How to Stay Regular Without Laxatives


Millions of Americans experience chronic constipation. But laxatives might not be the answer. Here’s why.

The United States is a constipated nation.

Constipation complaints account for more than 2.5 million doctors’ visits every year  — and those are just the people who seek treatment. Doctors suspect that many others struggle with slow transit time (close to one in three Americans, by some estimates) but that most folks are too sheepish to seek help. Following the money, however, helps fill in the blanks: Americans spend hundreds of millions of dollars every year on laxatives.

Interestingly, humans have fretted about the dangers of slow transit time since the beginning of recorded health literature. An Egyptian papyrus from the 16th century BC warns that constipation is the root of all disease, arguing that decomposing food in the colon releases material that poisons the body.

Today, that ancient hypothesis still holds up. Most of the toxins, heavy metals, and drugs we encounter every day are directed quickly to the colon — to take the very next train out of the body. If that train is running late, though, those toxins can get reabsorbed and cause more health problems than they might have in the first place.

Laxatives, however, may not be the answer. We tend to think of laxatives as a benign source of relief, offering fast results with very few side effects. But laxatives have a downside — and given the amount we’re consuming, it’s worth taking a closer look at these over-the-counter remedies.

The Trouble With Laxatives

Laxatives work in one of four ways: by stimulating the lining of the intestines to push stool through the system faster; by drawing water into the colon to soften the stool; by introducing a lubricant, like mineral oil, to create a type of internal water slide for stool; or by bulking up the stool with fiber so the colon is stimulated naturally to push it through the system quickly. But overuse of laxatives can lead to several problems: 

Laxative dependency. Chronic laxative use can make the colon forget how to do its regularly scheduled job. “Laxatives can interfere with the enteric nervous system,” says Thomas Sult, MD, a functional-medicine practitioner in New London, Minn. The enteric nervous system is the part of the autonomic nervous system that governs gastrointestinal function.


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