Just Be Good to Your Colon and Your Colon Will Be Good to You

Just Be Good to Your Colon and Your Colon Will Be Good to You
By: Roy M. Arnold MD

Many of us don’t think about our colon very often, that is until we experience a problem. Myths abound regarding colon (or large intestine) function – frequency of elimination, consistency, toxin elimination, fiber requirements, probiotics, colon cancer screening, and a whole host of others. Hopefully, this article will enlighten the public and assist in filtering the plethora of information.

First and foremost, the colon’s primary functions are threefold – absorption, storage and transport. Daily, about 1 ½ quarts of intestinal contents enter the colon and ultimately about 10 ounces are excreted. The colon absorbs water and electrolytes primarily. The only nutrients absorbed are short chain fatty acids. The colon has the capacity to increase its absorptive capacity fivefold when necessary and under most circumstances the transit time is 24-36 hours. Most of the common colonic complaints such as constipation, diarrhea, cramps, bloating and urgency arise when the motility is affected.

Many people are raised to believe that a daily (or more) bowel movement is essential for good health. Advertisements often report the same, often leading to worry or resorting to laxative use. In fact, variation in the frequency of bowel movements, and their consistency are very common in the healthy population. In the 1970’s a body of research emerged indicating that the Western diet contained significantly less fiber than in other parts of the world, and speculated that perhaps this paucity of dietary fiber could explain the higher prevalence of constipation and other colon maladies like irritable bowel and diverticulosis. Research showed that increasing dietary fiber to more than 25 grams per day increased stool weight in most people. This increased fiber can come from consuming more whole grains, fruits and vegetables and if necessary fiber supplements.
Diverticulosis of the colon is a disease in which is quite common in the US, Europe and Australia but rare in Asia and Africa. This disorder is characterized by the formation of pouches through the muscular layer of the colon that communicate with the lining. Occasionally, these pouches can become infected, a condition called diverticulitis. Diverticulitis can be serious and often requires medical attention or hospitalization. The higher prevalence in Western societies is thought to be due to lower fiber and higher meat consumption in these areas. Besides the preventive effect of a high fiber diet, increased fiber intake is often used as part of the management of uncomplicated diverticular disease. Although there has been no documented regression of diverticula on high fiber diets, overall symptoms do seem to improve with increase fiber intake.

Beyond its vital functions of absorption, transport and storage, the colon is home to literally trillions of bacteria. Only within the last few years has science learned about the vital role these one-celled organisms play in maintaining overall health. Collectively referred to as the “gut microbiota” the bacteria play a critical role in maintaining the health of the lining of the intestines and in generating certain critical nutrients that the body cannot produce on its own. They can also serve as protection against harmful microbes and their byproducts. The beneficial microbiota prevent inflammation and more evidence is accumulating that having the wrong mix of bacteria in the GI tract may play a contributory role in the development of obesity and Type2 diabetes. Even a single course of oral antibiotics can dramatically alter the composition of the gut microbes and may permit infection with an organism called Clostridium difficile, a disease which causes more than 340,000 hospitalizations and 14,000 deaths annually.

Some foods contain probiotics; a live culture of beneficial bacteria that once consumed can reproduce in your GI tract and improve the overall efficiency of your gut microbiota. Although more research is needed, there’s encouraging evidence that probiotics may help treat diarrhea, especially following treatment with certain antibiotics, prevent and treat vaginal yeast infections and urinary tract infections, treat irritable bowel syndrome, and speed treatment of certain intestinal infections. Specific foods that are naturally rich in beneficial bacteria include yogurt, buttermilk, aged cheeses (unbaked,) sauerkraut, cold-packed pickles, tempeh (fermented bean curd,) kimchee and miso. Other foods or supplements may contain added cultures of beneficial bacteria.

“What about colon cleansing?” you may ask. Colon cleansing consists of solutions containing various herbs or plant derivatives that are either ingested orally or administered as an enema. The theory behind colon cleansing is that toxins or undigested food somehow accumulates in the colon and adversely affects health. This simply isn’t so. Most physicians don’t recommend colon cleansing for detoxification. Their reasoning is simple: Your digestive system and bowel naturally eliminate waste material and harmful bacteria — your body doesn’t need colon cleansing to do this. Potential harmful effects of colon cleansing include risk of dehydration, bowel perforations, risk of infection, and changes in your electrolytes, which can be dangerous if you have kidney disease or other health problems. It is very important to discuss this matter with your personal healthcare provider before considering colon cleansing.

The last topic to discuss is colon cancer. Approximately 140,000 cases of colon and rectal cancer will be diagnosed this year and 50,000 persons will die in the US. By sheer numbers, colorectal cancer is the fourth most common cancer in the US behind lung, breast and prostate cancers. Colorectal cancer is very preventable by early screening and removal of precancerous growths called polyps. If you have a family history of colon cancer or polyps, you are at increased risk. Other risk factors include obesity and age. Current guidelines recommend screening begin at age 50 for those without a family history and earlier for those with a family history. The most effective screening tool is a procedure called colonoscopy, which involves viewing the interior of the colon with a flexible telescope under moderate sedation. If polyps are discovered, they can usually be removed before they become cancerous. This procedure is very safe, virtually painless and can be performed as an outpatient. Depending upon the findings, the study may need to be repeated every 3-10 years.

In summary, colon health is very important to overall health and well-being. This article has covered most of the major topics about colon health; however I encourage you to discuss this matter with your personal healthcare provider.

References:
Feldman: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed. Copyright © 2010 Saunders, An Imprint of Elsevier.
“Some of My Best Friends Are Bacteria,” Michael Pollan. The New York Times Magazine, May 19, 2013.
Agency for Healthcare Research and Quality, Research Activities, March 2012, No. 379
Mayo Clinic Consumer Health www.mayoclinic.com/health.
“Cancer Facts 2013,” American Cancer Society