Recently a patient came in to be treated for constipation. He asked his medical doctor how long he could go without having a bowel movement (he hadn't gone in a month). He was stunned by the answer: "It doesn't matter. When it gets to the point that you can no longer stand it, we'll just take your colon out!" Mortified at the possibility, and not given a satisfactory answer, he called us for help.

You are officially considered constipated if you have three or less bowel movements per week. However, most health-care providers agree that less than one bowel movement per day constitutes constipation.

Constipation is a symptom, not a disease. It is a good monitor of your general health. Most people know that stools contain the waste-byproducts of foods eaten. However, that is only half of the dry weight of stools. The other half is dead, discarded cells, bacteria, viruses, parasites and other metabolic wastes from normal physiological functions. When your system is gummed up, you may be reabsorbing these waste products.

Most common causes of constipation are well within our control. First is inadequate fiber in the diet. It is best to have both soluble and insoluble fiber in every meal. That means both raw and lightly steamed vegetables, fruits and whole grains.

Next is lack of physical movement. Regular physical activity, whether aerobic or strength training is helpful. Yoga, stretching and Pilates are also great for keeping tone and movement of the bowels.

Certain foods tend to be constipating. Pasteurized milk products, especially cheese, white flour products, bananas and processed bakery foods can contribute to constipation, especially if they are consumed in lieu of fresh vegetables and fruits. A diet lacking in meats and other healthy fats can also be constipating. When eating meats or other foods containing fat, bile is released to emulsify the fat. Bile is the No. 1 bowel mover the body makes. But it is released only when called to act on fat in the diet.

Other causes of constipation include: Side effects of medications, changes in life routines, such as vacationing, pregnancy or change in job; dehydration, certain medical conditions such as neurological diseases, blood sugar issues and hypothyroidism.

Too frequent use of laxatives, functional problems with the colon or diseases of the colon or rectum also can result in constipation.

Sometimes constipation is due to not taking time to go to the bathroom. We get so busy that even when we get the urge to go, we put it off. Fortunately, we can re-train ourselves to go regularly again. I "lovingly" tell my patients they need to be potty trained, then I tell them how.

Another help is to include the use of probiotics. The best probiotics are ones you create by making homemade yogurt, sauerkraut or other cultured foods. Probiotics in store-bought yogurt or in a bottle are second best.

While it is most commonly a digestive issue that needs corrections, it could be a number of other health challenges as well. The use of acupuncture, chiropractic, herbal and nutritional remedies are generally the best option for getting down to the core cause of constipation. Just taking laxatives (whether herbal or OTC) is not recommended for long term. Fixing the digestion or other cause is essential.

Holly Carling is a Doctor of Oriental Medicine, Licensed Acupuncturist, Doctor of Naturopathy, Clinical Nutritionist and Master Herbologist with more than 32 years of experience. Carling is currently accepting new patients and offers natural health care services and whole food nutritional supplements in her Coeur d'Alene clinic. Visit Carling's website at www.vitalhealthandfitness.com to learn more about Carling, view a list of upcoming health classes and read other informative articles. Carling can be reached at (208) 765-1994 and would be happy to answer any questions regarding this topic.