To Your Health

Q. My bowel habits have been poor all my life, and seem to worsen as I get older. I am well aware of the importance of good elimination. How can I do better?

A. Good elimination starts, but doesn't end, with good digestion. From antiquity to the present, the great healers have noted the connection between good health and proper digestion and elimination, processes that take place in stages through the length of the gut with quite different conditions needed for each stage.

Digestion actually begins in the mouth, but food spends very little time there so hardly any digestion takes place. Digestion really gets under way in the stomach under acid conditions, so when antacids are used too soon after meals there may not be enough acid to continue the digestion process. When stomach acid is insufficient for whatever reason, the next and probably most important stage of digestion, in the small intestine, is compromised. It is not unusual as one gets older to find that supplemental acid in the form of betaine HCl improves digestion and elimination. The symptoms of too much and too little stomach acid are very similar so check with your health care provider about ways to test stomach acid before trying a betaine HCl supplement.

The arrival of acid in the top of the small intestine signals the pancreas to release pancreatic enzymes and bicarbonate. The success of the digestive process largely depends on the ability of pancreatic enzymes, under alkaline conditions, to completely break down food into bits that can be absorbed. Nutrients are not absorbed from undigested food, and furthermore undigested food stimulates the overgrowth of any unfriendly intestinal bacteria present, with resulting gas and other discomfort. Pancreatic enzymes are available in capsule form and are safe to try for a few weeks to see if they provide any benefits.

Problems with digestion and elimination that start after taking a course of antibiotics or after a trip to a foreign country may result from an imbalance of the friendly and unfriendly intestinal bacteria. Replacing unfriendly bacteria with friendly ones (by eating real yogurt or taking "acidophilus" capsules) often solves the short-term problem, and may help even if your problem is lifelong. Ideally your diet supplies just enough indigestible food, in the form of fiber, to feed the friendly intestinal bacteria.

Because energy is required to generate the peristalsis or rhythmic squeezing that moves food through the gut, several nutrients that aid in energy production directly affect elimination. The most likely helpers are pantothenic acid and magnesium, but vitamin C, vitamin E, and folic acid have often been credited with improving elimination.

Although it is not pleasant to contemplate, you should occasionally look in the commode after a bowel movement and examine your stool. Your stool should be light tan and the consistency of oatmeal. Also the time from eating a meal to excreting that food (your "transit time") should be 18-24 hours. You can check your transit time by eating red beets and noting the time required for the red color to appear in your stool. A long transit time increases your risk of colon cancer.

Restoring regularity can yield a host of rewards, from clearer skin and fewer headaches to increased energy and milder allergy symptoms. Take the time now to rectify this situation.