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Correcting the laxative habit



DEAR DR. DONOHUE: This question is one I cannot ask my family physician. I take about 15 laxatives a day – all at once – and have been doing so for about two years. I feel I am really doing myself harm, but I can’t seem to wean myself from them. Your thoughts are appreciated. – A.B.

ANSWER: You’re going to need your family doctor’s input in getting you over the laxative habit. The doctor isn’t going to recoil in disgust or swoon on hearing this. He or she has heard the same story many times. The dangers of laxatives have been overstated in the past, but taking 15 a day is a bit much for anyone’s colon. There are four general classes of laxatives. I don’t know which you’re taking, so I’ll spend a moment on each.

Osmotic laxatives pull water into undigested food. MiraLax, Cephulac, Enulose and milk of magnesia belong in this class. They have few side effects. If your stools are loose and voluminous, you can lose minerals like potassium. That applies to all laxatives.

Bulking laxatives attract water into the food residue too. Metamucil, Citrucel and psyllium are such laxatives. So is fiber. And fiber can safely replace the 15 laxative pills you take. As you decrease the number of your laxative pills, increase the amount of fiber you eat. Do this slowly; too much fiber gives you gas and bloating. Drink more fluid than you usually do. Fruits, vegetables and whole grains are fiber sources. We’re supposed to get around 25 grams a day. An apple with skin has 4.7 grams; a carrot, 4 grams; 1 ounce of All- Bran cereal, 14 grams; 6 prunes, 8 grams; a cup of baked beans, 9 grams. If all 15 of your pills are bulking agents, you’re not in deep trouble at all.

Stool softeners act like soap to promote the mixing of food and fluids. They keep stools moist and soft. Colace is an example. Stool softeners don’t get people into dire straits.

Stimulant laxatives irritate the colon wall and cause it to contract more forcefully. If taken in large amounts, they have the potential to disturb colon action, but the colon can return to normal when a person eventually gets off them. Senokot and Cascara are stimulant laxatives.

Do tell your doctor, who can work with you to get you over your laxative habit.

The booklet on constipation and laxatives treats this topic in depth. To order a copy, write: Dr. Donohue – No. 504W, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 67 and have high blood pressure, high cholesterol and arthritic knees. Walking was my favorite exercise, but knee pain now prevents that. What exercise would be best for my knees? – R.C.

ANSWER: Swimming would be the ideal exercise. Even if you don’t know how, 67 is not too old to learn. You also could do water aerobics – exercising in the water. Water provides buoyancy that protects your knees.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475.

©2008 North America Synd.

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