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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35023
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Integrative expert experience in meal planning constipation

Customer Question

Integrative expert experience in meal planning constipation conflicting opinions, digestive aids, to ensure better absorption and effective efficient bowel elimination and the prevention of impaction and constipation. I need a very detailed diet that is guaranteed to produce regularity in an elderly person that eats very little and doesn't like to be told when and how much liquid to drink. The diet must not have a lot of carbohydrates because they easily become itchy.

I have questions such as; why does prune juice or prunes recommended for constipation,, or why do some people say psyllium makes them constipated? OR why do some people drink 8 glass of water a day and do not have bowel movements and eat enough fiber? Why do some people eat very little fiber and have bowel movements without constipation?

Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello and welcome.

If you wish, I can help you here. We have interacted many times before.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Hope your mother is doing good.

Let me know if you have questions.

Customer: replied 1 year ago.

Hi there. CAn you describe, how you have worked with elderly female women that also wear pessary rings for a dropped bladder into their old age and if you succeeded with diet alone, to produce regularity with bowel movements.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello and welcome,

I do following measures with the elderly with dropped bladder:

1) Start Psyllium Husk

2) Also start Flax seeds.

3) Occasionally use suppository.

4) Start pelvic floor strenghtening exercises (please see the reference resource to learn them):

And do following dietary measures:

1) Increased fluids

2) Prune juice and dried plums

3) Increased fiber; prepration like Benfiber can be tried.

4) An herbal tea, "Smooth Move," have been found to have good result in moving the bowel.

5) Toilet after meals; Toileting 15 to 30 minutes after eating makes use of the gastrocolic reflex. The gastrocolie reflex results in propagating spikes in the colon and rectum within a half an hour after a meal. When we eat, our stomach distends and this sends reflex signals to the large intestines (colon) facilitating for their movements. If one utilizes next half hour of meal, for toilet, the stool elimination time is decreased.

6) Increase in exercise

7) Stimulant laxatives stimulate intestinal motility and increase intestinal secretion. They are anthraquinones (cascara, aloe, and senna) and diphenylmethanes (bisacodyl, sodium picosulfate, phenolphthalein).

8) Avoidance of stress

9) Wheat bran, 20 gms per day can decrease the rectal transit time

10) Vegetables,

11) Fruits (especially dried fruits)

12) Cereals like whole wheat, bran or oatmeal

13) Celery

14) Grainy breads, such as whole wheat, rye or pumpernickel

15) Legumes, such as chickpeas, baked beans and lima beans

16) You can try ground flaxseed sprinkled on salads, cooked vegetables, and cereals.

Food which cause constipation and should be avoided are;

Ice cream


Meat / Red meat

Chips, cookies and pizza


Foods that contain white flour


Junk food or fast food


Let me know if you have questions.

Customer: replied 1 year ago.

You already gave me a list like this.

I need a specific sample of a time line from the time a person wakes up until they go to sleep and what the portion size should be and how much time between a drink and a meal and what time a person should eat the prunes the psyllium etc...

Expert:  Dr. Arun Phophalia replied 1 year ago.

You may choose from the following plan;

The portion sizes are according to an individual's appetite;


Fresh fruits or dried fruit

Half a bowl of bran cereal OR wholemeal cereal OR rolled oats with milk OR muesli

Wholemeal toast or muffin spread or margarine

Baked beans or creamed corn


Mixed grain sandwich with lots of salad and chicken, salmon, tuna, cold meat, eggs, cheese or baked beans OR

Whole meal bread, lentils, vegetables any one or two from above.


Grilled fish or chicken or lean meat

Hhigh-fibre vegetables (corn, peas, cabbage, Brussels sprouts) OR bean salad

Rhubarb and apple crumble

Between meals (can pick from any of these)

Fresh fruit, dried fruit esp 5-6 prunes, fruit and nut trail mix, nut bars, wheatmeal biscuits, bran biscuits, cake made with wholemeal flour or bran or bran cereal, brown rice cakes or rye crispbread with peanut butter, air-popped popcorn, apple or pear, with the skin OR other fresh fruit, serving of brown rice or jacket baked potato.

Also please remember that constipation in her age can be due to following reasons;

1) Sluggish intestinal movements.

2) Pelvic floor abnormalities.

3) Prolapse causing obstructive constipation.