Poop or Get Off the Pot! (AKA. Constipation Clarification)

Forgive the expression, but it's tough to think of a catchy title to talk about CONSTIPATION. That being said, constipation is a really common complaint- from toddlers to toddering elders. When I talk to patients about constipation, the first thing I do is to establish what is NORMAL for the patient. Often folks are surprised to hear that "normal" does not equal "daily" bowel movements. If you go once every few days and have no abdominal bloating or discomfort, then you are NOT constipated, that is simply YOUR "normal". Others have several bowel movements each day, and again, that is "normal" for them if there are no associated uncomfortable symptoms.

So what IS constipation? Constipation is "unsatisfactory defecation" with relatively infrequent and/or painful passage of stool. Typically this means less than three BM's per week, too much time straining (or hanging out reading) on the potty, or a sense that there is either bloating in your belly or that after you go, you feel like you still should poop more. Women suffer from constipation twice as much as men (likely in part from our hormonal swings that may affect the gut.)

Please don't ignore constipation, because there are many medical conditions that can slow the gut and cause constipation, such as diabetes, low thyroid hormones, pregnancy, metabolic disturbances (like low potassium levels), to name a few. Additionally, medications such as blood pressure pills (calcium channel blockers especially), antacids, antihistamines, antidepressants and pain pills also can slow the bowels.

The vast majority of the time, however, constipation is simply the result of a poor diet. Three things are needed to move your bowels: FIBER (goal 25g/day), MOVEMENT (walk, run, skip, bike- whatever works, just get up and move!) and HYDRATION (more water.) Caffeine is a gut stimulant, which is why people often poop right after their morning java, but too much caffeine dehydrates you and actually slows down the process. What's the goal? Whatever frequency is "normal" for YOU, and no abdominal discomfort. That being said, I rarely see a patient who truly averages 20g of fiber per day in their diet (not from supplements) who does not have "comfortable" daily BM's.

BOTTOM LINE: If you've had no change in your diet, medications or activity level, and you notice your bowel movements have become painful or less frequent, go and get checked out at your family doctor.

Can You Smell That?

Did you know that smells provide your strongest sense of memory? A quick whiff of sunscreen make take you to childhood beach memories, hairspray back to high school, freshly baked cookies back home or perhaps a certain cologne to a special person. Yesterday, I had the pleasure of smelling "fall" as I hiked through a beautiful aspen grove, the path covered in what my daughter calls the "crunchy golden blanket" of leaves. Too bad we can't bottle up that marvelous smell of nature!

Smell might be the sense we think about the least- until there is a problem with it. Without smell, taste is muted, leading to either decreased appetite or overeating (or over-spicing!) as we try to find something to satisfy a craving. If you wonder about your sense of smell, see if you can distinguish some common smells such as cinnamon, peanut butter, vanilla, coffee or lemon.

What causes your sense of smell to decrease or disappear? Some people are simply born without a sense of smell. Most commonly, however, we see transient lack of smell (the medical term is anosmia) from nasal congestion due to colds or allergies. Smoking, of course, not only destroys taste buds, but also decreases the ability to smell. Overuse of nonprescription nasal sprays such as Afrin is another common cause. Less common are medical disorders such as zinc deficiency and hypothyroidism, and rarely loss of smell can be a sign of diseases in the frontal lobe of the brain such as tumors or dementia.

BOTTOM LINE: If you notice you can no longer distinguish smells very well (and have no obvious cause such as a cold, chronic allergies or smoking habit), it's time to head to your doctor for a check up!