The most common form of constipation is known as idiopathic or functional constipation. This means that the cause is unclear, therefore the disease can only be defined by the symptoms that it displays. Very often, the first line treatment is high fiber therapy. However, in the cases that it doesn’t work (which is the majority), patients will often turn toward laxatives.
Generally the opinion among the scientist and researcher population is that using laxative constipation treatments properly is safe. But as constipation is occasionally a chronic condition that necessitates use of laxatives over long periods, suspicions about unintended side-effects and health issues have arisen. One problem is the development of myths regarding this line of medication.
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.
With respect to the third, informal evidence from self-reporting patients suggested the idea of rebound and intolerance to laxatives. Well-controlled studies, on the other hand, showed that in patients who had used medication for as long as 30 years still benefited from consistent usage. Animal studies suggested also a lack of the intolerance effect.
In all, laxatives remain a helpful weapon in the arsenal against constipation. Ideas that they lead to long-term damage need to be taken with a grain of salt, and patients should consult with physicians to manage their fears.
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