Dear Miss Nurse: Here's my body's metro traffic report. The cars are bumper to bumper below my beltway. In fact, nothing has moved for days. What counsel have you for a decidedly cursed case of constipation?

--End of the Road

Dear End:

Goodness gracious, it does seem that readers appeal to me with more than their fair share of poop-chute problems, doesn’t it? Sometimes I think I should enroll in night courses in proctology just to keep up with these queries. But if I did, when would I find time to pursue the amateur study of Italian transvestites of the cinquecento? Here’s what I do know about bowels that won’t budge:

Constipation is this country’s number one gastrointestinal complaint. Get a load of this: Some 4.5 million Americans report being constipated most or all of the time. A diet high in fiber-poor processed foods and lack of exercise are leading causes of a clogged tailpipe. Others include: low fluid intake (water and juice help to “round out” the stool and lubricate its journey through the colon); some medications (particularly narcotics, aluminum--containing antacids, iron supplements, antispasmodics, diuretics, anticonvulsives and some antidepressants); life passages (such as aging and pregnancy, which cause metabolic or hormonal changes); the condition known as Irritable Bowel Syndrome (or spastic colon) and a number of diseases (multiple sclerosis, Parkinson’s Disease, stroke, lupus, diabetes and thyroid conditions). Other culprits are ignoring the urge to “go” and “holding it” until it passes, and overindulging in laxatives and enemas, which can damage the colon’s nerve cells and impair the contractions that cause you to “move.”

How did Mussolini keep his trains running on time? An iron fist. But Nurse advises a softer touch. Con-suming 20 to 30 milli-grams of fiber every day makes for a healthier stool and a happier you. High-fiber foods include beans, bran cereals, and fresh fruits and veggies such as apples, bananas, asparagus and carrots. (Cooking tip: Mix bran or whole grains into your favorite casserole and meatloaf recipes to boost fiber content.) And start hydrating, sweetie, by upping your intake of water, juice and clear soups to eight to 10 glasses a day. Natural bulk supplements such as psyllium and hemicellulose may also do the trick. (“I give birth to a small child every morning,” reports one of Nurse’s psyllium-silly sisters.) And you may want to try magnesium supplements (500 to 1,000 milligrams a day) since deficiency of this key mineral—common among HIVers—is a big-time constipator.

Of course, some form of daily exercise is also key, for a variety of health and beauty benefits. And do devise ways to have quality time on the throne; remember, Rome wasn’t built in a day!

If your daily dose of prune juice isn’t breaking up the logjam, don’t lunge for the laxatives without first checking in with your doc. Laxatives come in many forms and flavors—liquids, tablets, gums, suppositories and powders—and work in different ways to clear your road. Bulk-forming types such as Metamucil, FiberCon and Citrucel, taken with water, are safest, though they can interfere with absorption of certain medications.

Contraction-stimulating laxies include Correctol, Dulcolax, Purge, Feen-a-Mint, Senokot and senna. Members of the stool-softening variety are Colace, Dialose and Surfak. And Milk of Magnesia, Citrate of Magnesia and Haley’s M-O help move things along by drawing water into the colon. Caveat emptor: Laxatives can be habit forming, and Nurse knows of no 12-step programs to help kick them. Finally, know that constipation is rarely serious, and overtreatment may aggravate rather than relieve. Strive—don’t strain--for well-formed, soft bowel movements, preferably a couple a day. To that end, I'll see you in the produce department, dears.