Stay Regular: 10 Laxative FAQs

Irregular bowel movements are often thought of as an elderly concern. But marketers today are pitching laxatives to a younger audience. So will laxatives “beautify your insides,” “purify” your colon and help you lose weight?

The inability to have regular bowel movements is often thought of as an elderly concern—grandfather with his daily bowl of prunes. But marketers today are pitching laxatives to a younger audience. Some offer to “beautify your insides” with a product packaged in yellow or pink and such flavors as pink lemonade. Others promise a “purified” colon and weight loss. But when do you really need to use a laxative?

1. Do you need to cleanse your colon?

No. The colon is quite effective at maintaining its cleanliness. You need no laxatives, enemas or “colonic irrigation” to do this. (Colonic irrigation is an out-and-out scam, and can be dangerous, too.) Don’t believe any ad that promises to “remove toxins” or make your intestines beautiful. Taking a laxative won’t make up for poor dietary choices.

2. Laxatives: Effective weight loss aid?

Not really. Bulk laxatives (which are basically fiber supplements) might help with weight control by making you feel a little fuller, so you may consume fewer calories afterwards. But claims that they will quickly take off lots of pounds are greatly exaggerated. Many dietary supplements and “teas” that promise weight loss contain herbal laxatives, which are not safe or effective.

3. Should I worry about constipation?

There’s no strict definition of constipation. Some people have a bowel movement daily or twice daily, others only three times weekly, with no problems. Fewer than three times a week is usually regarded as constipation. If you have chronic problems with bowel movements, if your stool is always hard and causes you to strain, or if you experience bloating, cramping or bleeding, you should see your doctor.

4. What causes constipation?

The chief causes are a low-fiber diet, lack of fluids and being sedentary. Many medications, including antacids, and dietary supplements such as iron can cause it. Travel, emotional stress, depression and lack of access to toilet facilities (on a long bus trip, for example) can bring on constipation.

5. What’s the best way to stay regular?

Healthy habits promote regularity. Don’t rely on laxatives. Increase your fluid intake and eat more fiber—found in fruits, whole grains, beans and vegetables. Fiber adds bulk to the stool, absorbs water and stimulates the colonic contractions that produce the urge to defecate. To prevent bloating and gas, gradually increase your fibre intake. Regular exercise—such as daily walking—will also help.

6. What kind of laxative is best?

Use occasionally. Bulk-forming laxatives, which contain psyllium or other fiber (such as Metamucil, Fibercon, Citrucel and generics), are effective, gentle-acting and less likely to produce side effects than stimulants. Some also have sorbitol or other sugar alcohols, which have laxative properties. Lubricating laxatives(such as mineral oil and glycerin) make stool oily and thus easier to pass. Some stool softeners also work this way. Osmotic laxatives like milk of magnesia include sodium biphosphate or magnesium salts. They are fast-acting. Follow directions, and don’t take large doses.

7. What about stimulant laxatives?

Stimulant laxatives (such as Ex-Lax, Senokot and Dulcolax) cause fluid secretion in the colon and irritate the lining of the colon to produce contractions. They may contain herbal ingredients such as senna, cascara sagrada and other harsh stimulants. Many people reach for these first because they act forcefully and quickly. If you try them, follow directions carefully and use them only for a day or two. They may cause cramping and diarrhea. Castor oil is a strong stimulant laxative and should be used only on medical advice.

8. Can laxatives harm my colon?

It has long been thought that stimulant laxatives could harm the colon or cause dependency. But a study published in 2005 in the American Journal of Gastroenterology found that stimulants did not harm the colon when used at recommended doses. The researchers did not find evidence for laxative dependency or rebound constipation. However, laxative dependency has been little studied.

9. What about yogurt?

Several yogurt brands, notably Dannon’s Activia, now claim to promote regularity. According to some study, some yoghurts include live bacteria that may hasten intestinal transit time or have other benefits that may aid in preventing constipation. Still, how much of a difference this would make is questionable. It is also recommended to consume yoghurt with living cultures to prevent diarrhoea.

10. What about prunes?

An excellent choice. Despite the fact that they contain a lot of fibre, prune juice, which has very little fibre, also has laxative properties. Both the fruit and juice naturally contain high amounts of sorbitol and other substances that promote bowel movements. However, the cause of their laxative action is unclear.

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