# Laxative Dependence



## Sean (Feb 8, 1999)

I was thinking today about a dirty little secret that I suspect a few of us who post on the IBC-C and chronic constipation board share. It has kind of crept up on me over the last few years, but I admitted to myself today that I can apparently no longer have a bm without a stimulant laxative. A little bit of background: I have been posting here for about 11 years. I am 37 and have had problems with chronic constipation since I was 16. When I was 25, I was diagnosed with colonic inertia. My doctors and I have tried all kinds of treatments over the years: OTC laxatives, enemas, Fiber, Zelnorm, Amitiza, various pro-kinetics, lactulose, etc. Miralax and Zelnorm worked for a few weeks, but then gradually lost their effectiveness. The one remedy that seems to work reliably is Dulcolax. I know that it is a stimulant laxative and that conventional wisdom is that chronic use is very bad for you. At first, I only used it when I felt that I really needed it - maybe two or three times a month. But over the past few years, my usage has crept up. It kind of sneaks up on you.To be fair, there is some new thinking out there that stimulants may not be so bad for people who have chronic constipation if nothing else is working. There was a study done in Germany that tends to confirm this new thinking. Of course, it was funded by the company that makes Dulcolax. An abstract is available at http://www.ncbi.nlm.nih.gov/pubmed/15654804, and concludes: "It is unlikely that stimulant laxatives at recommended doses are harmful to the colon. A proportion of patients with chronic constipation is dependent of laxatives to achieve satisfactory bowel function, but this is not the result of prior laxative intake. Tolerance to stimulant laxatives is uncommon. There is no indication for the occurrence of "rebound constipation" after stopping laxative intake. While laxatives may be misused, there is no potential for addiction."I guess that this gives me some comfort that I am not completely destroying my digestive tract. I am just one of those patients that can't go to the bathroom without laxatives. What is my alternative? Surgery to remove most of my colon. Maybe it is time to get on with that while I am still young and have a better ability to overcome the high complication rate. But I am still very athletic and active, so I am not ready to have my colon cut out just yet. I now take Dulcolax twice a week, and my bowels move twice a week. It isn't fun because there is some cramping. Because of the uncertainty of exactly when the results are going to occur, I have to hang around home until after it works the first time, and be reasonably close to a toilet for the rest of the day. I do have to admit that I feel a whole lot better after it works, and maybe the relief I feel is part of the "addiction." Over the years, I have had to increase my dosage a bit to ensure a result. Two tablets would clean me out in my 20's. Now, it takes three to get a decent laxative result. I know that I have rambled here, but I would appreciate others' thoughts about this topic. I wonder if I should even be worrying about this. Sean


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## annie7 (Aug 16, 2002)

hi Seanoh no you're not alone on this. did you read the cascara sagrada thread we had going recently? there was quite a discussion on this--here's the link.. http://www.ibsgroup.org/forums/lofiversion...php/t99976.htmli have to take something everyday--if i don't i just have little rabbit poops and am in lots of pain and misery for the rest of the day. i described my regimen in detail in the cascara sagrada thread...basically i take a stimulant lax alternately with tegibs (generic zelnorm) i've had ibs-c for over 40 years--i'm fifty seven now. and for all but the last four years i just suffered through each day--tried everything but nothing worked except for my current regimen. and yes i've read the muller-lissner report you cited in the nih link above--there's a longer version of that in medscape in their gastro section and also an even longer pdf file of the entire report somewhere--but still i used to worry at times about taking stimulants but you know---it's the only thing that works and at this point i've had enough of suffering. so as far as i'm concerned, if this is the only thing that will let me poop and have a stab at living a normal life than so be it...and yes like you said, even with the stimulants it isn't easy--the cramping etc--but for me it's so much better than the alternative.and i have read other posters say that this is the advice they have received from mayo clinic docs---that it's ok to use stimulants if they've tried everything else and that's the only thing that works.....


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## amg (Mar 29, 2009)

I'm with you. About a year ago everything just stopped, and I take either senna or a Dulcolax suppository to go. I had about a week of good results taking the Force Naturals vitamins (there's a thread about them, titled "something that really works for IBSc" or something like that, but we're right back to the old routine. I'


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## Rose (Mar 25, 1999)

AMG, I'm sorry the vitamins stopped working for you. They are not working very well for me either. I just posted on that thread. I haven't taken a laxative in a week and I feel totally miserable. I have been taking the vitamins for a week now and have not had a decent bowel movement in all that time. I was so hoping they would work for me, especially when you told me you were laxative dependent and they were working for you. Looks like I am going to have to take a laxative tonight because if I don't, I really think I will explode. I guess after taking laxatives every night for over ten years, my system just won't work without a stimulant.







Rose


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## amg (Mar 29, 2009)

I have used one the last three days in a row. I think the vitamins help, it haven not had any problems with pain, but I don't think I'll be able to stay away from laxatives permanently. I am very bummed out.


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