Cohen comforts his patients by assuring them they are not alone. “I tell them this is perfectly normal at their age,” he said. “Maybe 50 percent of people experience this.’’
He starts by prescribing a change in diet and an increase in fruits, vegetables and whole grains. When that doesn’t do the trick, he prescribes stool softeners and fiber supplements. The point is to increase the daily fiber intake to 25 to 30 grams. Most people only eat 15 grams of fiber daily.
The second biggest complaint Cohen hears from older patients is acid reflux, which he estimates affects anywhere from 10 to 20 percent of his patients (Leavitt puts the number higher, at 40 percent). Again, Cohen will start with asking patients to look at their diet and eliminate high-acid foods and drinks like orange juice, coffee and tomatoes. Still, he acknowledges that rarely works.
“There are dozens of foods and drinks that are high in acid,’’ he said. “If people stopped having everything in that category, there would be nothing to eat.’’
Cohen frequently prescribes acid-blocking medicine such as Prilosec and Nexium, which can now be purchased over the counter.
“Everyone at some point has had these symptoms, but it happens more as they get older.’’
Just ask Rosy Lopez. The Fort Lauderdale marketing manager never had digestive issues until 2009, when, after Thanksgiving dinner, she started feeling sick to her stomach. She didn’t sleep the entire night and the next morning, at 6 a.m., she asked her husband to take her to the emergency room at Baptist Hospital.
Lopez was diagnosed with gallstones, which had become dislodged and gotten infected. Surgeons could not operate to remove the gallbladder until the infection cleared up, two nights later.
Additionally, the gastric acid was so strong it had seriously burned Lopez’s esophagus. It took months for her esophagus to heal.
Since then, Lopez, 47, has suffered from acid reflux. She has altered her entire diet, eliminating coffee, most meat and anything oily or fatty. She also takes an acid-blocking medication, Protonix, daily.
“I really, really watch what I eat now,” Lopez said. “But every once in awhile, I give in to the urge for a nice big chocolate shake.”
Yet another condition that a small percentage of people can develop in middle age, according to Miami Beach cardiologist Dr. Arthur Agatston, is celiac disease, which is an inability to process gluten, which comes from grains and additives in foods such as salad dressings, soy sauce and soups.
Agatston, creator of The South Beach Diet, is now addressing gluten sensitivity in his new book, The South Beach Diet Gluten Solution. He is medical director of wellness and prevention at Baptist Health South Florida.
“Whatever age you are, if you are having irritable bowel syndrome or diarrhea, you should be tested for celiac disease,’’ said Agatston, whose uncle was diagnosed with celiac disease in his 70s.
Even if a patient tests negative for celiac disease, Agatston recommends anyone suffering from gastric problems like IBS, bloating or acid reflux to try removing gluten from their diet for one month and then gradually phase it back in.