# Why Laxatives Are a Vicious Cycle...



## balancedgrub (Jul 13, 2014)

Hey everyone

I usually comment on other peoples posts within the community but never write my own so this is new for me!

I just want to share my views and opinions on laxatives. I don't want you to think I selling anything, this is purely a post to help you and all of us in the "constipation" community.

If some of you don't know my story I'll keep it short. From birth I suffered with constipation, growing up was a miserable experience for me, I was forever in and out of hospitals and doctors surgeries, taking tons of laxatives and passing stools that were so painful I would often black out from passing them. By the time I was a teenager I was abusing laxatives and developed an eating disorder, I would take up to 12 per day of any stimulant laxative I could get my hands on and then not eat (the purge affect). It was up until beginning of 2014 that I changed my whole outlook and become a nutritionist to help people like myself overcome the vicious cycle which is laxatives.

*Why are Laxatives a Vicious Cycle?*

I often have to remind my clients that constipation is a symptom of an underlying problem, not the problem itself. Often it is down to diet, lack of exercise or food intolerance's. Sometimes it can be down to more challenging causes such as SIBO, colonic inertia or other medication. The trouble is, peoples biggest complaint when they go to the doctors is "I'm constipated" so, unfortunately more often than not, the doctor will prescribe laxatives and because the cause of the constipation is not being treated the symptom turns into a chronic one, hence chronic constipation.

*The Dreaded Stimulant Laxatives*

The bowel is a muscle, if it's strong and healthy waste/stools move through the gut at a healthy speed and don't become dehydrated. The problem I have with stimulant laxatives are that they often feed the problem of constipation by weakening the bowel and make it become dependant on aided stimulation in order to have a bowel movement. Imagine a body builder lifting weights only to have a robot standing behind him taking most of the weight, he becomes weaker and loses tone, until eventually he can't even life 20kg. The same principles apply to the bowel, and in turn you become more constipated and need more laxatives until they are ineffective and you need to up the dose.

*What Should I Do?*

I AM NOT A DOCTOR, I'm a nutritionist so I am not going to give you medical advice and tell you to go against your doctors wishes. I will simply tell you that if you are not satisfied with living your life on laxatives and you constantly worry when you will be able to have a bowel movement again, go back and ask your doctor to investigate the root of the problem. Your quality of life is important, and he should show concern for this. I was lucky enough to ask the right questions and find a doctor that was passionate about the welfare of his patients. I now haven't taken any form of laxative in 1 year. My constipation was due to lack of serotonin production and I now and manage my constipation through diet, exercise and take Resolor Prucalopride which I hope to come off in about a months time and be drug free! Yay for me! It's been a long emotional road but living a life free of constipation has been worth it there have been ups and downs, backward steps and various other obstacles and I'm sure there will be more ahead but in the mean time I hope to spread the word and help others similar to me and I hope you will take something away from this long post.

I would love to hear your experiences and challenges living with constipation too.

Stay Positive!

Kate

@balancedgrub


----------



## flossy (Dec 8, 2012)

I haven't heard of anyone else that said their constipation was due to a lack of serotonin production... Hmmmmm.

Also:

Prucalopride was approved for use in Europe in 2009[8] and in Canada (named *Resotran*) on December 7, 2011[9] but it has not been approved by the Food and Drug Administration for use in the United States. The drug has also been tested for the treatment of chronic intestinal pseudo-obstruction.

http://en.wikipedia.org/wiki/Prucalopride


----------



## annie7 (Aug 16, 2002)

right, Flossy--prucalopride is not available here in the usa.

i wish it were. i'd like to try it even though i'm not sure it would help me because zelnorm, another serotonin 5HT-4 receptor agonist similar to prucalopride, didn't really do much for me. zelnorm was withrawn from the market in 2007 (i think that's the right year--lol) because of cardiac issues. prior to that, cisapride (propulsid), another 5HT-4 receptor agonist, was withdrawn for the same reason. prucalopride has a better safety profile than either zelnorm or cisapride..

because of my experience with zelnorm and based on my other tests, i don't think a lack of serotonin my problem. certainly not my main problem. but yes, it can be the missing link for some people. back in the day when zelnorm was available we had a number of threads here on the board about zelnorm and serotonin etc etc.

hopefully one of these days prucalopride will be approved for use in the usa.


----------



## balancedgrub (Jul 13, 2014)

Yes Serotonin plays a big role in the motility of the bowel. It manages the peristalsis in the colon which enables waste to move through the colon at a reasonable speed.

Kate


----------



## oceannir (Mar 6, 2012)

I don't really agree with people saying 'its a symptom, not a disorder', because it kind of implies its a symptom of things you listed, fluids, diet, lifestyle, exercise etc.

I agree with what you said that those factors can be an influence but there are people and I'm guessing a few of them are on this forum that have underlying functional problems with their body that causes the constipation.

I agree that overall laxatives should be avoided at all costs until all other avenues are exhausted. Ive been taking them sparingly for the past 12 months after avoiding them all my life and so far I haven't really noticed any negative effects taking them irregularly on the lowest dosage which was recommended by my GI doctor.

The problem is two fold, if you encourage laxatives then the people who don't really need them will use them when they should look at other avenues, but if you discourage them sometimes the people who can really have an improved quality of life will avoid them.

I do agree with the serotonin connection. Mine is far too effected by my mood for there not to be something like that involved.


----------



## annie7 (Aug 16, 2002)

well said, oceannir.

I am one of those people who have underlying functional problems with my body that are causing my constipation. my tests have shown that. my slow transit is caused by colonic inertia as well as a long (shortened a bit now lol) twisted colon. I have pelvic floor dysfunction, megarectum and rectal hyposensitivity which are all medical conditions. and now I have adhesions from my surgery gumming up everything inside. and I have mitochondrial disease which slows all my bodily functions down, including my colon.

so yes, I need to take laxatives. my gastros docs and colocrectal surgeon have all told me to take whatever I need to go. and I am grateful that the laxatives work because without them I cannot go at all. biofeedback for pfd has helped with the pfd. I've worked on diet and nutrition for years--and both of those are very important of course--but for me it's not the whole solution.


----------



## minimalizer (Jun 8, 2014)

No osmotic laxatives like Miralax or others. Instead, you *Take* FIBER, (so-called laxative unfortunately), that is* non-gassy*, ie non-fermenting, which is claimed by Citrucel (It's true);The convenient unsweetened methylcellulose fiber caplets are *available also* in Equate/walmart brand, also on Amazon. VERY CHEAP;Or a slow fermenting/low gas fiber one that is a prE-biotic/feeds good bacteria in the colon which is acacia fiber, available in a tasteless powder that you can also both sprinkle on food and can't tell it's in your water bottle. Both are excellent *soluble fibers* that help move you by weighting through you for BOTH constipation and diarrhea REGULATION.







I challange you......!It's a must to drink at least 8 *or maybe even 10C of liquid per day, especially if constipated, or are encouraging gas from all fiber intake.* While building up probiotics slowly, you might consider simethicone for gas. Once things move through better, heartburn improves too.


----------



## flossy (Dec 8, 2012)

minimalizer said:


> No osmotic laxatives like Miralax or others. Instead, you *Take* FIBER, (so-called laxative unfortunately), that is* non-gassy*, ie non-fermenting, which is claimed by Citrucel (It's true);The convenient unsweetened methylcellulose fiber caplets are *available also* in Equate/walmart brand, also on Amazon. VERY CHEAP;Or a slow fermenting/low gas fiber one that is a prE-biotic/feeds good bacteria in the colon which is acacia fiber, available in a tasteless powder that you can also both sprinkle on food and can't tell it's in your water bottle. Both are excellent *soluble fibers* that help move you by weighting through you for BOTH constipation and diarrhea REGULATION.
> 
> 
> 
> ...


As I said in another thread about this (just my two cents!):

For those of us who truly have IBS-C, I would first recommend trying more fiber in your diet. But if that makes things worse, don't be surprised. Most of us think more fiber makes us more constipated. In some cases, it gets way worse.

If adding more fiber in your diet makes it easier to go, consider yourself lucky.

Also, I tried drinking a lot more water than usual (tried it for a week or two) and it didn't make one bit of difference in my constipation.

I'm still thinking those of us who have IBS-C need more (or less?) gut flora in our intestines...


----------



## annie7 (Aug 16, 2002)

well said, Flossy.

sure--if the fiber water thing works for you--go for it. it's a place to start.

but it's not the solution for all of us.

way way back in the day when i was first (incorrectly, as it turned out) dx'd with IBS-C --or spastic colon as they called it back then--the docs gave me the fiber water exercise mantra. 40 grams of fiber they told me to eat. bleh. constantly i heard this. and i did it. and exercise does help, no doubt about it. but for me, all that fiber just plugged me up all the more because, as my tests showed later, i have slow colonic transit and pfd, megarectum, rectal hyposensitivity and now adhesions and even drinking 64-80 oz of water a day (which i still do) didn't help move that all fiber out. it just sat in there and plugged me up all the more. every time a doc felt my belly, he/she would say i was "full of stool". no kidding. wonder why lol..

thank goodness i listened to my body and started to cut down on the fiber til i reached a more manageable amount.

so yes--if fiber works, lucky you and go for it. it's also good for your cholesterol. but if it doesn't...

oh--and i do think, Flossy, you're right about the gut flora. kefir does seem to be helping me a bit.


----------



## flossy (Dec 8, 2012)

@annie7 - Are you drinking your kefir or eating it?


----------



## annie7 (Aug 16, 2002)

i've been drinking 8 oz a day for the past week.


----------



## annie7 (Aug 16, 2002)

i posted this elsewhere but here it is again if you didn't see it:

i just read this article about kefir and constipation on the IBS Newsfeed board. it is about a recent study done on the effects of kefir on constipation. the study showed drinking kefir has a positive effect on constipation and that kefir accelerated colonic transit. the study participants drank 500 ml of kefir a day ( a little over 16 oz)

*Effects of a kefir supplement on symptoms, colonic transit, and bowel satisfaction score in patients with chronic constipation: A pilot study.*

Turk J Gastroenterol. 2014 Dec;25(6):650-

http://www.ibsgroup.org/forums/topic/209409-pubmed-effects-of-a-kefir-supplement-on-symptoms-colonic-transit-and-bowel-satisfaction-score-in-patients-with-chronic-constipation-a-pilot-study/

i might try drinking 16 oz a day just to see what that does. at that amount it gets a little pricey for me since we're retired but as my husband says--if it works, it's worth it...


----------



## Gooby (May 11, 2013)

minimalizer said:


> No osmotic laxatives like Miralax or others. Instead, you *Take* FIBER, (so-called laxative unfortunately), that is* non-gassy*, ie non-fermenting, which is claimed by Citrucel (It's true);The convenient unsweetened methylcellulose fiber caplets are *available also* in Equate/walmart brand, also on Amazon. VERY CHEAP;Or a slow fermenting/low gas fiber one that is a prE-biotic/feeds good bacteria in the colon which is acacia fiber, available in a tasteless powder that you can also both sprinkle on food and can't tell it's in your water bottle. Both are excellent *soluble fibers* that help move you by weighting through you for BOTH constipation and diarrhea REGULATION. I challange you......!It's a must to drink at least 8 *or maybe even 10C of liquid per day, especially if constipated, or are encouraging gas from all fiber intake.* While building up probiotics slowly, you might consider simethicone for gas. Once things move through better, heartburn improves too.


My constipation seems to come from too little water left in my stools. I call them "riverstone logs" since they seem to be shaped like a normal stool but are made up of small balls all jammed together. And it is not because I don't drink enough water, but because my colon ends up removing too much of the water from my stool before it passes through. So, I need something to pull water into my colon to keep my stools from getting too hard to pass without pain, discomfort, and bleeding. The generic form of miralax has been the best option I have found so far, and I take it in combination with several other things like flax, magnesium, avacados, etc.


----------

