Can You Overcome Long-Term Laxative Addiction?

Good digestive function is widely recognized as a cornerstone of good health. As a consequence, some people who have trouble with constipation may be tempted to use laxatives. If they do so repeatedly, they may find themselves in a vicious cycle where they become increasingly dependent on their chosen medication. Is there such a thing as laxative addiction?

Using Senna and Bisacodyl Every Day

Q. I think I’m addicted to my laxatives. I take the bisacodyl suppositories in the morning after having taken four 50mg stool softener/senna tablets at bedtime. I’ve got to get rid of this habit. What can I do to stop?

Senna Is Not as Gentle as They Say

A. Senna is being advertised as “gentle, dependable constipation relief.” The plant Senna alexandrina has been used as a stimulant laxative for many centuries. Regular use of this natural herbal product is associated with dependence, as you have discovered.

Many medications can contribute to chronic constipation. You will find a list in our eGuide to Overcoming Digestive Disorders. If a drug you are taking is responsible for your constipation, you may need to discuss alternatives with your healthcare provider.

How Can You Turn Laxative Addiction Around?

Q. No one knows I have this problem. I have been using the laxative bisacodyl every day for twenty years and have steadily increased the dosage.

I’ve stopped taking it for a few days at a time. Not surprisingly, nothing moves. Are there any studies on this? Might I have done permanent damage to myself? Is it better to cut back slowly or stop altogether and just see what happens? I know it’s not healthy for waste to back up in my body, so I’m worried about stopping AND I’m worried about continuing.

What You Can Do to Break a Laxative Habit

A. You clearly have developed a laxative habit. Bisacodyl is considered a “stimulant” laxative, which means it triggers intestinal contractions. This can lead to loss of crucial minerals such as magnesium and potassium. Cramping and diarrhea are other possible side effects, along with a “lazy” colon that will not function properly without laxatives.

A gradual phase-off under medical supervision may allow your body to reestablish a more natural rhythm, and allow you to overcome your “laxative addiction.” The doctor may recommend supplemental fiber such as psyllium (Metamucil, for example). Magnesium supplements or flaxseed tea can also be useful in this situation.

In certain cases, physicians have prescribed diuretics in the short term (three months) to help patients break long-term laxative addiction (CEN Case Reports, Nov. 2014). Special exercises to strengthen the muscles of the pelvic floor can greatly reduce the need for laxatives and the temptation for laxative abuse (World Journal of Gastroenterology, July 21, 2014).

Lasting Problems from Laxative Addiction

Q. My mom has been addicted to laxatives for over 30 years. Last year she had to be operated on because her anus had constricted to the point where not even a pencil would have passed. She was one step away from a blockage.

Four months later she had to go back for the very same problem due to lack of post-operative instructions. The only advice she was given this time is to take Metamucil three times daily.

Now she complains that she has no bowel movements at all. I am so worried. What should she do? I tell her to be patient but she feels very uncomfortable not being able to ‘go’ daily.

A. Chronic laxative use can impair the ability of the digestive tract to function normally. The dependence on chemical stimulants often leads to a vicious cycle of constipation. It will take time, along with gradually increasing fluid and fiber intake, for your mother’s bowel to recover its normal activity.

There are some simple approaches in addition to fluid and Metamucil that may be helpful. Boiling two tablespoons of flaxseed in three quarts of water and consuming two ounces of the liquid daily is one. Chewing sugarless gum is another. A magnesium supplement of 300 to 500 mg per day can be helpful, so long as her kidneys are healthy. Magnesium supplements could be dangerous for people with kidney disease.

Understanding “Laxative Addiction”

Q. I have relied on daily laxatives for more than 50 years. I am working at ways to stay healthy without taking laxatives, but it is a challenge if I want to have a regular bowel movement. What can you suggest to help me get over my laxative addiction?

A. You are not actually addicted to laxatives the way someone might be dependent upon strong pain relievers. After decades of regular use, however, your digestive tract may have become “lazy.” Stopping strong stimulant laxatives cold turkey could indeed lead to severe constipation for prolonged periods.

Gradual laxative withdrawal can be helpful in combination with additional fiber, fluids and stool softeners. Sugarless gum containing sorbitol or mannitol can often be helpful. (Be careful not to overdo, as that could lead to diarrhea.) Bulking agents such as psyllium, polycarbophil or methylcellulose are a much better choice than stimulant laxatives.

Learn More

We are sending you our Guides to Constipation and Digestive Disorders for information on non-drug approaches such as dynamite pumpkin muffins and “Power Pudding,” a special constipation remedy with bran, applesauce and prune juice. These may be helpful as you gradually discontinue the use of high-dose stimulant laxatives under medical supervision.

You may also wish to listen to our interview with Dr. Robynne Chutkan. It is Show 1115: How You Can Conquer Constipation. Learn how to add real fiber to your diet, bolster your intestinal microbes and get your digestive tract moving as it should.