Should I worry about my bowel habits? I only poo once every four days

ARE you among the 13 per cent of the population who smokes?

I know you’re already aware that smoking is horrible for your health, but in recent weeks, Cancer Research warned that cancer cases caused by smoking are at an all-time high, with 160 people diagnosed daily.

Olivia West

A University College London study found smokers’ brains age faster, with memory declining by as much as 85 per cent over ten years.

Stopping smoking is hard and, often, people want to kick the habit but don’t do so until they experience a “wake-up call” or similar.

I’m not here to judge, as that does not help.

But I do want you to know that help is available through your local NHS stop smoking services which you can access via pharmacists and GP surgeries.

You can get medication or free nicotine replacement therapy (gum, sprays).

Accessing this type of support trebles your chances of quitting.

I’ve also heard that Allen Carr’s book EasyWay to Stop Smoking has helped many smokers to quit.

Should I worry about my bowel habits?

Q) IS it healthy that I only poo once every four days ?

A) It’s usual for some people to open their bowels infrequently compared to others, but the general advice is that it’s normal to open your bowels anywhere between three times a day and three times a week.

Therefore, you are less regular than is considered normal.

If you presented to me in clinic, the first thing I would want to know is, “Is this normal for you?”.

If it is, you have no symptoms and you have a healthy diet and lifestyle, then I would happily reassure you that I wasn’t concerned.

If there were also symptoms of constipation, I would want to know a little more – which I’ll go into.

But if this is new for you, then I would say to discuss it with your GP.

Any changes to our toilet habits, whether it be going more frequently or less, experiencing loose stools , diarrhoea or constipation , are considered a potential warning sign of bowel cancer.

For many, there is likely another cause, such as constipation.

Many people think of constipation as not being able to go at all.

However, you may sometimes go, but the stool is made of small lumps, is dry, hard or difficult to pass.

It can also cause bloating, feeling sick and having a stomach ache.

Good hydration and regular exercise are ways to keep your bowel movements regular.

If you’re not drinking enough – I’d advise someone with constipation to have at least two litres per day – or if you’re particularly sedentary, add more movement to optimise the performance of your intestines.

Food is pushed through the long tube that makes up our gut by muscular, wave-like contractions called peristalsis.

If we move our bodies, be that a walk, hoovering, gardening or some stretches, we increase peristalsis and food (eventually stool) moves through easier.

Pelvic floor weakness and, in women, certain times of the menstrual cycle, can slow bowel movements.

Tip of the week

IF you find your bedroom too hot at night and struggle to sleep as a result, keep the curtains closed during the day.

And if you have a loft, leave the hatch open to draw hot air upwards.

Whether to sleep naked is often contested. I say do whatever you find most comfortable.

Fed up with lack of help for PMDD

Q) I HAVE premenstrual dysphoric disorder . Why will no one help me and what can I do about the symptoms?

A) PMDD is a severe form of PMS. It can be utterly debilitating for the women who live with it.

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Symptoms occur in the lead up to your period, sometimes for two weeks, and can include severe mood swings, anger and irritability, anxiety, a sense of hopelessness and suicidal feelings.

You may find it hard to avoid conflict and have a sense of rejection.

In fact, I’ve heard women describe it as though each month a monster takes over their body for a week or so and then they spend the rest of the month putting their life back together.

The symptoms are down to fluctuations in hormones, so strictly speaking this is an endocrine condition rather than a mental health one, even though severe mental health symptoms are often a feature.

To get diagnosed, it’s best to keep a symptom diary for at least two months, and look at the resources on mind.org.uk.

It is poorly understood, even by healthcare professionals, so ask if there’s a doctor or nurse who specialises in mental health or women’s health at your GP practice.

Treatment options include talking therapies – which you can self-refer to – antidepressants, oral contraceptives and hormone injections.

Self-care options like exercise and a healthy, balanced diet can sometimes make the condition more manageable.

Make sure your sleep pattern is regular and restorative. Spending time in nature may also decrease symptoms.

You’re not alone – look for communities on social media and forums and see what has worked for them. Some supplements may help ease symptoms like anxiety.

Explaining to loved ones and those at work what you’re experiencing can make a difference, too.

Bad circulation

Q) I AM struggling to walk due to peripheral neuropathy.

My circulation is really bad, first pointed out by my chiropodist who pressed on my toes to show how slowly the colour comes back into them.

The doctor just said: “There is no cure, keep your feet warm.”

It is worse at night when they get very hot, with stabbing pains in my toes.

What can improve my circulation?

A) It sounds as though there are two separate symptoms to discuss.

Firstly, peripheral neuropathy does fit with much of your description.

Most commonly, symptoms start with tingling or numbness in the toes and can spread to the rest of the foot and then cause burning, throbbing and/or shooting pain that may worsen at night.

Yes, it is true that in most cases, peripheral neuropathy has no cure.

But symptoms can be somewhat managed with medication or other therapies.

The other symptom that you mention is the poor circulation.

Sometimes the veins no longer do a great job of taking blood away from the feet, and this can cause swollen feet, varicose veins or brownish discolouration to the skin.

But sometimes, if arteries which supply oxygenated blood to the legs and feet are blocked and not working properly this can be a more serious problem which requires treatment.

We use the term “claudication” to describe the pain that comes from poor blood supply.

Usually, people complain of leg pain when walking up a hill, but some people have pain in the legs or feet at rest, especially when in bed, because the gravity which helps the blood flow downwards has been removed.

Patients often feel the urge to hang their feet out of the bed at night.

If you think you may have this type of circulation problem you can ask your GP or nurse to arrange a test, called ABPI to check the blood flow to the feet.