Bowel function varies widely with the young

Tots to teens

January 23, 1996|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,SPECIAL TO THE SUN

I have a bowel movement once a week. Sometimes I don't even have one for 10 days. Is this normal for a teen-ager?

Just as teen-agers are not the same height or weight, not all of them will have bowel movements with the same frequency. If you are otherwise healthy, do not have pain or blood with your bowel movements and have had this pattern for a number of years, you are almost certainly normal. If you find that it is getting more difficult for you to have bowel movements (defecate) on a regular basis, then you should get checked by a physician. Difficulty in having bowel movements (constipation) can be one sign of certain health problems, such as an under-active thyroid gland (hypothyroidism). Difficulty defecating can be a sign of cancer in adults but this would be extremely unusual for someone your age.

How often an individual has a bowel movement is related to a number of factors. Stool is composed of dead intestinal cells, bacteria (millions of bacteria live in the intestines), water and undigested food. The large intestine removes water from stool as it is formed so the longer an individual goes without a bowel movement, the harder the stool becomes and the more difficult it is to defecate.

The undigested food that forms a significant part of the stool content largely comes from undigested portions of grains (cereals, pasta, breads), vegetables (including dried beans) and fruits. This is referred to as fiber. Breads and cereals that contain whole grains (such as wheat or rye) have more fiber than refined products made primarily with white flour. Teen-agers who eat a lot of fiber will usually have more frequent bowel movements than those whose diet consists mainly of protein (meat, fish, cheese) or a lot of refined products like candy bars, ice cream or other snack foods.

As the undigested fiber reaches and builds up in the last portion of the large intestine, it stimulates the nerve endings there which you experience as the urge to defecate. Since the stool does not sit as long in the rectum, more water is retained in the stool and it is softer. Also, if you drink a lot of water, the undigested fiber tends to hold the water in the stool and increases its bulk.

If you are concerned about how often you have a bowel movement, you might first try drinking more water and adding fiber to your diet. Nutritionists recommend that all of us should have at least five servings of fruits, vegetables and grains daily. In addition to providing bulk in the stool, these foods provide the body with important nutrients, including complex carbohydrates and vitamins. Recent studies also show that a high-fiber diet can help control weight (the fiber makes you feel fuller even though you've consumed fewer calories), lower cholesterol and protect against certain forms of cancer.

Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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