QUESTION: I need to know if taking laxatives is safe. Some-times I feel all blocked up and want to clean my system. Is it dangerous at all, and how often can I take them?
I am hectically busy at work and very seldom get time to go to the toilet – and when I do, I struggle.
Answer: 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, and certainly there are medical conditions and medications that can slow bowel movement or peristalsis.
Are laxatives safe?
The simple answer is that it depends on how much, and how often you use them. There are various classes of laxatives, and they work differently. My biggest problem with constipation is that everyone wants a quick fix to get up and go – but the root causes are not identified or treated. So it is bound to be recurrent.
Most people opt for the natural products due to fewer side effects and a lower risk of overdose. 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 stools 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 to theatre. For most people, a glycerine or dulcolax suppository does the trick for a distal plug in constipation.
How to kick-start your gut
l Drink some water as soon as you open your eyes.
l Don’t skip breakfast.
l Include soluble and insoluble fibre as part of a balanced diet.
l Eat regular small snacks instead of three main meals a day.
l Exercise, or even do just regular movement and stretching.
l Be regular – book a time slot to go.
l Do not rush the moment – be patient.
* 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.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen.
The advice in this column does not replace a consultation and clinical evaluation with a doctor.
Cape Argus