«Laxatives
Chronic Side Effects
Many of the side effects listed in the introductory article appear in the short term, ie in the hours and days following the excessive intake of a specific laxative product. However, the real problem with laxative abuse concerns the consequences of chronic use . In fact, if the occasional ingestion of a purgative is unlikely to be harmful to health (unless the doses are particularly high), the same cannot be said for habitual or frequent use.
Anyone who uses laxatives should in fact know that, while in normal defecation only the fecal material present in the descending colon (terminal colic portions) is eliminated, the more energetic purgatives promote the emptying of the entire colon. Consequently, after taking them, several days are needed to reform a quantity of faecal material sufficient for the appearance of a new and spontaneous stimulus to evacuate. Unfortunately, many patients interpret this condition of relative constipation as an abnormal phenomenon, which drives them towards a new assumption of laxatives. Once in this vicious circle, the abuse of purgatives causes worsening symptoms over time: chronic diarrhea, abdominal cramps and pain, atony and colonic neuropathy (loss of muscle function of the last part of the intestine, with inevitable worsening of constipation ), pseudomelanosis, hypokalemia, secondary hyperaldosteronism and nephropathy.
Anyone wishing to investigate, on a case-by-case basis, the side effects of the various laxatives and their drug interactions, can visit this link.
The abuse of laxatives is also frequent in those affected by eating disorders, where the drug is perceived as a remedy to get rid of the hated food.
What to do before taking laxatives
We list below some observations and tips to consider before resorting to laxatives:
- if the constipation is occasional it is necessary to review its own food style, making sure that it brings the right amounts of fruit, vegetables, whole grains, legumes and liquids. Exercise also helps improve bowel function. To learn more about this topic, you can consult our article on dietary and behavioral therapy of constipation.
- If in spite of compliance with the rules listed in the previous point, constipation shows no sign of improving, medical consultation would become mandatory. Too often people believe, mistakenly, that they can treat their constipation on their own by listening, for example, to the misleading advice of an acquaintance or advertising campaigns which, given the appalling incidence of the disorder in our society, are increasingly widespread and convincing.
Because of this tendency, a doctor is forced to remedy the damage caused by the abuse of laxatives much more often than he is led to prescribe them .
It is therefore no coincidence that one of the first recommendations given to patients suffering from chronic constipation is, absurdly, to gradually suspend the use of laxatives .
Following is the recommendation to drink two to four liters of non-alcoholic drinks per day; to eat a lot of fruit (in particular dried prunes), vegetables and whole grains (possibly supplementing one's diet with 20-40 g of bran); to carry out regular physical activity (for example walking every day for 40-60 minutes); not to ignore the urge to defecate and to keep the feet raised or the classic Turkish position during the physiological act. Only if the defecation has been missing for five days an enema is performed or a glycerine suppository is introduced.
