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Don't Fall in Love with Laxatives

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Why are people so interested in their bowels? Most folks don't obsess about their livers, lungs or kidneys. But ask any gastroenterologist and you will learn that people are fascinated with what ends up in the toilet.

They report on whether their stool sinks or floats, whether it is brown or yellow, hard or soft, and on how often they move their bowels. This is far more detail than most physicians want to hear.

Many people have been taught that regularity ranks right up there with cleanliness and godliness. If they don't visit the bathroom by 9:00 am every day, they fear dire consequences could result. What exactly could go wrong is not specified.

This may explain why "inner cleansing" has renewed its popularity in recent years. The notion of purging "toxins" from the system was a nineteenth century approach to healing that fell into disfavor. Now it is back, in the guise of herbal products that are supposed to reduce the risk of serious ailments as well as aid in weight loss.

In reality, laxatives can't lead to lasting weight loss. But herbal cathartics can deplete the body of vital minerals, leading to life-threatening complications such as heart rhythm disruptions.

Regularity is individual. Some people are perfectly normal with three bowel movements a day while others have three a week with no adverse consequences.

On the other hand, constipation can be very distressing. One reader shared her agony:

"I suffer from spastic colon, have used over-the-counter harsh laxatives from childhood and have tried just about every herbal laxative known to man. I am on numerous prescription painkillers that cause constipation, so I'm in a lose-lose situation.

"I would be very grateful for information that could help. I've gone 14 days without relief, and when I do have a movement, it is too painful to describe. I am desperate for a cure for this problem, but nothing my doctors have recommended has worked.

"After years of abuse, the bowel lining is damaged, so even when taking laxatives I have to use suppositories or a Fleet enema to stimulate the process. The bloating and discomfort are getting to be more than I can bear."

Laxative abuse can lead to this sort of complication, but the powerful pain relievers she is taking definitely add to her problem. One gastroenterologist has recommended sorbitol, which is a sugar that is not well absorbed and in excess may cause diarrhea. He also recommends MiraLax (polyethylene glycol).

For those who do not suffer such extreme constipation, a home remedy may be helpful. A reader shared this "Power Pudding" recipe with us: Mix one cup applesauce with one cup coarse unprocessed bran and three quarters cup prune juice. This thick paste should be refrigerated. Take a tablespoon daily, washed down with eight ounces of water. This should bring results within a week.

Of course high-fiber fruits, vegetables and whole grains are essential for good health, along with lots of water daily. For most people this is all the "inner cleansing" that is necessary.

Here are some remedies that readers of this column have recommended:

"Taking flax seed oil with 100% pure unsweetened cranberry juice daily is the only thing that has helped me after 66 years." K.S.

Unsweetened cranberry juice is an acquired taste. We are talking TART! Lots of folks find prune juice a bit more palatable.

Greg offers a different approach:

"An effective short term cure is steamed or boiled okra. Buy a bag of frozen okra and keep it in the freezer. Whenever they are needed, take 4 or 5 pods out and put them in a cup of water. Cook several minutes in the microwave until soft. I believe this is a much safer method than many of the laxatives available today."

"As a child and into my teens, I always had chronic constipation. My parents tried everything the doctor recommended, including every available known over the counter treatment. Then my mother heard that the cereal All Bran might help. I tried it and NEVER had any other problems again! It is filled with good nutritional ingredients, including 30% daily value of magnesium which is known to help that problem. You should have a drink of water with it.

"My husband had a serious illness this year and is on medications that cause constipation. No medication to counteract that helped him, so he tried All Bran (in his case twice a day), and it worked perfectly. --- Since it is more natural than medications for this problem with no known side effects if taken with adequate fluid, then it should certainly offer a highly effective and safe solution to the problem!" R.M.M.

Share your own constipation remedy below. You may also find our Guide to Digestive Disorders of interest. It has common sense solutions to flatulence, constipation, diarrhea and heartburn. There are details on the recipe for "Power Pudding" against serious constipation. Also learn how to phase off proton pump inhibitors such as omeprazole or lansoprazole. Our Guide to Constipation also has a dynamite Pumpkin-Bran muffin recipe that our friend Kit says works wonders for regularity.

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I suffered from constipation all my life. Getting a diagnosis of celiac disease and going gluten-free was the answer. It is one of the 300+ symptoms of gluten sensitivity/intolerance. I was astounded, but this was the answer after trying all of the other "remedies" mentioned here. Do your homework, and you will see that this is definitely a cause. Also, low magnesium.

For constipation:

I, too, was given harsh laxatives when I was a child and this has caused me problems into adult years. Here are some the things that have worked for me.

Magnesium Oxide, try 200 mg, if this doesn't work, try 400 mg
or take 500 to 1,000 mg. Vitamin C daily.

mentamucil - a teaspoon in a cup of water: stir and drink quickly. Do this EVERY DAY. "Smooth" mentamucil is kinder. "Orange" tastes better.

Slow way down on carbs and sugar.

Eat Oranges and apples

Don't eat coconut

My suggestion would be to use psyllium seed husks (pure) without flavor. This is natural substance & work great with one to two tea spoon in your cereal. It is natural fiber & it is not a drug.

After 68 years of being regular, constipation became a problem causing very painful hard bowel movements. Remembering my mother's remedy, I began eating 3 prunes (I use pitted prunes), then 4, then 5 a day which has solved the problem. I always drink plenty of water. My mother heated hers in water but I just eat them from the package.

My nurse daughter recommended 1/4 cup Bran Buds every morning. This has been perfect for me to avoid bowel diahhrea and/or constipation and it is delicious when I blend it with multi-grain cheerios.

When I was a kid, my grandmother's first question to me every time I saw her was "Did you have your BM today?" I thought she was nuts, but now that the answer is often "No," and the discomfort and bloating and occasional bloodiness are very disturbing, I can see where she was coming from. Another part of the problem is that when one takes whatever remedy, it's impossible to know if or when one might have to report to a bathroom ASAP when away from home. I'd like to follow this conversation, and get some ideas. I tried the "pudding," but it didn't seem to stimulate peristalsis, so I'll try the okra next.

Thanks for having the discussion.

Metamucil every night is great. Follow directions on package. Also my aunt drank a glass of warm water every morning before breakfast.

A big mouthful of mineral oil just before bedtime will work every time. Will not cause dehydration/runs and your movement will be a natural one. A doctor told my daughter in law about this years ago while she was pregnant.

Used psyllium fiber 12 years. very effective and no side effects.

I have struggled with constipation for decades- I recently read a magnesium deficiency can cause it. I added a little to my supplement routine and FINALLY not having to drink prune juice, eat bran, take metamucil etc etc etc...

All of my life I suffered just as the person above described. My mother gave me X-Lax as a child. I have chronic constipation and horrific spastic colon attacks. Then in my early 50's I discovered a miracle, or at least it worked a miracle for me. Magnesium.

Many people are deficient in magnesium and I have horrible migraines as well. When it was suggested that I take magnesium to help prevent migraines I also discovered it began to relieve my constipation.

There are many different types of magnesium but the one that I found that helps me the most with regularity is magnesium oxide, 400 mg. I take different dosages depending on how constipated I am but I do take at least one pill each night. It will depend on how much you weigh and how your body reacts to it. Hope this helps. It was the beginning of a new life for me.

Flax Seed Meal works for me; 2 tablespoons mixed with cereal and a few raisins (for flavor) have softened my BMs and lessened the great effort, which I feared would raise blood pressure enough to damage my eyesight.

I am just another one with a constipation problem. I tried many OTC solutions but none worked very well. In talking to my daughter about my problem, she suggested generic Miralax (polyethylene glycol). Immediately after starting taking it my BM changed from very hard lumps to smooth BM's. I have used it every night for probably 2 years, my daughter told me her doctor told her it would not harm you to keep taking it.

Recently I have learned that being constipated can cause the pelvic floor to weaken. For Women in particular it can result in the disturbing discomfort of a prolapse... whether a uterine prolapse or bladder or rectal prolapse. It is very very important not to become constipated. Once the deed is done, however, one must be vigilant to try and prevent it from re-occuring. Also constipation can cause incontinence in women. So often they believe it is from giving birth vaginally but that is not always the case. Anyone who is constipated is weakening the pelvic floor muscles and thereby causing many of these issues to appear.

Women must learn to do Kegels correctly. Otherwise they are facing needless surgeries for prolapse and incontinence. Kegels should be done by every woman every day and should be done correctly with the proper breathing program. Once a routine is established, one can avoid having surgeries that usually don't work anyways. Metamucil is a good way to reduce constipation and anything that works to prevent the pelvic floor muscles from being damaged is a good remedy indeed.

A nurse suggested drinking successive glasses /cups of hot and cold water. Also, papaya and mangoes are great for this problem.

My husband used the prune pudding and a hour after the first dose he had instant relief!

I started taking Magnesium Citrate at bedtime, when I read about its effectiveness, dealing with insomnia, in one of your columns. Much to my surprise, taking it has also made me "regular". This probably is because magnesium is a mild laxative. I take a 200 mgm tablet of Mg Citrate nightly. I also take a stool "bulker", a combination of Citrucel & Metamucil, daily at about 4:30pm. Have been following this regimen for several years, and no matter what I eat, I have no problems with regularity. Also drink plenty of water!!

This article asks: "Why are people so obsessed about their bowels?" (when they don't feel the same way about their lungs, liver, etc...) Well, it makes total sense to me! Unlike those other organs, we are much closer friends with our bowels, which send us multiple messages throughout the day. We get gas pains and indigestion. We get "gut feelings" about things. Our bowels "speak" when we're hungry. Their output, besides indicating all kinds of things re the state of our health and habits, also triggers an array of emotions -- especially when the output is prodigious, difficult or overdue.

The bowels, especially the rectum, come with all kinds of sexual baggage and complicity. Last but certainly not least, the bowels emit a physical extension of ourselves -- something which WAS "us" but now goes into the world separate from us, like a crap baby. Many 3rd World cultures consider the expelled feces a part of themselves through which magic can be perpetrated on them, either for good or ill. Lower animals, too, have strong behaviors built around excreting.... Well, there's probably more but I guess I'll stop here as I'm feeling pretty well relieved. By the way, I'm the world's best crapper, with a total of at least 6 per day, and I really like that.

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