Joe, 75 years old, Martha, 82 years old, and Marilyn, 91 years old, all comment at the Healthy Aging forum they attended that gut dysfunction runs their lives. They say things like, "If my gut is functioning I have energy and I can go forever. I can think straight and do things with my friends." And, "When my gut is in trouble I feel weak, confused and off balance. I just want to stay home until it gets better."

The gastrointestinal system (GI) runs your life, especially as you age. Colon health is part of physical health and fitness. It is a major factor in energy, endurance, strength, balance, mental alertness and pain-free movement. It is a major factor in life viability.

The GI system impacts heart function. The GI system changes heart rhythms and speed via the vagus nerve. It can stop the heart if it is under severe stress.

Taking care of the GI and its nervous system can improve physical, mental and emotional aspects of life as we age. It can lengthen life and make it more enjoyable.

What is 'Normal?'

Normal bowel function, as defined by allopathic medicine, is a gastrointestinal function that occurs at an unconscious level after food has been eaten, and only becomes conscious again when it is time for the elimination of waste.

Normal bowel function is defined as having a bowel movement daily or every other day that is of a soft but solid consistency, a length and shape of a small to medium size, and eliminated without straining.

Prevalence of GI dysfunction increases with age. Constipation, fecal incontinence, diarrhea and diverticulitis increase with age. Digestion, absorption and gastric mobility decrease with age. Essential digestive enzymes from the pancreas, liver and gall bladder also decrease with age. So keeping the same old routine will not provide the healthy results we experienced in our youth.

Optimal physical and mental function with healthy aging requires changes in eating, physical activity and elimination habits. Joe complains of constipation and has been diagnosed with diverticulitis (pouches in the colon wall that fill with fecal material and become inflamed). Martha experiences fecal incontinence (uncontrolled passage of fecal material) associated with impaction (stool that is hard, dry and immovable) and urinary incontinence. Marilyn describes extreme bowel and bladder urgency with periodic diarrhea and urge incontinence (strong unexpected urge with large loss of urine).

Marilyn asks, "Are the nerves in my gut dying before the nerves in my head?" Joe comments, "My gut is 'stoved up' just like my back and hips." Martha laments, "What do I expect after six kids?"

Aging nerves of the enteric division of the autonomic nervous system are a major factor in bowel function. The enteric nervous system slows and becomes sluggish with age, much as our muscles become soft and small if we don't exercise on a regular basis.

Pathologies such as arthritis, multiple sclerosis, Parkinson's disease, stroke and heart problems can change bowel patterns and bowel control. Medications used to treat the pathologies often change bowel function. Pregnancies and delivery complications catch up with women as they age, changing bowel function as the result of scar tissue and the descent of pelvic organs, called prolapse.

Aging nerves, pathologies and pregnancies are all factors in bowel function, but they do not have to be the determining factor in healthy physical function. Activating the four G's can modulate aging and pathology effects and prevent deterioration.

The four G's are: Gulp water, Go for daily walks, Grab fruits and vegetables, and Grow with inversion and Roll for Control exercises.

Gulp Water-Just Drink

Hydration is important for all body functions. It's essential in the bowel to keep the stool soft and sliding down the colon. Water is the best fluid for the job of colon health. Coffee, tea and soda can act as irritants or diuretics. Diuretics pull fluid out of the bowel, resulting in a hard solid stool that sticks in the colon instead of sliding.

Many individuals over 65 use blood pressure medications that act as a diuretic. Cardiac medications can also change bowel patterns. Most medications will alter bowel patterns in some aspect, but drinking water can help maintain best-case function.

Guideline: approximately two liters of fluid daily. Adequate fluid should lead to urinating every two to four hours for 10 to 20 seconds of urine flow.

Go for Daily Walks

Walking tones the bowel as well as exercising the pelvic muscles. Walking stimulates natural colon activity, called peristalsis. Mushy peristalsis creates pools of putrid stool sinking deep in the colon. Toned colon activity is active peristalsis, where the stool is progressively propelled toward the rectum in a strong delivery. Only at the end elimination site does the individual become aware of the bowel activity.

Walking and dancing also increases circulation to the bowel and stimulates lymph flow. Such activities can improve immune system function (70 percent of the immune system is located in the GI) to fight infection and illness. Walking and healthy bowel function are directly related, while inactivity and bowel dysfunction are directly related in several studies.

Guideline: Walk 20 to 60 minutes a day at a moderate pace. Walking duration can be divided into two to three segments with rest periods in between.

Grab Fruits and Vegetables

Changing dietary habits can significantly improve bowel patterns. Increased fruit and vegetable intake is important for micronutrient absorption as well as for their natural fiber and carbohydrate content. Adding the appropriate fruits and vegetables can often change bowel patterns in five to seven days.

There are two types of fiber. One moves the stool through the gut faster than the other. Apples and bananas have the slower type of fiber. Pears, peaches, plums and berries have the faster fiber. Fiber pills can plug up the system as we age, so eating your fiber in food is a better idea.

Guideline: When constipation/impaction are the problem, add three to five servings of bright green vegetables (iceberg lettuce doesn't count) and bright colored fruits.

For example, add a salad of fresh spinach and pears with extra virgin olive oil as the dressing. Minimize white pasta, rice and bread. Add small servings of yams, whole grain pasta, rice and bread. Add ½ cup of cooked beans daily.

When diarrhea is the problem, add servings of banana, applesauce, white pasta, rice and bread. Avoid the vegetables and fruits used for constipation, and decrease fluid intake somewhat. When normal bowel habits become common, it is possible to add those other foods.

Grow With Inversion Exercises

Grow up instead of down with age. Inversion on a Wonder W'edge allows the spine and colon/bowel to return to normal alignment by reversing gravity's effect. It frees up the breathing diaphragm for normal movement. The intestines no longer are compressed in the bottom of the abdominal cavity where they pull the rest of the abdominal contents and trunk down and forward.

Adding "Roll for Control" exercises facilitates normal pelvic and bowel muscle tone. Inversion on the Wonder W'edge with Roll for Control exercises lengthens the spine and reverses gravity's pull. Realigning the intestines and spine enables posture to "grow" upward and centered rather than down toward the ground.

Joe practiced the four G's for three weeks. His symptoms of diverticulitis were gone and his bowel pattern was normal. He commented, "I have so much more energy than before."

Martha practiced the four G's for six weeks and normalized her bowel pattern, which then eliminated the bladder problems. "What a relief it is to not have the constant heavy and uncomfortable feeling in my abdomen. And I sleep so much better," she commented.

Marilyn practiced the four G's for four weeks and improved her bowel patterns and urge incontinence. "I can go to church and out to shop again. That is a very important part of living for me," she said.

The four G's can be a positive program for bringing the gastrointestinal system back to healthy aging function or for preventing the deterioration of function. When healthy aging programs include a healthy bowel program, improvement can be long-term and more beneficial. 

Resources

1. Hulme, J. (2011). Bowel & Gastrointestinal Webinar: phoenixcore.com

2. Hulme, J. (2008). Beyond Kegels: Fabulous Four Exercises and more to prevent and treat incontinence. Missoula, MT: Phoenix Publishing.

3. Wexner, S., et al. (2005). Complex Anorectal Disorders. London: Springer-Verlag.

Janet A. Hulme is a physical therapist with more than 35 years of experience. She is an international speaker on abdominal and pelvic muscle function in relation to women's health.