Dr. Gott: Bowel movement once a month is not normal

Dear Dr. Gott: I am a 35-year-old female and am relatively healthy but have chronic constipation. I am taking Zelnorm and milk of magnesia but still have a bowel movement only once a month, usually at the time my period starts. It is very painful to pass the stool because it is like a big ball.

Recently, I started feeling tired and run down after normal activity. I consulted my doctor, who ordered a colonoscopy and blood tests. The results of the colonoscopy were negative. Blood tests indicated my red-blood-count was 4, so I’ve been taking iron pills for three months. It is still 4. Where do I go from here?

Dear Reader: A red-blood-cell count of 4 is hardly abnormal. I don’t believe you are anemic.

When did the constipation and fatigue start? Do they coincide? Have you been diagnosed as having Irritable Bowel Syndrome with constipation? Having one bowel movement a month is a near physical impossibility, especially when taking milk of magnesia and Zelnorm, a drug used for the short-term treatment of IBS with constipation.

Zelnorm shows improvement in most people who take it, but it can cause diarrhea. Milk of magnesia encourages evacuation. I’d think that by taking both these medications, you would hardly be able to leave the house for fear of constant diarrhea. It also suggests that you may have an intestinal abnormality causing obstruction or a similar disorder.

You need to see a gastroenterologist. I believe your symptoms are related to your chronic constipation. If the gastroenterologist determines there is no physical reason for the constipation and believes the fatigue is from your very slight anemia, you may wish to see a hematologist (blood specialist) for further evaluation.

To give you related information, I am sending you copies of my Health Reports “Irritable Bowel Syndrome” and “Blood – Donations and Disorders.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dear Dr. Gott: My husband and I are doing the grape juice-and-pectin cure for arthritis. One of your readers recently remarked that the sugar content of purple grape juice is too high. We have found that Welch’s makes a white grape juice that is light, with only 17 grams of sugar. Our problem is finding a cheaper source for the pectin. It’s not available in bulk in any store we’ve checked. Kraft maintains that even if you are a major jam maker, you have to buy the 6-ounces package. Doesn’t that seem strange?

Dear Reader: All reports I’ve received refer to purple grape juice for arthritis pain. If white grape juice works for you and your husband, stick with it.

Unfortunately, pectin purchased in a grocery store is available only in small packaging because the volume is tied to the amount required to make a batch of jam or jelly. Perhaps fewer people are making homemade goods, and packaging larger volumes is not profitable. How sad. It’s one thing that could certainly be sold in bulk, since many people with arthritis profit from the grape juice/pectin combo for relief of their joint pain.