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Laxative-induced constipation

- a new health concern -

Constipation due to long-term use of laxatives is the latest public health concern and its proportion in the total number of chronic constipation cases is consistently on the rise. It is prevalent among people over the age of 40 years.

Over-The-Counter medicines allow individuals to self-treat common symptoms. Among the various OTC medicines available in India, laxatives are commonly used and abused since many options of laxatives are available in allopathy, homeopathy, Ayurveda, herbal etc. Just because laxatives are easily available it does not mean they are safe and suitable for everyone.

The rampant abuse of over-the-counter laxatives, which can become a habit and gradually descend to complete dependence. This habit has made bowel movement almost impossible for many.

Patients who have been prescribed laxatives by a doctor in the past continue to self-medicate and use these medicines for a prolonged period. Reliance on medicines is increasing by the day and simpler, natural means to deal with health issues are forgotten. Most people buy a strip of laxative when constipated, but it is not a good idea. Laxatives cause bowel movements by irritating the colon which causes the muscles in the colon to go into a spasm, artificially ejecting the stool. Overuse of laxatives can make colon muscles lazy leading to chronic constipation and a dependence on them. The chronic use of laxatives ultimately leads to increasing constipation and the need for even stronger purges. It can result in the loss of essential nutrients and water and cause severe electrolyte imbalance, fatigue and cramps among other harmful effects. Laxative abuse can cause severe health problems Unless a doctor has prescribed laxatives, one should stop taking them freely. They are not the answer and will only worsen constipation.

Constipation can be prevented or managed by making changes to the diet and lifestyle rather than relying on laxatives. But there is lack of awareness.

The consumption of refined, processed and preserved foods, fast foods and what we call 'junk food' is on the rise leading to the elimination of fibre from the diet and an increasing rate of gastrointestinal issues.

Besides lifestyle modifications, some treatment modalities like MCDPA that includes medicine (M), constac (C) which is a herbal laxative powder formulation, diet (D) physiotherapy (P) and ayurvedic (A) oil therapy which aims at the root of the problem rather than simply trying to manage symptoms and biofeedback therapy that helps in evaluating pelvic muscle function accompanied with kegel exercises and colon hydrotherapy can help resolve constipation to a large extent.

Ayurvedic View:
According to Ayurveda, if you are eating a diet high in insoluble fibre, drinking adequate water, and exercising daily, this is enough to maintain a healthy, constipation-free digestive system. Constipation occurs when we deviate from this time-tested formula.

Good sources of Fiber include whole grains, fruits, vegetables, beans and nuts. But when it comes to a lazy bowel, foods rich in insoluble fiber may be most helpful. Insoluble fiber does not dissolve in water and helps move food through your digestive system, improving regularity. Foods with lots of fibre include cereals such as wheat germ and wheat bran, whole-wheat and rye flours, oat bran, grainy breads, fresh fruit (especially berries), dried fruits such as prunes and figs, vegetables, and legumes such as chickpeas, lentils and beans,cucumbers, tomatoes and carrots can help you get more insoluble fiber in your diet. Increase fibre intake gradually to avoid getting gas or diarrhea, or worsening constipation.

Drinking adequate Water lubricates the intestines and also moistens the food you eat, aiding its flow through your body.

Regular Exercise stimulates your intestinal muscles to work more efficiently. It also decreases the amount of time needed for food to move through your intestines, so stools stay moist

For occasional help, there are several laxatives to choose from: Bulk-forming laxatives, such as Metamucil or Prodiem, increase water content and bulk up the volume of the stool so it moves through your bowel faster.Osmotic laxatives, help fluids to flow, and stimulate muscles that aid in digestion. Saline laxatives, such as milk of magnesia, draw water into the colon so the stool passes more quickly. Stool softeners, such as Colace, Surfak, Docusate and Soflax, make them easier to pass. Stimulant laxatives, such as Dulcolax ,Senokot and Ex-lax, cause muscle contractions in the intestines that are needed to get things moving, these are harsh and should be used sparingly.

Ayurveda has described number of safe and effective laxatives.Read more about them here.

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