seemingly unrelated conditions and work well. My guess is that the reduction of fatty substances in your colon curbed your diarrhea and related symptoms. Or you are less stressed, have modified your diet or medications, and have taken other steps without realizing the positive impact they have had.

To provide related information, I am sending you a copy of my Health Report “Irritable Bowel Syndrome.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Cascara sagrada is a shrub native to the western coast of North America. The dried bark of this plant was used by Native Americans for years but was not widely adopted until the 19th century as a stimulant laxative. The main ingredients are anthraquinones, organic compounds whose structures serve as the basic building blocks for a number of naturally occurring plant pigments. The compound is used in the production of dyes, as a catalyst for the production of wood pulp and has a number of other purposes. The product is available in capsule form, liquid extract and as a dried bark that can be made into a bitter tea. Fresh bark should not be used because it can cause diarrhea and vomiting. Traditionally, the bark is either dried for at least one year or put through a special heat treatment. A common dose is from 20 to 70 milligrams daily. It should not be used for longer than seven or eight days in a row without physician approval. The herb is commonly taken in the early evening, since it takes from six to 12 hours to work. Cascara sagrada is one of the few herbs approved as an over-the-counter by the Food and Drug Administration.

The product should not be used by people with congestive heart failure, severe anemia, cancer of the GI tract, liver, kidney or diverticular disease, ulcerative colitis and a number of other conditions. It should not be used by women who are pregnant or plan to become pregnant, those with allergies or stomach pain, or in conjunction with prescription or nonprescription medications, herbals or dietary supplements. I have no experience with this remedy for constipation and recommend that you speak with your primary-care physician before using it.

Side effects include severe allergic reactions, such as hives and itching, rectal bleeding, difficulty breathing, abdominal cramping, potassium loss and a few other unwanted symptoms. It can also turn urine pink, red, violet, yellow, brown or black.

Your physician should be consulted to determine whether your constipation is caused by a specific medical condition that should be addressed. While waiting for an appointment, modify your diet to include between 20 and 35 grams of fiber daily. Fiber can be found in whole-grain breads, fortified cereals, fresh fruits and vegetables. Limit your consumption of processed foods, meats and cheeses. Increase your fluid intake, and coordinate a regimen of regular exercise. Laxatives should be avoided if at all possible because they tend to be habit forming. Try a stool softener, saline laxative or a fiber supplement such as the Metamucil you are on. If this fails to work, acupuncture or massage to the abdominal area might be helpful. If all these suggestions fail, ask your physician for a referral to a gastroenterologist.

To provide 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 No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Magnesium citrate is an over-the-counter substance used to treat constipation. It is taken by mouth in liquid form that can be mixed with water or juice. The dose depends on the reason a person is taking it. Magnesium citrate works by pulling water from tissues into the small intestines, thereby stimulating a bowel movement within 30 minutes to three hours. When smaller doses are taken, especially when taken with food, the process slows. Following each use, a person should drink two additional glasses of water to replace the fluids that will be lost during evacuation.

Side effects can include nausea, bloating, abdominal pain and a loss of normal bowel response if the magnesium citrate is used on a long-term basis.

Laxatives can result in diarrhea. This, in turn, can cause a loss of electrolytes, essential nutrients such as potassium and other fluids in the body. If diarrhea occurs, a person should replace those lost fluids with two to three quarts of sports drinks or other fluids daily until the diarrhea stops. Some brands of magnesium citrate contain sugar and should be avoided if a person has a history of diabetes.

I am unsure why you are taking the product. If you have regular bowel movements and don’t suffer from constipation, perhaps you don’t need the weekly cleansing. Instead, you might consider a trial of eating more fresh fruits and vegetables, including cereals with bran for breakfast and drinking up to three quarts of fluids each day. If you do suffer from constipation on a regular basis, I recommend you make an appointment with a your physician or a gastroenterologist to review your medical history and medications to determine the cause. Certain medications can contribute to constipation, so that would be an easy place to begin.

To provide 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 No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.