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Home , Constipation, Laxative, Psyllium

Cornell Health Use: What to Know

Live Well to are medicines that treat , Learn Well either by softening the stools or by stimulating the lower intestines to push out stool. They can Web: do more harm than good if used improperly. Get health.cornell.edu the facts, and the myths, about laxatives. Are you Phone (24/7): using them for the right reasons? 607-255-5155 Types of laxatives Fax: laxatives such as (Dulcolax), 607-255-0269 , cascara sagrada, (Senokot), and Appointments: are dangerous, despite the fact that they are non-prescription . These Monday–Saturday are the most commonly abused laxatives. They Check web for hours, stimulate the nerves in the walls of the large services, providers, intestines and cause intestinal contractions as well and appointment as fluid and changes, and can be habit- information forming. In addition, tolerance develops, meaning Laxatives can do more harm than good that higher and higher doses are needed to obtain if used improperly: get the facts! 110 Ho Plaza, the same effect. Ithaca, NY people often find it very difficult to stop taking “Natural” stimulant laxatives usually contain laxatives even if they want to. They can become 14853-3101 senna. They are stimulant laxatives (see above) physically and psychologically dependent on that happen to come from plant sources. Their laxatives. dangers are the same as those of synthetic Some people use laxatives in the mistaken belief stimulant laxatives, listed previously. that it will help them with . Laxatives Non-stimulant laxatives are safer if used correctly flush water and waste from the intestine, but they and in appropriate doses. They include the do not flush calories from the body. following: • Osmotic laxatives include Milk of Magnesia, Potential harms Epsom , Golytely, Colyte, , • Constipation.With laxative abuse, the and Miralax. These work by drawing intestines lose muscle and nerve response. The fluid into the intestines and are less habit- intestines then become dilated and ineffective forming, but can still cause fluid and electrolyte in moving stool out. This results in dependency imbalances when used incorrectly. Some on the laxative, so that higher and higher doses require a prescription. are needed to produce stools. • Lubricant and emollient laxatives, such as oil or (Colace), work by • Alternating constipation, , and softening the stool. These are generally safe to gas. Laxative use can result in rebound use for a limited time. constipation, which may include trapped gas • Bulk-forming laxatives, such as in the intestines. This can cause the laxative (Metamucil), Citracel, and FiberCon, are user to constantly try to treat those symptoms generally safe and also are a source of dietary with more laxatives, and a vicious cycle of fiber. When used in higher than recommended laxative use may follow. For a better approach doses, bulk-forming laxatives can cause to bowel health, see “How to keep regular,” on intestinal problems and block absorption of the next page. other nutrients. • .Sub-normal body water content Laxative abuse occurs when too much fluid is lost in the diarrhea caused by laxative abuse. Common Some people take large quantities of laxatives at symptoms include thirst, decreased urination, one time. Others take small amounts of laxatives, headache, light-headedness, diminished perhaps not more than the “recommended dose,” sweating, dry mouth and weakness. but on a fairly regular basis. Most young, healthy people should rarely, if ever, require a stimulant • Electrolyte abnormalities.Electr olytes such laxative, and laxatives should never be used in as sodium, potassium, and chloride are lost at higher than directed doses or over long periods abnormally high rates in diarrhea. This can lead of time. Once the pattern has started, however, to weakness, irregular heartbeats and death.

Although such severe complications (from water and stool). Remember What’s normal? are infrequent, they are unpredictable that in the long run your symptoms There is wide range of variability in how and can happen to someone who will improve, and you will be much often people have bowel movements. abuses laxatives for the first time, or healthier and feel better when you Anywhere from 2 to 3 times a day to someone who has abused laxatives are not taking laxatives. to once a week can be normal. After for years. Keeping “regular” laxative abuse, it is important to expect • in stool. Irritation of the colon To prevent constipation and avoid using that your bowel movements may be can lead to blood in the stools, which laxatives: irregular for a time. Feeling bloated does in turn can cause . • Be sure to include at least 8 cups not mean that there is a problem. If you • Impaired function of the intestines. of fluid per day (64 oz total) from are following the guidelines detailed in After long-term laxative abuse, the beverages (including water, tea, this brochure and your stools are still intestines lose normal tone and nerve coffee, juice, milk). Dehydration is the much less frequent than before, speak response, and can no longer contract number one cause of constipation. to your health care provider about the to evacuate stool normally. This is But don’t overdo it. Too much possibility of alternative medications. often reversible, but recovery may be water can also cause electrolyte If you are experiencing hard and large a slow process. abnormalities. stools, pain with bowel movements, • . Chronic severe • Increase fiber in your diet, gradually. or blood on your stools, you will likely diarrhea caused by laxative abuse can Fiber softens stools and helps prevent benefit from alternative laxatives. both diarrhea and constipation. cause the inside of the intestines ot cereals are an excellent source of More information protrude through the anal opening. fiber. Check the labels on the side of This condition usually requires the box for the fiber content. Consult these sources for useful surgical treatment. and , nuts and seeds are information on fiber, constipation, IBS, other good sources. Excessive fiber and other digestive problems: Steps to stop laxative abuse can cause and gas, so don’t • Cornell Healthy Eating Program • Stop now. It is generally better to stop overdo it. Also, make sure to consume (CHEP) provides additional completely and quickly rather than to adequate fluids when increasing the information and resources at: try to cut down slowly. fiber in your food. health.cornell.edu [search“CHEP”] • Dispose of any laxatives you have. • Get regular, moderate . • The Mayo Clinic’s comprehensive • Take steps to prevent possible Exercise is important in promoting website on health: Mayoclinic.com constipation right away. See ‘How to normal intestinal onc tractions. keep regular’ on the next page. Moving your body helps your • NEDA (National Eating Disorders Association) advocates and supports • Prepare to deal with the urge to use intestines get moving, too. • Eat regularly. Eating is a powerful individuals and families affected by a laxative. Laxative withdrawal refers eating disorders. to symptoms people experience when stimulant of intestinal contractions. they stop laxative use. Think ahead Give yourself plenty of opportunities Phone: 800-931-2237 about the situations in which you for normal intestinal onc tractions by Website: nationaleatingdisorders. might have the urge to use a laxative. eating 3 meals a day plus 2-3 snacks. org/laxative-abuse-some-basic-facts For some people this occurs after a • Pay attention to the gastro-colic • NDDIC (The National Digestive binge, or when they haven’t had a reflex. Within about half an hour Diseases Information Clearinghouse) bowel movement in a few days. after eating, most people will have answers questions and provides Come up with a few alternative plans some intestinal movement which publications about digestive disorders. of action in case you do have the urge sometimes leads ot the urge to Phone: 800-891-5389 (e.g., a large glass of water, take defecate. For some people, scheduling a walk, or call a friend for support). a few minutes to sit on the toilet Website: digestive.niddk.nih.gov • Seek support. Letting a friend or shortly after breakfast or dinner may relative know about the problem can help. Suppression of the normal urge help. to have a bowel movement will lead • Get help. Your health care provider, to harder, larger stools over time, and nutritionist, and therapist can help decreased intestinal tone. Reading you achieve health-related goals. a book may help the body relax and Call to set up appointments now. allow the gastro-colic reflex to occur. Not everyone experiences laxative Avoid straining. withdrawal, but it helps to be • Keep a record of your stools. If you go prepared for this possibility to guard more than 3-4 days without a stool, against restarting the laxatives. call your health care provider for safe Symptoms can last from 1 to 3 to help you get through weeks, or occasionally longer, and this period without resorting to include fluid retention, constipation, stimulant laxatives. bloating, and temporary weight gain

health.cornell.edu 10/19