DEAR DR. DONOHUE: Why aren’t there more experts in constipation? Why don’t more doctors study just this one area so we can know what to do? John Wayne had 40 pounds of feces in his intestines when he died. Elvis had around 30 pounds. Why? Intestines should be shortened so food passes through faster. Who needs all the feet of intestines that we have? I have a relative who can hardly move her bowels. She is bloated up. Her doctor doesn’t do a thing for her. Do you have any suggestions? – S.C.

I’m not a constipation specialist, but I have treated people who have had it, and I have had more than a nodding personal experience with it. Does that qualify me? Gastroenterologists specialize in all things dealing with the digestive tract, so they could be called constipationologists, I suppose.

The definition of constipation is having less than three stools a week. Constipation stools are hard and difficult to pass.

Fiber can soften stools for some people. Fiber is the stuff that isn’t digested as it passes through the intestines. It holds onto water and keeps stool moist and soft. Vegetables and fruits, especially with their skins, are good fiber sources. So are high-fiber cereals. We’re told to get 25 to 30 grams of it a day. People need to increase fluids when they increase fiber intake.

Prunes and prune juice are nature’s laxatives. Your relative ought to begin pruning herself.

After eating, the brain sends out a reflex that causes the intestines to contract and push food along. Taking a walk shortly after breakfast intensifies this reflex.

A new prescription laxative has just been approved for sale. It’s Amitiza, and it might help your relative.

Serious medical conditions can sometimes be the cause of constipation. An underactive thyroid gland, Parkinson’s disease and colon cancer are examples. They should be investigated.

Your idea about shortening the intestines was tried. It failed, and it caused more problems. How did you obtain the information on John Wayne and Elvis? Careful. They might be offended by the suggestion that they were so full of feces.

DEAR DR. DONOHUE: I am in my 20s and have a desk job. I find it difficult to sit without crossing my legs. In one year, I have gotten noticeable varicose veins. I exercise 30 minutes every day. I take birth control pills. Does the risk of blood clots go up with the appearance of these veins? How can I stop their progression? – C.E.

Varicose veins can encourage clot formation, but clots in varicose veins that can be seen are not usually dangerous clots. Clots in the veins deep in the legs are the ones that present a serious threat. Pieces of those clots can break off and be swept into the lungs, where they cause big trouble.

Stop crossing your legs, even if you find it difficult. Crossed legs hinder the return of blood to the heart and dilate leg veins. For the same reason, don’t wear anything that constricts the thighs or the waist. Do wear elastic support stockings. While at your desk, get into the habit of contracting your leg muscles every 15 minutes, five to 10 times. That keeps blood moving in the leg veins. If you can get up and walk around, that’s even better.

Birth control pills do promote clots.

The varicose vein report describes this problem in great detail. Readers can order a copy by writing to: Dr. Donohue – No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Write something about the hypothalamus. Where is it? What are its functions? – K.M.

The hypothalamus is in the brain, just below a part of the brain called the thalamus. “Hypo” is a Greek word for “under.”

It has many important functions. It controls the release of hormones from the body’s master endocrine gland, the pituitary gland, which is also in the brain. It also keeps the body in proper water balance.

What prompted this question?

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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