Koreans confront bowel trouble with new remedies

For the first time since he was sent to the principal’s office in third grade, Kyung Hun-ki felt as if his heart had slipped down into his stomach as he dragged his feet to the president’s office.
The 37-year old Web designer who worked at a medium-sized design firm in southern Seoul almost jumped with surprise at the resounding sound that his knock made on the wooden door.
“What’s wrong?” barked Mr. Kyung’s short-tempered, stingy superior, whom we will only identify as Mr. Shin.
“I’d like to take a couple days off next week,” Mr. Kyung said. “You can deduct it from my summer leave.”
Mr. Shin’s face soured as he asked why.
“Actually, I’m having an operation.”
“For what?”
“Um... hemorrhoids.”
Mr. Shin’s response was far from what the designer had expected. Looking extremely worried, the president whispered, “Constipation?”
Mr. Kyung nodded.
“Internal or external?”
“External.”
Mr. Shin cringed. “It must be painful. I myself had an operation a year ago.” He went on in a gossipy manner to relate his own experiences, later giving Mr. Kyung advice and permission to take off work.
Mr. Kyung added that when he returned from the hospital, his affliction was no secret, and several co-workers came to comfort him, admitting that they had had operations.
“I didn’t know hemorrhoids were such a common disease,” Mr. Kyung said.
Unfortunately for Koreans, “common” is an understatement. According to a report released by the Health Insurance Review Agency in May, hemorrhoids topped the list of insurance-covered operations in the first quarter of this year. Statistics from the National Health Insurance Corp. show that 25 percent of Koreans have hemorrhoids.
Hemorrhoids are abnormally swollen veins in the rectum and anus, and symptoms are swelling, itching and bleeding. Although there are many causes, the most common is sitting for a long time, especially on the toilet, and strained bowel movements from constipation. Constipation is difficulty in having a bowel movements because of various reasons, the most common being a lack of three factors ― fiber in one’s diet, liquids, and exercise.

Although it used to be an embarrassing subject, Koreans are talking more openly about constipation and constipation-related problems.
In the popular television drama “My Name is Kim Sam-soon,” the main male and female character discuss constipation problems.
In a recent television advertisement, a young woman looks at the camera with daring eyes and a sexy pose. A fan placed somewhere behind the camera is blowing her long black hair wildly behind her in a sensual manner. “If you don’t come out, I’m barging in,” she says.
This may not be an exact translation, since Korean sentences can still make sense without the subject. A more literal translation would probably be “If (blank) doesn’t come out, (blank) is barging in,” leaving it up to the listener to fill in the blanks.
What looked like an invitation to a party or publicity for some kind of match-making agency, however, was actually an ad for a yogurt drink called Quebyeon, which literally means “feeling refreshed after going to the bathroom and relieving oneself.”
While the advertisement for Quebyeon stirred public interest due to its bluntness, it wasn’t the first product in the dairy market catering to constipation sufferers.
Yogurt is one of the main products in Korea’s extensive “constipation market,” which has more than 30 different brands of yogurt drinks alone.
Pasteur Milk, the dairy company that produces Quebyeon, has several other yogurt drinks chock-full of fiber and lactic acid, compounds makers claim prevent and cure constipation. Other companies like Namyang Dairy and Maeil Dairy also have similar products. A pricey 400 milliliter bottle of the yogurt drink that contains cactus and chlorella can cost up to 3,600 won ($3.40).
Pharmaceutical insiders say the domestic laxative market is approximately 41.3 billion won, with more than 100 types of laxatives sold in drug stores nationwide.
According to Park Hee-jeong, an official at Boehringer Ingelheim Korea, a pharmaceutical company that makes laxatives, about 25 percent of Koreans suffer from constipation ―the same as the United States ― but it has a high chance of rising.
“We’ve seen a 15 percent sales growth in laxatives over the past five years,” Ms. Park said. The company’s main laxative product, Dulcolax, is sold in 37 countries around the world, with sales figures in Korea ranking third after the United States and Germany.
The market for constipation-related products is also huge, with items such as chair cushions with holes in the center for people who have hemorrhoids, vibrating belts to assist in bowel movement and thousands of dietary supplements sold both in regular stores and on the black market.
Of course, it goes without saying that hospitals are benefiting from those afflicted. Kim Eop, who runs a promotion agency for private clinics, said clinics that treat the affliction are earning the most money among private hospitals.
“I can’t reveal the name of the hospital, but let’s just say that the ones I know are paying at least 10 million won every month for just online advertising,” he said.
Evidence of Koreans’ obsession with well-functioning intestines are efforts to create, or rather, discharge nice-looking excrement.
In the book “Banana Poo,” intestine specialist Oh So-hyang emphasizes that it is important to examine the contents of the toilet after doing a No. 2.
“In the well-being age, we must make an effort to produce pretty poo,” she says. The book goes into detail about constipation, hemorrhoids, and how to analyze one’s health by looking at the color, shape, and texture of one’s feces. There are also seven guidelines that will help one make banana-shaped poo, such as eating “green foods” that have a lot of fiber such as vegetables and seaweed.

Why are Koreans so constipated? According to Yang Hyung-gyu, a specialist in intestinal ailments, changing eating habits combined with sedentary lifestyles are causing more Koreans to become constipated.
“The number of people that have constipation is rapidly growing, especially among women,” he said. “About 30 percent of all women experience constipation. People should eat vegetables and coarse wheat that contains a lot of fiber, but more are eating processed wheat, meat and instant foods.”
Choi Kyung-cheol, an official at Namyang Dairy, pointed out more specific changes in Koreans’ diet.
“The fermented milk market in Europe or the United States is about eight times bigger than that of Korea; people in the West consume about 10 times as much fermented milk products such as cheese and yogurt. Koreans are eating less kimchi, which contains lactic acids since it is fermented, but they aren’t drinking as much milk as Westerners,” he said.
Although it is not certain whether the growing level of constipation among Koreans is a local issue or one in context with global changes, it is evident that Koreans are indeed more concerned about what goes on in their intestines.
“Everyone is concerned about health, but Koreans, in particular, are more interested in eating and drinking special foods to cure the diseases than thinking of preventing them in the first place. This applies especially with constipation; there is even a popular saying that well-being is well-byeon (byeon = excrement),” Mr. Choi said.

Are you constipated?

1. How often do you have bowel movement?
(1) Once a day
(2) Twice a week
(3) Once a week
(4) Two to three times a week
(5) Once a month

2. How much time do you spend on the toilet for a bowel movement?
(1) Under 5 minutes
(2) 5-10 minutes
(3) 10-20 minutes
(4) 20-30 minutes
(5) more than 30 minutes

3. How many times in a day do you fail to move your bowels?
(1) Never
(2) 1-3 times
(3) 4-6 times
(4) 6-9 times
(5) 10 or more

4. How long have you had constipation?
(1) less than 1 year
(2) 1-5 years
(3) 5-10 years
(4) 10-20 years
(5) 20 or more years

5. Do you have pain during a bowel movement?
(1) No
(2) Once a month
(3) 2-3 times a month
(4) 2-3 times a week
(5) More than once a day

6. How often do you feel unrelieved even after a bowel movement?
(1) Never
(2) Once a month
(3) 2-3 times a month
(4) Once a week
(5) At least once a day

7. How often do you feel you strain or experience difficulty during a bowel movement?
(1) Never
(2) Once a month)
(3) 2-3 times a month
(4) Once a week
(5) At least once a day

8. What supplements do you use to assist bowel movement?
(1) None
(2) Laxatives
(3) Enema

Add up the numbers:
14 or lower: Normal
15-19: Minor constipation
20-24: Constipation
25 or more: Severe constipation (see a doctor)
[Test courtesy of Hansol Hospital]

by Wohn Dong-hee