Laxative use has been continually on the rise in recent years, and an ever-increasing number of people are reaching for a quick fix for their not-so-pleasant issue. What many fail to realize, however, is that constipation is not actually the problem but merely the symptom of an unhealthy lifestyle. Studies estimate that 40% of laxative users abuse these strong medications, resulting in serious health effects over time.  As laxatives are considered over-the-counter medications, the products are easy to access by people of all ages. Side effects such as decreased bowel motility and constipation are just two of the many health outcomes of chronic laxative use. 
12 Facts About Laxatives
Here are some of the most common (and not-so-common) facts associated with laxative abuse. While some of these facts may seem rather obvious to most healthy individuals, many of them may surprise you.
Fact #1: Laxative Abuse Comes in Many Forms
The effects of laxative abuse includes inadequate water absorption, electrolyte imbalance, malabsorption of nutrients (which can lead to malnutrition), and a drastic shift in the acid/base balance of the body. Laxative Abuse Syndrome (LAS) is a common term coined by medical professionals used to describe individuals who chronically misuse laxatives.  There are three basic reasons for laxative abuse:
- Eating disorders
- Quick-fix weight loss
Occasionally, a lack of awareness of what constitutes normal bowel behavior may lead to habitual laxative use.  People with a diet full of processed, lifeless, fiberless food are also more likely to reach for a laxative for constipation relief.
Fact #2: Laxatives May Promote Constipation
While it sounds contradictory, laxative use may actually cause the very problem many people are seeking to remedy. The overuse of laxatives on a constant basis can actually cause cramping, bloating, diarrhea, nausea, and constipation. If the bowels become dependent on laxatives, they can stop functioning on their own, further aggravating constipation issues.
Fact #3: Over-the-Counter Label Doesn’t Define Safety
There are an abundance of over-the-counter medications on the market today, all of which carry some level of risk to human health. Many laxatives contain stimulants that may have toxic properties when consumed in higher-than-recommended doses.  One study found that more than 40% of laxative users did not use the medications correctly, and 41% of individuals took laxatives without consulting a doctor. 
#4: Does Not Promote True Weight Loss
Laxatives are often used to promote quick weight loss, and many users incorrectly believe that these medications can result in the loss of ingested calories or fat. Calories and nutrients are absorbed through the small intestine before they reach the bowels, meaning that the majority of fecal matter that is expelled as a result of normal bowel movement or laxative-induced movement is merely waste product. Any weight loss that does occur is simply water weight and is generally temporary. Due to the loss of water from excessive laxative use, an electrolyte imbalance can occur.  Those with bulimia nervosa will often use laxatives to control weight; however, most studies indicate that their results are typically related to the combination of laxative use and dietary restriction. 
#5: Commonly Used By Those With Eating Disorders
While the myth that laxatives prevent weight gain has been repeatedly refuted, the products still remain popular among those suffering with bulimia and anorexia nervosa.  Some research has shown that individuals who take laxatives for weight loss reasons display a greater degree of personality disorder, anxiety, depression, and suicidal thoughts.   Laxative abusers also tend to display higher levels of perfectionistic behaviors and avoidance techniques, common traits exhibited in individuals with eating disorders. 
#6: Can Damage the Colon
Frequent diarrhea alternating with constipation and bowel pain is a common symptom seen in patients with irritable bowel disease (IBD). These symptoms are also associated with habitual laxative use, and if the cycle is allowed to continue, damage to nerves and neurons lining the small intestine and colon can result.  Water and potassium loss exacerbates problems associated with the colon and also leads to various health problems.
#7: May Lead to Heart Failure
One case of a 60-year-old woman who experienced heart failure following an immediate cessation of chronic laxative abuse highlights a very important issue in over-the-counter medications. It appears that potassium, a necessary electrolyte essential for cardiac function, can decrease significantly following laxative therapy. Fortunately for the woman in this case, recovery was possible after replenishing her body’s electrolyte stores.  Individuals who have been on laxatives for a long time should seek professional advice from a physician before completely stopping their use.
#8: Withdrawal Creates Anxiety
Laxatives have the power to reduce water absorption and destabilize overall digestion and body function. The majority of the body’s serotonin levels reside in the intestinal tract, and this neurotransmitter is responsible for maintaining mood and neurological function. One study showed that bulimia nervosa patients who stopped using laxatives showed increased anxiety levels.  While this could be in part to the instability of the digestive tract, it could also be purely psychological as many bulimic patients may believe they will gain weight after halting laxative use.
#9: May Damage the Pancreas
Gastrointestinal changes that result from laxative abuse have wide-ranging health effects, many of which aren’t immediately apparent. One study involved the examination of 10 patients with a history of laxative abuse and its impact on insulin and glucose. The study’s findings showed that pancreatic function and insulin secretion were hindered by laxative use as a result of dramatic gastrointestinal changes.  This can be detrimental to those suffering from type II diabetes, a condition where the body has difficulty responding to insulin and regulating blood sugar (glucose).
#10: Causes Kidney Failure?
Constant use of laxatives induce high calcium levels and promote potassium deficiency, two conditions known to cause kidney failure.  A reported case of a young woman suffering from severe kidney failure as a result of years of laxative use makes this painfully clear.  Even herbal laxatives, when used excessively on a daily basis, can lead to impaired kidney function and liver failure. 
#11: Encourages Kidney Stones
Laxative abuse creates an ideal situation for kidney stones to form by lowering the levels of potassium and citrate in the body. The risk for kidney stones increases for people suffering from excessive urinary calcium excretion. Researchers have noted that individuals with eating disorders who constantly use laxatives as a means of purging wastes have the greatest risk. 
#12: Finger Clubbing
Finger clubbing is defined as the softening and curving of nail beds, usually resulting in fingers appearing swollen. The condition occurs most frequently in patients with lung cancer or cardiovascular disease as well as similar health issues that decrease blood oxygen levels throughout the body. Abuse of laxatives, especially senna, has been identified as a cause of finger clubbing.   One case saw a reversal of finger clubbing following senna cessation and the implementation of nutritional therapy. 
The Best Approach for Healthy Bowels
Constipation, diarrhea, and general gastrointestinal distress is often a symptom of an underlying problem. Once that problem is addressed and remedied, these symptoms can be eradicated without the use of laxatives. A diet that is devoid of probiotics, fiber, and water can contribute to unhealthy and irregular bowel movements. Toxic buildup can also lead to symptoms associated with constipation and irregularity, making cleansing and detoxifying helpful for keeping the bowels healthy. Although certain laxatives can prove useful on rare occasions, their use should always be accompanied with the advice of a medical professional.
-Dr. Edward F. Group III, DC, ND, DACBN, DCBCN, DABFM
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