Laxative Usage For Combating Recurrent Constipation
The most prevalent type of constipation is known by the descriptor “idiopathic” or “functional”. The meaning of these words imply that the root cause is not known, but the condition is clearly diagnosed from its symptomatic effects. Often the first treatment is dietary fiber infusion. In the event that this is not effective (which is approximately 70% of cases), patients can try out medical laxatives.
There seems to be widespread agreement among scientists and doctors that the judicious use of laxative constipation treatments is tolerated and safe. However, as some patients take such medications over extended periods, suspicions have surfaced about long-term side effects and problems. A result of these suspicions are some misconceptions about laxative use.
Roughly the myths concerning laxatives can be divided into three types. First, some believe that laxatives cause nerve damage to the colon. Second, some believe that cancer can be caused by laxatives. Third, some believe in the concept of laxative “intolerance” and “rebound” effects, resulting in worsening constipation after medication.
With respect to the first, reports first surfaced in studies on patients who had been using laxative constipation treatments for a long term. Studies of the colonic lining showed a discoloration. Follow-up showed that some had nerve damage. THe problem is that these studies were not well controlled with a placebo population. Critics say that patients with constipation already have higher predisposition to nerve damage. Later studies did not hold up the causal link between constipation medication and laxatives.
On the topic of the second, people reported a connection from laxatives to cancer by looking at animal experimentation. Rodents which were given very high doses of laxatives showed more DNA damage and thus propensity toward cancer. Yet the studies used extremely high concentrations of drugs that are never seen in humans. Likewise, studies with such high concentrations of aspartame and artificial sweeteners show a link between consumption and cancer that are rarely realized in epidemiological surveys.
Regarding the third, it seems that anecdotes from patients who were seeing decreased efficacy gave rise to the belief of laxative intolerance. However, studies both in rats and in paraplegic patients who had been on laxatives for as long as 34 years showed that the efficacy of laxatives remained more or less undiminished over these long times.
It would seem that laxatives should not be discounted for their great utility against constipation because of these misconceptions. Patients should continue to research for themselves and ally with their doctors to understand the evidence concerning laxative efficacy.
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