[Medicine-for-people] Love Your Colon: Honor Your Anus

Douwe Rienstra medical at olympus.net
Thu Jan 3 14:28:11 PST 2008


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Medicine for People!

January, 2008
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Contents
- Love Your Colon: Honor Your Anus
- New Year's Resolution
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=== Love Your Colon: Honor Your Anus ===

January is the month when people flock to gyms and diet 
programs.  I'd like to offer you another way to get a fresh start on 
health.  In this season of the return of the light, I want to talk 
about the place "where the sun never shines."  That's right folks, 
this issue is dedicated to the lovely, five-foot-long structure that 
snuggles down in our lower abdomen and has a great deal to do with 
whether we feel peppy and energetic or sluggish and dull.  This 
month's newsletter is dedicated to the colon and how to keep it 
chugging happily along.

  = Colon Disorders =
Unfortunately, a backed-up colon is more common than you might 
think.  In many people who don't think they have an elimination 
problem, physical examination of the left lower quadrant of the 
abdomen reveals a descending colon that is palpable and somewhat 
tender.  The patient has normal stools, no awareness of discomfort or 
problem, yet he suffers from some slowness in the colon.  On other 
occasions, people come with abdominal pain and heartburn that, 
unknown to them, result from a sluggish bowel.

  = Colon Disorders are Linked to Diet =
Our modern diet puts an increased burden on the colon. The resulting 
disease can be as mild as occasional constipation, as painful as 
diverticulitis, or as deadly as colon cancer.

What our diet lacks is fiber.  Our ancestors consumed a bulky, 
fiber-rich diet. Even today, colon disorders are much more common in 
developed countries than where people eat simple, unprocessed food 
such as root vegetables, leafy vegetables, and whole grains.  In the 
US, we tend to consume a lot of meat, poultry, fish, eggs, dairy 
products, and baked goods.  These foods have their virtues, but none 
of them contain significant fiber.

  = The Benefits of Fiber =
A sluggish bowel can almost always be improved by eating more 
fiber.   Here's why:

1. Fiber keeps the stool hydrated.  Dry stool doesn't move very 
well.  Hydrated stool is bulky. The colon can more easily get a grip 
on it and move it through.  Drier stool results in greater pressure 
inside the colon and the formation of pockets called 
diverticuli.  (See this illustration at 
http://www.rienstraclinic.com/newsletter/2008/2008January.html)

Diverticuli are like miniature appendixes, and like the appendix, can 
become infected, sometimes dangerously so.  Best to avoid them 
altogether by maintaining a high fiber diet.

2. A high fiber diet does more than help promote happy bowel 
movements.  A high fiber diet encourages vital bacteria to grow in 
our gut.  Bacteria in our colon use a fermentation process to turn 
fiber-based gums and pectins into beneficial nutrients such as 
butyric acid.  Data are conflicting, but some evidence indicates that 
butyric acid reduces the risk of colon cancer. Don't bother with 
butyrate supplements; the butyrate has to be produced on-site.  For a 
detailed scientific explanation of butyric acid, go 
to:  http://en.wikipedia.org/wiki/Butyric acid

3. Healthy bowel flora provide us with essential vitamin K and biotin.

4. Certain fibrous foods, such as oats, have been shown to reduce cholesterol.

  = Types of Fiber =
There are two main types of fiber.
1. Insoluble fiber, such as bran, doesn't dissolve in water, but it 
does help to increase the bulk of the stool.
2. Soluble fiber dissolves in water, and though we humans can't 
digest it, the beneficial bacteria make good use of it, as mentioned 
above.  Soluble fiber also increases stool bulk, and includes the 
following substances:
  -- Arabinose is found in legumes.
  -- Beta-glucan, in oats, barley and rye, has been shown to reduce 
the risk of heart disease.
  -- Gums in beans, rice, barley, oats and seaweed, made into 
butyrate by bacteria in the bowel, also can reduce irritable bowel symptoms.
  -- Pectin in fruit, made into butyrate by bacteria in the bowel, 
reduces absorption of cholesterol.

For more about dietary fiber, go 
to:  http://en.wikipedia.org/wiki/Dietary_fiber

== Fiber in Food ==
The best way to obtain more fiber is by eating a diet that is high in 
fruits, whole grains, legumes, and vegetables.  Unprocessed foods 
tend to be a better source of fiber than processed ones.  Whole 
grains, including brown rice and whole oat groats, do not raise blood 
sugar as does grain processed into flour.  Whole grain bread is 
healthier than white bread but still a mediocre source of 
fiber.  Juices are touted at healthy drinks but, unfortunately, most 
of the fiber has been removed.  You can see the amounts of fiber in 
common foods by consulting one of the many fiber content charts on 
the Internet such as this 
one:  http://www.hcf-nutrition.org/fiber/fiberchart.html.

  == Fiber Supplements ==
Fiber supplements do not replace the many types of fiber listed above 
and do not substitute for a healthy diet.  However, once you have 
achieved as good a nutritional intake as you can, you may still not 
be consuming as much fiber as Paleolithic man and you may benefit 
from a fiber supplement.

Choices of fiber supplements include:
  -- Psyllium seed husk, available as Metamucil in most of the 
western world or in bulk at the Food Coop.  Metamucil has an orange 
flavor.  This product is well tolerated by most people but 
occasionally can cause gas.
  -- Herbal blends such as Rejuve include psyllium along with 
bowel-active herbs.
  -- Citrucel is a brand of hydrocellulose fiber supplement that is 
also easy to take and rarely causes gas.  Citrucel is available 
over-the-counter at the drugstore.

For any of these fiber supplements, start with one tablespoon in 
water twice a day.  Drink it right away or you'll get to observe how 
much water these absorb and end up with a glassful of gel.  Drink 
adequate water or you may experience abdominal pain as the fiber 
absorbs water in the digestive tract.

  = A River Runs Through It =
Once you increase your fiber intake, it might take a few days for it 
to penetrate the entire bowel column. I liken the GI tract to a 
stream.  You can improve the health of the upstream area as much as 
you wish, but until that downstream logjam goes, it ain't gonna flow. 
So even if a person starts to eat a high-fiber diet, there might be 
enough of a logjam at the bottom that they will require a laxative 
just to break things lose and get moving normally again.  My favorite 
laxatives, in ascending order of oomph, are prune juice, milk of 
magnesia (one ounce), or castor oil (four or five teaspoons, best to 
ask your doctor first).

  = The Rectum is a Wonderful Thing =
The rectum, an under-appreciated structure, makes up the last six 
inches of the colon.  After some twists and turns, the colon makes a 
bee line for the exit and it then takes on the Latin name for 
straight - rectum (as in rectitude).

Normally the rectum is empty and if I do a rectal exam on a healthy 
individual I will not feel any stool.  The way the mechanism works is 
that the colon will, from time to time, push a quantity of feces down 
into the rectum.  This stretches the rectum, which causes that 
unmistakable feeling.  If we obey nature's call, the stool is passed. 
Any small amount of remaining stool is pushed back into the sigmoid 
colon, leaving the rectum empty.  Should we not obey nature's call 
when it comes, the rectum becomes habitually full.  Those stretch 
receptors and their associated reflex mechanisms then lose the 
ability to function normally.  That nice little cycle of empty 
rectum-full rectum- signal to the brain-emptying process-empty rectum 
breaks down.

People in this situation report distress from a continued sense of a 
need to empty their bowels but not being able to.  The result can be 
general misery.  It is far easier to obey nature's call and keep the 
rectum operating normally and happily.

  = The Underappreciated Anus =
Here is a traditional tale told by Johnny Moses 
(http://www.johnnymoses.com/), a Tulalip Native American storyteller 
raised in the remote Nuu-chah-nulth village of Ohiat on the west 
coast of Vancouver Island.

Raven gathered the people in the great lodge, complimented them on 
their many accomplishments and virtues, and pointed out that if only 
they didn't have that shameful anus beneath their clothing, they 
would be perfect.  So the people gave Raven gifts in exchange for his 
magical removal of their anuses.  Immediately they felt so much 
cleaner and less embarrassed.  The next few days, though, 
inexplicably, everyone seemed faintly ill-at-ease.  Then the people 
realized their mistake and began searching frantically for the now 
missing raven.

While the people continue their search, let me point out the wonders 
of the anus.  Consider this:  when those stretch receptors in the 
rectum signal the brain, the rectum may contain gas, stool, or 
liquid.  The anus can tell the difference and sort out what action to take.

Sometimes, though, when the anus is ailing, it cannot do that 
important job.  It may leak. It may hurt.  It may be unable to tell 
stool from gas.  The weight loss drug orlistat (Xenical) works by 
impairing fat absorption.  As a result the stool contains excess fat, 
and this confuses even a healthy anus, which cannot distinguish oily 
stool from gas, and lets it pass.

When our mothers made us, they made us with an anus.  We need to care 
for it as our mothers did, with nurturing concern and freedom from 
judgment.  Otherwise we'll need, as in the Native American story, to 
make amends.  Only our gifts will not be to Raven to reverse his 
magic, but to a modern medicine man.

So let us always appreciate our colon, the healthy bacteria it 
carries, and the anus that bids our stool farewell. Let us treat our 
personal plumbing well.

=== New Year's Resolution ===
Easy does it.  Rather than a sudden, impossible-to-maintain change, 
find foods that are rich in fiber that you'll enjoy in your everyday 
meals and snacks.  Buy fruit and keep it on the table.  You'll remind 
yourself to consume it before it goes bad.   Cook a pot of beans, and 
freeze in portion-size units for last-minute meals. This will make 
your colon happy.  And when Mr. Colon is happy, everybody is happy.

=====================

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Medicine for People! is written by Douwe Rienstra MD, edited by 
Carolyn Latteier, and published at Port Townsend, Washington. 
Copyright January, 2008.

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