Your Guide to Colon Health - Consumer Reports
Your colon plays a vital role in your well-being, absorbing nutrients and fluids from food and helping your body get rid of what you don’t need. But when problems arise, you may be reluctant to seek help. In one 2020 study published in the American Journal of Gastroenterology, just 38 percent of people with chronic constipation had ever reported their symptoms to their healthcare provider.
“Many people shy away from these topics, but they shouldn’t,” says Kyle Staller, MD, a gastrointestinal specialist at the Harvard Medical School. “Many of these seemingly embarrassing health conditions are solvable.” But some may signal serious diseases, like colorectal cancer, and need to be addressed.
Here are some common problems and strategies to deal with them.
Between 12 and 19 percent of adults in the U.S. are estimated to have chronic constipation, or a bowel movement less than three times a week for at least three months. It’s more likely to occur in women and in older adults—about 34 percent of women aged 65 and older experience constipation, according to Wolters Kluwer’s UpToDate, an online decision-making tool for healthcare professionals. Whatever your age, if you’re dealing with chronic constipation, see your doctor, who may want to examine you for contributing problems like anal fissures or hemorrhoids.
About 3 to 7 percent of adults report chronic diarrhea, or at least three daily loose stools for more than four weeks. It’s important to see a doctor for this problem because it can lead to dehydration or malnutrition.
Your doctor will want to check for autoimmune diseases such as Crohn’s disease and ulcerative colitis. Because those conditions can develop if your immune system attacks your digestive tract, you might be prescribed drugs to suppress your immune system.
Another possible cause is overflow diarrhea, where waste matter builds up in the colon and liquid stool leaks around harder stool, says Michelle Hughes, MD, a gastroenterologist and an assistant professor at the Yale School of Medicine. That requires a doctor’s visit and the use of laxatives to resolve the problem.
Some older adults may experience more significant leakage of stool—known as fecal incontinence—due to nerve damage from type 2 diabetes, a back injury or surgery, or, in women, pelvic muscle and nerve damage from vaginal births years earlier, Burke says. This is usually treated with a course of antidiarrheal medication such as loperamide (Imodium), pelvic physical therapy, and regular use of a psyllium fiber supplement.
Lactose intolerance (trouble digesting the natural milk sugar in dairy products) and bacterial overgrowth in the small intestine (which connects to the colon) can cause excess gas and uncomfortable bloating. For some people, regular use of proton pump inhibitors for heartburn (like Nexium and Prilosec) can also be a factor in the latter condition.
Unsure of the cause? You might try lactose-free dairy products or opting for milk supplemented with lactase (an enzyme that helps break down the milk sugar lactose). If that doesn’t make a difference, consider cutting out other common gas producers one at a time. They include fructose (in juice, sports and energy drinks, soft drinks, and fresh fruit); legumes; cruciferous veggies like broccoli or cabbage; and fructans (onions, peppers, asparagus).
If avoiding those doesn’t do the trick, see your doctor, Chey advises, to be screened for conditions like irritable bowel syndrome. Working with a nutritionist to follow a low FODMAP diet, which involves cutting out dairy, wheat, and certain fruits and vegetables, may offer a solution.
Because the bowels should be empty for a colonoscopy, you might be advised to drink up to a gallon of prep (water mixed with a laxative) the day before. If this is challenging, Lacy advises that patients go on a clear liquid diet for two days before, adding a teaspoon of the laxative polyethylene glycol to each 8-ounce glass of liquid consumed. That helps reduce the GI tract’s workload and jump-starts colon emptying, so you might need less prep. Plus, “you can mix the prep with ginger ale, 7UP, apple juice, lemonade—any clear liquid that appeals to you,” he says, noting that varying the flavors can make drinking the prep more palatable.
Also, ask about a prep that requires less total liquid, or about splitting the prep up, consuming half the night before and the rest 4 hours before the colonoscopy. (For an afternoon exam, you can down all of the prep the morning of the procedure.)
For more on when to get your first colonoscopy—a common screen for signs of colorectal cancer—see our article on colon cancer screening. But if you’ve already had at least one colonoscopy, most people don’t need another for 10 years. The exceptions:
Tell your doctor right away if you have potential symptoms of colorectal cancer, like blood in your stool, a sudden change in bowel habits, or unexplained weight loss. If you’re over age 75, ask about whether to continue colorectal cancer screening.
A version of this article also appeared in the April 2022 issue of Consumer Reports On Health. It was updated with additional information in May 2025.
Hallie Levine
Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.