To Your Health

My doctor says my constipation results from 'weak peristalsis.' What is this, and what can make it better?

Q. My doctor says my constipation results from "weak peristalsis." What is this, and what can make it better?

A. Peristalsis is a distinctive pattern of synchronized muscle contractions that push food in waves through the gastrointestinal tract and eventually out of the body. The peristaltic waves look a little like the movement of a snake as it moves along the ground. Peristalsis is an automatic process using the muscles we call "smooth muscles" that we have no conscious control over, as opposed to the "skeletal muscles" that move our arms, legs, etc. Weak peristalsis would imply a lack of strength in those smooth muscles. Unfortunately there is no way to intentionally exercise and strengthen smooth muscles as we can skeletal muscles.

All muscles require energy in order to contract. The energy is needed to move ions, the salts of minerals, across cell membranes. It is not simply the presence but also the movement of the ions of such minerals as calcium, magnesium, potassium, and sodium that regulate the contraction of muscles.

Skeletal muscles usually contract faster and stronger than smooth muscles because there is sometimes a great need to move quickly, so they need to be able to make and use a lot of energy in small bursts. In contrast, smooth muscles often contract rhythmically on a continual basis, so they use a slower but more efficient energy pathway compared to skeletal muscles. Both kinds of muscles use the same nutrients, but because smooth muscles and skeletal muscles work in slightly different ways, smooth muscle requires more of certain nutrients than skeletal muscles and less of some others. In addition, some substances not ordinarily considered nutrients, such as inositol, are involved in the process of muscle contraction. These can be part of the strengthening of these muscles.

You can start improving your elimination by checking to see if your diet has enough fiber. An emphasis on fresh vegetables and whole fruits, five or more servings per day, along with a change (if necessary) from refined grain products to whole grain products should provide the right amount of fiber. Allow about six weeks to adjust to a change in fiber intake, since at first it may even worsen constipation.

If dietary change alone is not enough help, consider using a food supplement program that would include a multivitamin with balanced B-complex, a good multi mineral (without iron if you are male or female not of childbearing age), and an antioxidant blend that includes vitamin E. More serious situations call for separate and more generous supplements of pantothenic acid, vitamin C, coenzyme Q-10, acidophilus, and magnesium. If these supplements are still not helpful, try adding supplements of L-arginine (as a way to increase nitric oxide production), inositol, choline, evening primrose oil, or fructo-oligosaccharides. These last five possibilities are "long shots" but there is some evidence that they could be beneficial, and long-term constipation can have serious negative consequences.

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