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Laxatives

What are laxatives?

Laxatives are substances that stimulate the excretion of feces from the bowels.

What are they for?

Laxatives are used to help relieve constipation—irregular, infrequent and/or difficult evacuation of the bowels. Before taking a laxative, make sure you really are constipated.

Signs of constipation include:

· Hard stools

· Difficulty passing stools (straining or pushing too hard)

· Passing stools les frequently than usual (Remember, one bowel movement every two or three days is normal for some people and does not automatically indicate constipation. Compare your current bowel movements to what is normal to your typical pattern, not someone else’s)

How do laxatives work?

Laxatives come in three different forms: bulk-forming, stimulant and osmotic.

Bulk-forming laxatives swell up inside your intestines. This swelling softens and increases the volume of your stools. This increase in volume urges your bowels to move, thus pushing the stool out.

Stimulant laxatives speed up the movements of the intestines, usually in about 8-12 hours.

Osmotic laxatives reduce the amount of water absorbed from your bowel, thus increasing the amount of water in your stools. This water softens your stools, making them easier to pass.

Are laxatives safe?

For occasional use, yes. However, the over-use of laxatives can cause your bowels to become 'lazy' and not function properly. If you are in fairly good health, you should not need to take laxatives regularly.

Who should take laxatives?

In general, laxatives should be reserved for people in the following situations:

· Illnesses that can worsen from straining to pass stool (eg. Angina)

· Hemorrhoids

· Constipation induced by prescription drugs (eg. Codeine) or illness

· Constipation induced by lack of mobility (eg. The elderly)

· Intestinal worms

· Pre-operative patients who need the digestive tract cleared before surgery

Laxatives should not be given to children unless prescribed by a doctor.

Which laxative is best for me?

What are the side effects?

Who should use laxatives with caution?

Use a laxative with care if you:

• have a narrowed and/or improperly functioning intestine
• are elderly or incapacitated (some laxatives can alter the balance of fluid and important body chemicals, such as sodium and potassium. People who are frail or ill might be unable to adjust to these alterations)
• have kidney or liver disease (especially with laxatives containing magnesium salts. Malfunctioning kidneys or liver can build up an excess of magnesium)
• are pregnant or breast feeding

Who should avoid laxatives?

Do not use laxatives if you are:

• A child
• Sensitive to gluten or have coeliac disease
• A sufferer of an inflammatory diseases of the intestines (eg. ulcerative colitis)
• Taking any other medications, including herbal remedies

How to use a laxative Bulk-forming laxatives come as powders, granules or tablets. They must be taken with plenty of fluids to ensure your intestines do not get blocked. Unprocessed wheat bran taken with food or fruit juice is a very effective bulk-forming laxative.

Stimulant laxatives come as tablets, suppositories, capsules, liquids and enemas. Senna has been used for centuries as a stimulant laxative.

Osmotic laxatives come as powders, liquids or enemas.

Laxatives of each of the three basic types can be bought without a prescription. Laxatives should only be used for short periods of time; discontinue using them once your bowel movements are back to normal. Then, you should keep your bowel movements regular by eating a balanced diet with plenty of fluids and fibre. When you are taking a stimulant laxative, start with a low dose and build up gradually until you feel comfortable when you pass a stool.

Examples of laxatives

• Milk of Magnesia (MOM) draws water into the colon. Use only as instructed to avoid an imbalance in your body's electrolytes (salts).

• Docusate laxatives allow water and fat to soften the stool. Mineral oil works in the same way.

• Castor oil works as a stimulant laxative.

• Enemas expand the rectum and flush out stool. These should also be used very rarely, if at all, unless recommended by your physician.

How to avoid constipation Ideally, you should not get constipated at all. To avoid constipation:

• Drink plenty of fluids (about 2 litres a day)
• Eat foods high in fibre, such as fruit, vegetables and whole grain cereals
• Exercise regularly
• Do not fight the urge to pass a stool
• Consult a doctor about any sudden changes in bowel movement, such passing blood when you pass a stool, pain, or changes in frequency or difficulty of passing a stool

Laxatives and Diets

A too-common misconception is that laxatives are an effective diet aid. Using laxatives to lose weight has proven both ineffective and dangerous. Laxatives are more likely to make you gain weight and, in the long run, can even lead to obesity. The excessive, every day use of laxatives exhibited by some dieters can lead to chronic diarrhea, which in turn can rob your body of vital vitamins and minerals. Overuse can also lead to bloating, cramping, dehydration, electrolyte disturbances and imbalances, cardiac arrhythmias, irregular heart beat and heart attack, renal problems, and death.