Changes in bowel habits prompt doctor visit

DEAR DR. ROACH »

I am a 74-year-old male. I had open heart surgery one year ago. I am taking several medicines. A month ago I started having very hard stools, with no changes to diet.

Can a person’s stool indicate a problem?

— D.M.

Yes, a change in a person’s bowel habits can be a clue to a health problem. It can mean an issue with the intestines and colon, or a systemic issue, such as low thyroid levels. Changes in diet or medication are the most common cause, but changes in physical activity also can cause hard stools. A study showed 25% of people — one person

ANSWER »

in four! — had changes in bowel habits related to the pandemic.

For many people, changes get better as mysteriously as they started. Even so, definitely make an appointment to see your regular doctor. In the meantime, increasing fiber through diet (whole grains and vegetables) and water may be of benefit.

DEAR DR. ROACH » We have read several letters about acid reflux and the longterm use of medications.

No one suggested raising the head of the bed as a solution.

My husband was on prescription-strength Nexium and then rabeprazole for many years until we purchased an adjustable bed. He raised the head about 4 inches; his GERD disappeared and has never returned. He no longer needs meds at all. When we travel, we put a pillow under the head of the mattress, which is a quick and simple solution. We hope others will find this suggestion useful.

— H.M.

ANSWER » Yes, doctors too quickly suggest medications to treat acid reflux, and I am glad you wrote about nonmedication treatments, in addition to raising the head of the bed. Another is to give time for the stomach to empty before bed.

Bedtime is critical for reflux because of gravity and swallowing. If acid gets into the esophagus, it tends to stay there without gravity pulling it back down into the stomach. Also, when we are awake, we swallow about once per minute, usually without being aware of it. This helps clear any acid that went into the esophagus. While asleep, you only swallow about three times per hour, so the acid can do much more damage.

Two hours — or, better yet, three hours — of time between dinner and bedtime allows the stomach to empty so there isn’t so much pressure pushing stomach acid backward into the esophagus.

As for diet: fat, caffeine, chocolate and carbonated beverages worsen reflux. Tobacco and alcohol are problematic. Even tight clothing makes GERD worse for some people.