Tuesday, February 13, 2018

Scatter or not to Scatter

Scatter or not to Scatter
Or, well this is not on scattering of light or scattering of rubbish in my neighbourhood but a rejoinder for the scat and scatology I penned sometime ago. 

It is on a subject at hand every one of us have had some problems associated with at some stage in life be that it may be childhood, adulthood or old age.
 Writing on medical subjects is an antithesis to me.  
This is a departure from that line of thinking. Away from clinical work having enjoyed academic activity liberally I have lost count of how many millions of our fellow beings are affected by the mother nature's call and its aberrations. So writing on a commoner garden topic was due for sometime. What I am going to talk about is our scat, the human variety not animal and the difficulty of its elimination first thing in the morning for most of us. 
The topic is constipation not the emotional (I had this at the time of election) variety but the physical variety of all that afflict my fellow beings. First of all this does not affect the animals in the jungle be that it may be an elephant or an ant to any alarming degree. If at all if it affects the animal kingdom it is the domesticated ones, the cats and the dogs that we associate with that have this man’s perennial problem inherited from our bad habits. 
In any case they (animals) do not need any special medication except for changing the diet.
Going back in history I don’t think that humans like animals were made to use toilets. When they were in the jungles when they got the urge they would go furtherest away from their dwellings and would scatter the scat like any other animal. But I don’t think they ever made use of this activity for marking the territories like animals. If they have done that animals would be in real trouble looking for a free space to populate their kind. 

Their nature is to avoid contact with this ambivalent species who have love and hate both at the same time in abundance and instance. 
I believe even our Vaddha’s children enjoy this activity what we call the nature’s call. By becoming domesticated apart from breeding mosquitoes in our cesspits we add complications to our own lives and to me constipation is just one of them.
This bad habit is probably cultivated and originated in early days of toilet training and tends to last our life cycle.
If one looks at a child he has his freedom restricted even in his early days and expected to adhere to a protocol that adults wish him to do. Whereas adults would do what ever they feel like at whatever time they like which applies even to going to the loo or postponing the desire. 

This is the beginning of the story and I have no intention of going into that except briefly stating that any child would use this scattering as a tool (not stools) against adults to score a point or two in their formative years.
I am interested in the adults for the time being and just a few tips for them especially the elderly. But what I say may apply to some but not to all. Intension is to make adult life easy and simple.
First and foremost majority of the people with constipation have no associated medical conditions but have created a bad habit for themselves and unlearning this bad habit is difficult in adult life.
This discussion is for those who are without medical or surgical conditions. 
A simple warning for adults at the outset is due before any further probing on this matter. If one has (his / her) bowel habits altered for no reason it is worthwhile seeing a doctor early lest a bowel cancer may be missed. Bowel cancers when detected early can be treated easily but if missed for a considerable length of time the treatment is painstakingly difficult. 
Constipation can simply be avoided with right understanding of the process. Evacuation when loaded is a physiological process and its frequency and consistency depends on the type of food one eats and the constitution of the individual. There is broad variation and nothing specific can be termed as normal and if the process is automatic with no straining involved one need not worry about this activity. However, if the consistency is hard and needs quite an effort to empty there is a little problem. What one has done is to complicate a simple process into complicated obsession, which needs divine (medical people) intervention.
One should make lifestyle changes gradually and not in an ad hock manner. If one has learnt a bad habit like taking a paper to the toilet (or having a cigarette to while away the time) it is one of the most difficult habits to get rid of. However, these habits automatically disappear when one's personal difficulty improves and his wellbeing is achieved.

1.Take the shortest time as possible to finish one's activity. Think that other people are (home folks) waiting in the queue.

2.First thing in the morning (what ever one has got used to, a cup of tea, a banana or a toast) fill one's empty stomach with something. Moment one fills the stomach it initiates a reflex action call a Gastro-colic reflex that makes one to void almost immediately and answer this call at once without delaying.

3.The voiding is a simple autonomic function and does not need any help from the individual except for relaxing the outlet gate (sphincter) which is the only part under voluntary control.

4.Wait for the automatic process to finish  (relaxing) without any voluntary action.

5.Even if one still feels full do not wait in the toilet just get out. If the next wave of Gastro-colic reflex does not come it would never come on your voluntary effort. Each one has his own rhythm and just make a note of how it comes the next time around and attend to it with the same relax mood.

6. Always talks to oneself that it is an automatic process and needs no help.

7. Beginning of the training may be difficult but once one has overcome the voluntary intervention the battle is won.

Some people think they should have a bowel movement every day. That is not really true. There is no "right" number of bowel movements. Each person's body finds its own normal number of bowel movements. It depends on the food one eats, how much water one drinks and among other things exercise and personal habits.

At one time or another, almost everyone gets constipated. In most cases, it lasts for a short time and is not serious. When you understand what causes constipation, you can take steps to prevent it.

What can one do about constipation?

Changing what you eat and drink and how much you exercise will help relieve and prevent constipation. Here are some steps one can take.

Eat more fiber
Fiber helps form soft, bulky stool. It is found in many vegetables, fruits, and grains. Be sure to add fiber a little at a time, so your body gets used to it slowly. Limit foods that have little or no fiber such as ice cream, cheese, meat, chips and pizza, and processed foods. 

My favorite fibre rich fruit is banana. 
Kohila and Bellie fruits are supplements that have special properties.

Drink plenty of water and other liquids such as soups and vegetable juices.Liquid helps keep the stool soft and easy to pass, so it is important to drink enough fluids. One has to drink at least 8  glasses of water a day and depending on the dryness and heat (tropical weather) even this may have to be increased. I am not in favour of sugary fruit drinks since the sugar is readily absorbed and defeats the benefits of slowing down of absorption of sugars by high fibre diet. The sugar in banana and starch in soy are absorbed slowly over long period of time without a surge in blood sugar upsetting the insulin secretion. This will help soften your stool. Try not to drink liquids that contain caffeine or alcohol. 

Caffeine and alcohol(diuresis) tend to dry out your system.

Get enough exercise.
Regular exercise helps one's digestive system stay active and healthy. One does not need to become a great athlete and little exercise help in relaxing the voluntary muscles which include the anal sphincter. A 20 to 30 minute walk every day is beneficial.

Allow yourself enough time to have a bowel movement.
Sometimes one feels so hurried that one does not  pay attention to the body's needs. Make sure one does not ignore the urge to have a bowel movement.
Use laxatives only if a doctor says you should.
Laxatives are medicines that make stools softer and make one pass a stool easily. Most people who are mildly constipated do not need laxatives. However, if you are doing all the right things and you are still constipated, your doctor may recommend laxatives for a limited time. Your doctor will tell you if you need a laxative and what type is best for you.
Laxatives come in many forms: liquid, chewing gum, pills and powder that you mix up with water.

Check with your doctor about any medicines you take
Some medicines can cause constipation. They include calcium pills, pain pills with codeine in them, some antacids, iron pills, diuretics (water pills), and medicines for depression. If you take medicine for another problem, be sure to ask your doctor whether it could cause constipation.

Points to Remember
Constipation affects almost everyone at one time or another. Many people think they are constipated when really they are not. In most cases, following these simple tips will help prevent constipation.

Eat a variety of foods, especially beans, bran, whole grains, and fresh fruits and vegetables.

Drink plenty of liquids.


Exercise regularly.
 

Don't ignore the urge to have a bowel movement.
 

Understand that normal bowel habits are different for everyone.
 

If your bowel habits change, check with your doctor.
 

Most people with mild constipation do not need laxatives.
 

However, doctors may recommend laxatives for a limited time for people with chronic constipation.
 

Medicines that you take for another problem might cause constipation.
 

It is important to drink at least 8 to 10 glasses of fluid a day.

What is Psyllium Husk?
Psyllium husk comes from the crushed seeds of the Plantago ovata plant, a herb native to parts of Asia, Mediterranean and North Africa.Psyllium is rich in soluble fiber. Traditionally, psyllium husk is used as a gentle bulk-forming laxative for constipation.

Psyllium Husk for High Cholesterol
3g to 12g of soluble fiber from psyllium seed husk when included in the diet help to lower bad cholesterol and reduce the risk of heart disease.Soluble fiber from psyllium husk forms a gel when mixed with liquid. One needs to eat a small serving to increase the content of soluble fiber to help achieve the cholesterol-lowering effect.
In addition, recent studies also show positive benefits of psyllium in  Crohn's Disease and Colitis. Psyllium acts as prebiotics - aiding to heal the inner lining of the inflamed intestine.  Standard preparations of psyllium are available in dry seed or husk form to be mixed with water as needed.

Warning:
In general, prescription drugs should be taken one hour before or two hours after psyllium, because the absorption and effectiveness of many drugs may be reduced.

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