The colon is an important organ containing trillions of micro-organisms whose collective genomes known as microbiota or microbiome, like finger prints, are unique to each individual. Its functions in absorbing water, and storing and discharging waste, are well known. Surprising as it may sound, we are only beginning to realise its role in manufacturing nutrients, vitamins and hormones, breaking down and diluting harmful chemicals and carcinogens, controlling overgrowth of harmful bacteria, viruses and fungi, and modulating the development of our complex immune system as well as our brain and behaviour. In addition to colorectal conditions like diarrhoea, constipation, cancer, Inflammatory Bowel Disease, Diverticular Disease and Irritable Bowel Syndrome, the colon is also implicated in conditions such as obesity, allergies like eczema and asthma, autoimmune diseases like diabetes and rheumatoid arthritis, and mental illnesses like anxiety and depression. A healthy colon is therefore essential to a healthy life.
Common questions on colonic health
1. Do I have to open my bowel everyday?
Not all normal people evacuate everyday. Some go once every three days and some three times a day. This range is normal provided that this is the regular habit and the bowel movement is normal.
2. What is constipation?
Constipation is defined as having two of the following symptoms:
• Passing hard and small lumpy stools
• Straining to pass stools
• Sensation of incomplete defecation
• Less than three evacuations per week
Therefore, you can still be constipated even if you go everyday.
3. What is a healthy diet?
A healthy diet is a balanced diet of fruits, vegetables, fish and meat including red and processed meat provided this is less than half a kilogramme per week. There should also be adequate water or fluid intake. It is inadequate when the urine is concentrated.
4. Do I need to take vitamins and mineral supplements?
It is not neccesary in a healthy individual but essential in malnourished patients and in special circumstances, like Vitamin D in regions with inadequate sunlight, in elderly with osteoporosis and during pregnancy.
5. Do I need regular probiotics for healthy colon?
Again, in a healthy individual, it is not necessary but it is helpful in cases of traveller’s diarrhoea, antibioticassociated diarrhoea and after major colon surgery.
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6. Why do I get diarrhoea after taking antibiotics like ampicillin?
Some antibiotics like ampicillin kill the bacteria in the gut indiscriminately allowing harmful bacteria, like Clostridium Difficile, to flourish and cause diarrhoea. This is a major problem in hospitals where very sick patients are prescribed with many powerful antibiotics giving rise to major infection and inflammation of the colon. There are very few
antibiotics to counteract the bacteria which are increasingly resistent. This has prompted the use of treatment with faeces from healthy people (faecal transplant) which have recently caught the eye of the popular press.
7. The colonic microbiota is important. When and how do we
acquire it?
Before birth the colon is sterile but by age three, the child’s colon microbiota has fully imprinted and developed. A baby by natural birth takes one month to stabilise the colonic microbiota while it takes six months for a baby by Caesarian section. A breast-fed baby has different bacteria than a bottle-fed baby. Whether this has an impact on the child’s health is still being studied and debated.
8. Do I need regular colon cleansing or coffee enemas to “detox”
my body?
The concept of purging the colon clean to detox is wrong. From evolutionary, physiological and genetic studies, we now realise the importance of our gut micro-organisms to our health. There is increasing evidence to show that for colorectal surgery, patients who do not undergo colon cleansing have less complications than those who do, and the successful use of faecal transplant in the treatment of badly inflammed colon from toxins of harmful bacteria prove the benefits of healthy colon bacteria. Therefore, colon cleansing or coffee enemas not onlydo not detox but can actually be harmful.
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