DEAR DR. DONOHUE: I know nothing about MiraLax, but my doctor suggested using it daily. It seems to be working fine. Back in 2009, I had a colonoscopy, and another doctor recommended Citrucel. Is it similar to MiraLax? MiraLax is called a laxative, and I thought that one should not take a laxative daily. It’s an osmotic laxative. What’s that? I am in my 80s and have always been troubled with constipation. — B.D.

ANSWER: The normal number of bowel movements ranges from three a day to three a week. Frequency isn’t as important as is stool consistency. Stool that is rock-hard and requires straining to evacuate is a better criterion of constipation.

At one time, laxative use was discouraged because it was believed it would create a “lazy” bowel, one that became dependent on the laxative. Most doctors now believe that’s not the case. Long-term laxative use is safe when prescribed by a doctor.

MiraLax is an osmotic laxative. That means it draws water into the colon to keep the food residue soft and easy to eliminate. At high doses, it’s used to prepare the colon for a colonoscopy. For ordinary laxative use, the dose is greatly reduced.

There is something to be said for staying regular on natural products. The addition of fiber to the diet helps many stay regular, but not all. Bran, the outer coat of grains, is a good fiber source. Health-food stores sell it. Many cereals are rich in fiber. Increase your water intake when increasing the daily fiber intake. Most fruits and vegetables also provide fiber. Beans, peas and raspberries are fiber-rich. Prunes are Mother Nature’s laxative. Six to eight prunes a day keeps many people regular.

Citrucel is fiber, as are Fiberall and Metamucil. If it worked for you in the past, it could work for you now.

The booklet on constipation and laxatives summarizes the main points of both these topics. Readers can order a copy by writing: Dr. Donohue — No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am an 84-year-old female who has had several urinary tract infections that have always been controlled by Septra. Recently I had an infection caused by Enterococcus faecalis. I am allergic to penicillin, Cipro and Macrobid. I was sent to an infectious-disease specialist. He has not been able to help me. If I don’t get treatment, what will happen? Does diet have anything to do with this? — B.M.

ANSWER: The most common cause of urinary tract infection is E. coli, a bacterium that lives in the colon. Enterococcus is another colon bacterium, a much less frequent cause of urinary infection. If you’re not having any symptoms of urinary infection, like painful urination, you might not require any treatment. Diet isn’t involved.

If you do need treatment, the antibiotic Monurol (fosfomycin) works for Enterococcus. Or you could possibly be desensitized to one of the medicines you are allergic to.

DEAR DR. DONOHUE: My mom, 73, has high blood pressure. Two weeks ago, while out at dinner her hands started shaking, and she fainted at the table. She came to in a few minutes. The next day, I had her take her blood pressure, and it was 190. I made her go to the ER, and her pressure there was 248. They admitted her and ran all kinds of tests, including an MRI of the brain. All the tests came back negative. The doctor increased her medicine and added a water pill to her treatment.

She now takes her blood pressure three times a day, and it’s always around 140/80. Isn’t this still too high for someone on medication? Can she have a stroke?

ANSWER: Your mother’s previous systolic pressures (the first number of a blood pressure reading) were in the danger zone. Her current readings are not. They are pretty good. Sometimes lowering blood pressure too much can be too great a change for a person who has had high pressures. You and she can be satisfied with her present blood pressure.

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 www

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