This is an important question. As a practicing gastroenterologist with over two decades of clinical experience, let me give you my best and thoughtful answer.
Firstly, is the colon especially prone to diseases? Answer: YES. I would say it is rivaled only by the breast in women, prostate in men, and lungs in both sexes as a source for morbidity and mortality. Colon diseases affect both men and women equally and throughout all ages. Indeed, colon cancer is the number one cause of non-smoking cancer-related deaths, surpassing both breast and prostate cancer. In addition to cancer, the colon is prone to polyps; inflammatory conditions such as diverticular disease, ulcerative colitis, Crohn’s disease; infections; irritable bowel syndrome; and hemorrhoidal disease. These diseases afflict millions of Americans and are responsible for illness, lost productivity, and hundreds of millions of dollars in medical expenses.
In addition to the above diseases, we are all quite aware of how we feel when our colon is not happy, from diarrhea due to a food item that does not agree with us to constipation stemming from eating a rich diet, dehydration, travel, as a side effect of a medication, and so on. Those of you who suffer from the irritable bowel syndrome can relate to this and also are aware of abdominal bloating and discomfort.
I know many of you are thinking about bowel movements and what is the normal frequency. Ninety-five (95) percent of the population has a bowel movement anywhere from 3 per day to one bowel movement every 3 days. If you are in the range and this is a normal pattern for you, then this is considered normal. What about flatulence? Believe it or not, this has been studied. The average person passes flatus 14 times per day. I am not aware if this pertains to both male and female or if this frequency changes with age.
Now that I’ve addressed the scope of colon diseases and touched on ranges of normal for bowel movements and flatus, let’s move on to what we can do to achieve optimal colon health.
Obviously, our diet is an important element in health and in achieving optimal colon health. My advice to patients is fairly simple. You should take in about 2400 calories per day for the average adult who is moderately active, less if you are sedentary and more if you are active. Avoiding obesity is important as your risk of developing colon diseases generally increases with obesity. Your diet should have a blend of carbohydrates, protein and fat. As a rule of thumb, carbohydrates should comprise 50%, protein 25%, and fat 25%. Importantly, you should try to consume 20-35 grams of dietary fiber per day.
Exercise is important to colon health. You should try to achieve ideal body weight by having a BMI (body mass index) of 25 or less. See my prior blog on exercise and weight loss.
If you smoke tobacco, stop. Smoking tobacco increases the likelihood of developing almost every known colon disease there is.
What about vitamins, micronutrients, and antioxidants? I developed The Colon Vitamin with this in mind. As a gastroenterologist, I am aware of the importance of certain vitamins and micronutrients in promoting colon health. For example, adequate vitamin D levels have been associated with a reduced rate of relapse in patients with Crohn’s disease and a decreased rate of colon cancer. Calcium supplementation has been shown to help prevent the occurrence of colon polyps. Curcumin is a powerful antioxidant that has been associated with decreased rates of colon cancer and is known throughout Asia as a food item that aids in colon health. All of the ingredients in The Colon Vitamin have been shown in scientific studies to help promote colon health.
Probiotics are very popular in our society today. In fact, the enthusiasm and embracement of the public towards probiotics has outpaced the science. There are only a few diseases where taking probiotics has proved beneficial in scientific studies. These include the irritable bowel syndrome, infectious diarrhea, diarrhea associated with using antibiotics, Crohn’s disease, and ulcerative colitis. I would not advocate taking a probiotic on a regular basis unless you have one of the above conditions and are being followed by a healthcare provider.
I would be remiss if I did not mention the importance of getting a screening colonoscopy. For the average person, this should start at age 50. If you have a family history of colon polyps and/or colon cancer, your screening should start at an earlier age.
If I had to distill the above advice to achieving optimal colon health into a single sentence, it would be:
‘Eat about 2400 calories per day in a balanced diet that includes 20-35 grams of fiber, exercise regularly and avoid being overweight, don’t smoke tobacco, take The Colon Vitamin, and get your screening colonoscopy.’
Here’s to your colon health!
Frank Farrell, MD, MPH, AGAF