How to keep your gut moving

Published Dec 4, 2013

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QUESTION: I need to know if taking laxatives is safe. Sometimes I feel all blocked up and want to clear my system. Are laxatives dangerous at all, and how often can I use them?

I am busy at work and I seldom get time to go to the toilet.

 

ANSWER: You have opened up a can of worms – thousands of South Africans suffer from constipation and the problem has many complications. Constipation shows no prejudice and affects adults and children. The excruciating pain and discomfort that can follow is a serious matter which often lands people in hospital for emergency treatment.

The Causes:

Dehydration, diet and lack of discipline are among the top three causes. Occasionally there are specific structural issues of the bowel that make voiding difficult. There are also medical conditions and medications that can slow bowel movement or peristalsis.

 

Are Laxatives safe?

The simple answer is that it depends how much and how often you use them. There are various classes of laxatives available and they work differently. My biggest problem with constipation is that everyone wants a quick fix, but the root causes are not identified or treated. So it is bound to recur.

Most people opt for the natural products due to fewer side effects and risk of overdose symptoms. Products like senna and herbal teas do work, but dependence becomes an issue if these are abused. The gut needs to be trained to be active and not get lazy.

Citrus fruits are useful and so are the debulking agents like Movicol and Pegicol.

For heavier, resistant cases, Picoprep or fleet enemas are used.

It’s no use softening up stool higher up in the bowel if there is a hard stone-like rock blocking the only exit.

Rarely, these hard impacted dry stony stools need to be removed by digital decompression – painful and uncomfortable, but if too difficult, the patient might even have to go into theatre.

For most people a glycerine or Dulcolax suppository does the trick for a distal plug in constipation.

 

Complications:

* Bowel perforation

* Mechanical obstruction

* Haemorrhoids

* Anal fissures or tears

 

To kick start your gut:

* Drink some water as soon as you open your eyes.

* Don’t skip breakfast

* Include soluble and insoluble fibres as part of a balanced diet

* Eat regular small snacks instead of three main meals a day.

* Do some exercise or even just regular movement and stretching

* Be regular – book a time slot to go.

* Do not rush the moment – be patient. - Cape Argus

 

* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.

He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.

If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.

* The advice in this column does not replace a consultation and clinical evaluation with a doctor.

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