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  • Writer's pictureDr. Sarah Penney, ND, MSc

Laxatives - The Good and The Bad

When it comes to resolving health concerns, shoppers who are looking for 'safe' often reach for something 'natural'. Constipation is no exception, and self medication is common because this condition is embarrassing to call the doctor about for some. Many people know about the risks associated with taking medical laxatives, the most important one being dependence. This of course means that once you are on them it is hard for your body to stop, which may present as a worsening of constipation. What is not well known is that not all natural laxatives are created equal, and some may do the same thing. Read on to know what to watch out for when choosing a natural laxative!

The two general classes of laxatives in both mainstream and alternative medicine are bulk laxatives and stimulant laxatives. Bulk laxatives are products or foods that help to increase the volume of (aka 'bulk' up) the stool. This helps with constipation because the stool will then put pressure on the intestinal walls, triggering a process called peristalsis which helps move it through the colon. Bulk laxatives also make the stool softer, meaning it is easier to pass. It is essential to remember to increase your water intake when taking a bulk laxative, as this is what helps cause the bulking effect and you could end up worsening your constipation if you are dehydrated. Bulk laxatives are generally safe for long term use, and your body does not develop any dependency on them. Don't use bulk laxatives if you have an intestinal blockage. One common example of a bulk laxative is the popular product Metamucil, which is made out of psyllium husk, but even foods like bran cereal fall into this category.

Stimulant laxatives are a totally different story. They way they work is by stimulating the activity of peristalsis in the intestine, over-riding your body's natural instincts and rhythms. These laxatives do not affect the bulk of the stool at all, but may cause diarrhea. Water intake is especially important if fluid is being lost with the stool to prevent dehydration. Although this type of laxative can be useful in some acute situations, stimulants are strongly discouraged for long term use because the body can become very dependant on them and the intestines can forget how to work on their own. Although many people know that medical laxatives can have this effect, one common stimulant laxative found in natural health products is a herb called Senna. This herb has the exact same stimulating methods as medical laxatives, but is often chosen by customers who think it is 'natural' so it will be safer. The other concerning place I see senna used often is detoxification products. Often times, the laxative effect caused by this herb can give a customer the impression they are 'detoxing' or their body is getting rid of things it doesn't need, when really this may just be a reaction the the stimulant laxative. Always be careful to read the ingredient list on combination products like that, and keep and eye out for Senna.

It can be helpful to stop and consider what might be causing your constipation before reaching for any kind of product. Some common causes I see as a naturopathic doctor to name a few are poor diet, food sensitivities, inadequate water intake, low fibre intake, stress, dysbiosis (imbalance of gut bacteria) and side effects resulting from medication. Treating the cause is always the best way to resolve the issue for the long-term and avoid laxative use. Don't be afraid to seek help for your digestive concerns- health care providers know what an important role digestion ban play in health and are happy to talk to anyone about their digestive questions.

- Dr. Sarah Penney, ND, MSc

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