Dear Dr. Roach: Several months ago, you had an article in the paper about an 82-year-old man who had a constipation problem. You mentioned a couple of medications to take. I am an 82-year-old man, and just shortly after that article I became constipated for a couple of days. My wife told me to take ex-lax; I took it for two or three days, and it worked. Three days later, I had it again, so I took another ex-lax or two, and it worked again.
I was sitting in my recliner a couple of days later when I remembered when I was in my late teens and had the same problem. My mother told me to eat some prunes — wow, does that work. Wouldn’t eating prunes be more healthy than taking drugs? My wife and I have been eating three or four prunes every evening since then, and I have had no problem. We read that eating prunes every day also makes our bones stronger. Is this really true, and how many should a person eat daily? — R.F.P.
Answer: Some over-the-counter constipation drugs used to contain phenolphthalein, which is not safe for long-term use. Occasional use of senna or docusate (the active ingredients in most OTC brands) is fine.
Prunes are a very effective treatment for constipation for many people. They are a fruit, but being dried, are higher in sugar than many others. Three to four prunes a day seems reasonable to me, and is effective for many people to treat constipation.
A recent review of studies on the effects of prune eating on bone mineral density suggested that there is some benefit. However, the studies were neither consistent nor of high-enough quality that I would recommend prunes solely for their purported benefit on bones.
Moreover, most of the studies used about 100 grams of prunes per day: 10-12 average-size prunes. This is a large sugar load (less than a typical soft drink, however), and it also might cause some abdominal distention, especially if a person started out eating 10-12 prunes a day; it’s smarter to increase fiber intake gradually.
Dear Dr. Roach: I am a 70-year-old senior in fairly good health, but I am losing my teeth and need many implants. I read in a well-known U.S. newspaper and on the internet that full-mouth X-ray can cause brain cancer. My dentist does not give me a direct answer, and I am afraid. Does the old-fashioned dental X-ray have a lower intensity? — K.L.
Answer: The amount of radiation in a dental X-ray is very, very low. The unit of radiation in this context is the millisievert (mSv), and a regular, old-fashioned bitewing X-ray in your dentist’s office is about 0.005 mSv. Just walking around in a day, we get about that amount from natural sources. A full-mouth or panoramic dental X-ray is about 0.01 mSv, but that is still less than a chest X-ray, which is 0.1 mSv. By comparison, a CT scan is equivalent to 4,000 or so dental X-rays.
While it is wise to be concerned about radiation from medical procedures, the radiation in dental X-rays is very small, and the risk of developing brain or other cancer is extremely small.
The thought should not keep you from getting the dental work that is so necessary for the quality of life of many people, including seniors. I’d advise taking whatever X-ray the dentist thinks is best.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or at 628 Virginia Dr., Orlando, FL 32803.