Dear Dr. Gott: I took exception to your position that fluid intake can be governed by one’s thirst except for those in hot climates and those who have been vigorously exercising. Then I saw the enclosed article about how much water is enough that was published in the American Journal of Physiology. In the study, experts confirmed that Americans are being misled by the bottled water companies. Thirst is, in most normal situations, a valid indicator of dehydration. Thus, I have to renounce my prejudice and credit you with being on the cutting edge.
Thank you for your informative column.
Dear Reader: Thank you for the compliment. I was not aware of the study you referred to, but I am gratified that the traditional 8-glasses-a-day “rule” is not only coming under question but is probably incorrect for the average adult. Remember that there are circumstances in which additional fluid intake, irrespective of thirst, is appropriate. These include vigorous physical activity, a warm environment, the needs of hospitalized patient and others in “nontypical environments.” The rule for such people is “drink enough so you don’t get thirsty.”
Thanks for writing.
Dear Dr. Gott: About 10 years ago, I had a stroke that affected my speech and muscular strength on my right side. I also began to suffer from constipation, for which I take a fiber supplement. Any other suggestions?
Dear Reader: Stroke patients often experience troublesome constipation. The reason for this is not known, but the problem may be related to the physical inactivity that plagues many such patients.
I recommend a stepped approach.
I agree that fiber supplements, in conjunction with increasing dietary raw fruits and vegetables, is a reasonable and inexpensive first option. If this is ineffective, I recommend a daily 8-ounce glass of hot prune juice.
Next, I suggest nonprescription medications (milk of magnesia, Senokot, Dulcolax and others).
Should this option fail, MiraLax or other prescription laxatives may be required, under the supervision of your primary care physician.
My advice: try the simple and natural laxatives first, then progress as needed.
To give you related information I am sending you a copy of my Health Report “Constipation and Diarrhea.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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