Here is some general info I think everyone should be aware of. Laxative sales exceed $700 million annually. They’re usually the first thing that comes to mind when most people think about constipation relief, but they often bring serious health risks and are not a valid or complete solution.
Many different types of laxatives are available and they utilize very different ingredients to achieve essentially the same result—eliminating blockage. Generally speaking, laxatives can be lumped into three categories: osmotic laxatives, stimulant laxatives, and bulk forming laxatives.
1. Osmotic Laxatives
Osmotic Laxatives cause excess fluids to be drawn into the intestines in a slow process that can take up to a few days to increase the stool’s fluid bulk. Basically, osmotics turn the stool into diarrhea so it’s easier to pass. This type of laxative can also cause severe dehydration and electrolyte depletion from water loss, as well as cramping and bloating due to gas buildup during the initial waiting period.
Examples of Osmotic Laxatives
- Lactulose: Duphalac®, Kristalose®, and Actilax® (Lactulose)
- Sorbitol: Sorbilax®
- Polyethylene glycol compounds: MiraLAX®
- Magnesium Hydroxide (milk of magnesia): Phillip’s® Milk of Magnesia, Dulcolax® Milk of Magnesia, and Freelax®
2. Stimulant Laxatives
Stimulant laxatives are made with harsh, often toxic chemicals or herbs that cause the intestinal muscles to spasm and contract. The popularity of stimulant laxatives stems from the fact they start working in a matter of hours. Unfortunately, stimulant laxatives can also cause the same diarrhea, dehydration, and gas-related pain as osmotic laxatives.
If overused, stimulant laxatives can become incredibly addictive and cause long-term damage to the sensitive intestinal lining. The intestines can quickly grow dependent on stimulant laxatives to trigger a “false” bowel movement, thus preventing normal intestinal contractions. This condition, known as “lazy bowel syndrome,” ultimately results in a long-term battle with chronic constipation and the loss of bowel muscle tone and strength.
Examples of Stimulant Laxatives
- Senna: Fleet® Liquid Glycerin Suppositories, Rite Aid® Senna Laxative, Traditional Medicinals® Smooth Move Herbal Stimulant Laxative Tea, ex-lax®, Senokot®
- Cascara Sagrada: Nature’s Way® Cascara Sagrada Aged Bark
- Castor Oil: Swan® Castor Oil, Now® Foods Castor Oil
- Bisacodyl: Correctol® Bisacodyl Stimulant Laxative, Fleet Bisacodyl®, Dulcolax®, Gentlax®-Rite Aid® Corrective Laxative Tablet
3. Bulk-forming Laxatives
Bulk-forming laxatives use highly absorbent materials (usually dead fiber instead of live fiber such as live fruits and vegetables) to increase overall stool mass. As the stool increases in size, the bowels are forced to expend more energy to force out the mass.
Fiber and increased stool mass are both usually good things, but bulk-forming laxatives can be dangerous since they have the potential to clog the bowels. Psyllium, used in most OTC (over-the-counter) fiber laxatives, can sometimes be troublesome and is one of the most common herbal ingredients in colon cleansers and especially in OTC fiber laxatives.
Examples of Bulk-Forming Laxatives
- Psyllium: Metamucil® Psyllium Fiber
- Guar Gum: Benefiber®
- >Methyl Cellulose: Citrucel®
There have been numerous reports of serious allergic reactions following the ingestion of Psyllium products. These reactions include labored breathing, skin irritations or hives, and potentially life-threatening anaphylaxis. Long-term use of products containing Psyllium may also negatively affect absorption of certain essential vitamins and minerals such as iron. Perhaps most ironically, obstruction of the gastrointestinal tract has also been regularly cited in studies of patients taking Psyllium products. These studies suggest this problem is especially common in constipation-prone individuals.
While good oxygen-based intestinal cleansers will attack the source of the constipation, traditional constipation treatments (such as laxatives) may only temporarily relieve the most common symptoms of constipation and do nothing to address the compaction or heal the delicate intestinal tissue.
-Dr. Edward F. Group III, DC, ND, DACBN, DABFM