Most people who suffer from constipation manage a type known as functional or idiopathic constipation. This type of constipation is so called because the underlying cause is not identifiable, yet the condition can be easy diagnosed due to the symptoms. Treatment at first consists of increased dietary fiber. If this is ineffective, patients are recommended to try a laxative.
The general consensus among physicians and researchers is that laxative constipation treatments is safe and well-tolerated. But given that some patients must take them over long periods of time, doubts have come up about both efficacy and long term, unintended consequences. A consequence of these doubts have been the appearance of what seems to be misconceptions concerning laxative usage.
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.
With respect to the second, reports linking laxatives to cancer were suggested by experimentation on animals. Rats fed extreme doses of anthraquinones had higher mutations in cells, leading to cancer-like problems. But the studies were not easily translatable to the human context because the doses were very non-realistic. Similar studies with extreme concentrations of aspartame sweetener and peanut oils show a cancer link, but are rarely relevant for realistic human consumption.
On the topic of the third, informal reports from patients who said they were seeing diminished effectiveness from medication initiated the idea of laxative intolerance. The counterpoint to this is that controlled studies in both animals and quadraplegic patients who used laxatives for as long as 34 years did not suffer from intolerance effects.
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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