Gas. Constipation. Heartburn. Eight of 10 adults occasionally or frequently experience those and other stomach problems. Here’s how to treat common digestive complaints.
About 15 percent of adults say they have two or fewer bowel movements per week, according to research published in June by JAMA Internal Medicine. And the older you are, the more common constipation becomes.
Try this first: Consume lots of fiber, which softens and bulks up stool. Women older than 50 should aim for 21 grams daily; men, 30 grams. You can get that from food. A medium apple (4 grams), a banana (3 grams), two slices of whole-wheat bread (4 grams),¾ cup of cooked broccoli (7 grams) and a medium potato (5 grams) add up to 23 grams. If you find it hard to take in that much fiber through diet, supplements that contain psyllium, such as Metamucil, may help. But some research suggests that snacking on high-fiber foods, such as prunes, might be a better bet.
Also consider: Scheduling your bowel movements. Most people who are regular have a bowel movement at the same time every day. So try to have one twice per day, about 30 minutes after meals, when your colon is most active, even if you don’t feel the need.
Be cautious about: Taking laxatives. People with frequent or long-term constipation often turn to over-the-counter laxatives or are prescribed one by a doctor, but in most cases, that’s not a good idea. Stimulant laxatives such as bisacodyl (Correctol, Dulcolax and generic) and senna (Ex-Lax, Senokot and generic) can cause dependency as well as dizziness, diarrhea and nausea. And stool softeners such as docusate (Colace and generic) don’t work better than a placebo, according to a commentary in JAMA Internal Medicine.
If self-help steps don’t work and you need short-term help, try a laxative that contains polyethylene glycol (MiraLax and generic) or lactulose (Cholac and generic). Such a laxative is less likely to cause dependence, although it can lead to diarrhea and gas, says Ari Grinspan, a gastroenterologist and assistant professor at the Icahn School of Medicine at Mount Sinai in New York.
As you get older and maybe put on a few pounds, you may find that heartburn crops up more often. The discomfort occurs when stomach acid backs up into the esophagus, the tube that carries food from your mouth to your stomach.
Try this first: Cut back on foods that trigger the burn. That includes alcohol, fried and spicy foods, garlic and onions, citrus fruit, chocolate and peppermint, says Gail Cresci, a registered dietitian at the Cleveland Clinic. Other lifestyle changes to try are smaller meals, eating at least two hours before bedtime, quitting smoking, losing weight, avoiding tight clothes, elevating the head of your bed and sleeping on your left side.
Also consider: For occasional heartburn, try OTC antacids such as Rolaids or Tums, or an H2 blocker such as famotidine (Pepcid AC and generic) or ranitidine (Zantac 150 and generic). But if you experience indigestion more than twice per week for several weeks, see a doctor. You may have a more severe form of heartburn called gastroesophageal reflux disease, or GERD, which over time can damage the lining of your esophagus and requires stronger medication.
Be cautious about: Proton pump inhibitors, or PPIs, such as omeprazole (Prilosec OTC and generic) and esomeprazole (Nexium 24HR and generic). They can be appropriate for GERD, but only if lifestyle measures or H2 blockers don’t help. Long-term use poses the risk of bone fractures, kidney disease and low levels of magnesium and vitamin B12. They may also make you susceptible to infections, notably those caused by the bacterium Clostridium difficile, which can cause severe diarrhea and, in some cases, death. “One role of the acid in your stomach is to kill off bad bacteria,” Cresci says. “If you reduce it too much by taking a PPI when you don’t need to, these germs can spread.”
Flatulence and belching can affect anyone, but older adults can be more vulnerable. Because chewing starts the digestion process, dentures that fit poorly, for example, can make it difficult to chew and swallow food, impairing the process, says Stephen Hanauer, medical director of the Northwestern Medicine Digestive Health Center in Chicago.
Try this first: If you’re belching, cut out gum chewing, smoking, drinking carbonated beverages and gulping down food and liquids. (All of those can cause you to swallow air.) If you have gas or bloating from eating foods such as broccoli, cauliflower and beans, cut back on them and reintroduce small amounts into your diet over time to help your digestive system adapt. Anytime you increase fiber-rich foods — such as vegetables, beans and fruit — in your diet, drinking more water should help prevent gas and bloating, says Samantha Heller, a registered dietitian at the NYU Langone Medical Center in New York.
Also consider: Taking an OTC digestive aid such as Beano when you consume gassy foods such as beans and broccoli. It contains enzymes that help break down hard-to-digest complex carbohydrates.
Be cautious about: OTC anti-gas products that contain simethicone, such as Gas-X. There’s little evidence they help.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.