Laxatives are widely used, often on self-prescription and in the absence of a real therapeutic need. Many people resort to these drugs to regulate their intestinal functions, believing they are beneficial. Others, obsessed with scales, use laxatives to "lose weight". Regardless of why they are taken, since they are available without a prescription, there is a tendency to pay little attention to their contraindications.
Only by knowing, at least in broad terms, their characteristics and repercussions on human health, can some unpleasant side effects associated with the abuse of laxatives be avoided.
-agar, bran, guar gum, psyllium seeds, cellulose, carboxymethylcellulose (synthetic), linseed.Mechanism of action
These laxatives increase the volume of the non-absorbable solid residue, bringing significant quantities of indigestible substances (dietary fiber). If taken together with abundant quantities of water, once they reach the intestine they form a sort of gel that increases the volume of stools and their softness, facilitating their evacuation. The mass effect helps intestinal transit, stretching the walls of the bowel and promoting , consequently, a secondary propulsive activity. All this is associated with a positive effect on the growth of the intestinal microbial flora, which contributes to further increase the fecal mass and to improve the functionality and health of the intestine.
The purgative effect is not immediate but only appreciable after 14-72 hours.
Side effects
This category of laxatives is the safest, as it is naturally present in many foods and capable, among other things, of reducing the absorption of cholesterol and slowing down that of simple sugars. Despite this, it is good to use these products with due caution as, if taken in excess, they can cause a series of disorders ranging from increased bloating to real intestinal obstructions. This latter eventuality is all the more probable the lower the simultaneous intake of liquids.
Mass laxatives should therefore not be used in the presence of esophageal or gastrointestinal strictures, ie in those cases in which constipation is due to a "mechanical obstruction (cancer, inflammation and chronic ischemia, endometriosis, hernias, neoplasms of the ovary or" uterus).
Laxative cake
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Mechanism of action
The effect of these laxatives is based on particular substances, produced in the laboratory or contained in the plant source used (anthraquinones present in aloe, cascara, rhubarb and senna), capable of increasing colic contractions, favoring the progress of the stool towards the " external.
These are quite strong laxatives (purgatives); for this reason their use should be sporadic (no more than 10 days), limited to minimal doses and should only and exclusively take place after consultation with the doctor.
Side effects
Irritating laxatives are probably the most dangerous in their class, especially if used indiscriminately for long periods of time. They act fairly quickly (6-12 hours) and, when taken in high doses, cause secretory diarrhea associated with abdominal pain.
Continued use can cause a disorder known as hypotonic colitis, since excessively vigorous colic contractions can compromise, over time, the functionality of the colon muscles. In practice, the peristaltic waves necessary to facilitate evacuation are at first strengthened "artificially" through the use of laxatives and subsequently weakened by the same drugs, which little by little make the muscles of the colon more and more spastic and unable to contract.
Anthraquinone purgatives can give the urine a pink or brownish color and are contraindicated in pregnancy and breastfeeding. It is therefore necessary to abandon the all too widespread idea that a laxative is at the same time harmless and effective only because it is naturally derived. Furthermore, while in pharmaceutical formulations the active ingredient is accurately dosed, in many herbal-derived laxatives the concentration of the " active ingredient is quite variable, because it is influenced by many factors.
Castor oil, in addition to a taste infamous for its unpleasantness, can cause malabsorption and hydroelectrolytic imbalances.
An additional undesirable effect linked to the abuse of these laxatives is colonic melanosis (or pseudomelanosis).
Update: New European Regulation of 18 March 2021
On April 8, 2021, the ban on marketing foods and food supplements containing hydroxyanthracenes and their derivatives, a family of molecules contained in various plants, such as aloe, cassia, rhubarb and senna, came into force.
More in detail, the new European Regulation of March 18, 2021 - which came into force, precisely, April 8, 2021 - modifies Annex III of Regulation (EC) No. 1925/2006 of the European Parliament and of the Council to as regards the botanical species containing hydroxyanthracene derivatives.
The full text can be consulted by clicking here. However, we can summarize the main points as follows:
- The following are added to the list of substances whose use in food is prohibited (Annex III part A of the aforementioned regulation):
- Aloe-emodin and all preparations in which this substance is present;
- Emodin and all preparations in which this substance is present;
- Preparations based on leaves of Aloe species containing hydroxyanthracene derivatives;
- Dantrone and all preparations in which this substance is present.
- The following are added to the list of substances whose use in food is subject to Community surveillance (Annex III part C):
- Preparations based on the root or rhizome of Rheum palmatum L., Rheum officinale Baillon and their hybrids containing hydroxyanthracene derivatives;
- Preparations based on leaves or fruits of Cassia senna L. containing derivatives of hydroxyanthracene;
- Preparations based on bark of Rhamnus frangula L. o Rhamnus purshiana A.D. containing derivatives of hydroxyanthracene.
Mechanism of action
By mixing with fecal material, these laxatives help to soften and lubricate it, facilitating intestinal transit.
They can be taken orally (they take from 12 to 72 hours to exert their effect) or rectally (glycerin suppositories), if an immediate effect is needed (15-60 minutes).
Side effects
They interfere with the absorption of fat-soluble vitamins and some minerals (calcium and phosphorus). If you take too much vaseline oil (over 2-6 tablespoons per day normally recommended) it can escape the containment action of the anal sphincter and stain the clothes. Furthermore, if the high intake lasts over time it can cause a narrowing of the anus.
(magnesia S. Pellegrino), sorbitol, mannite, tamarind.Mechanism of action
These laxatives, once in the intestine, retain and recall important quantities of water, giving the stool a semi-solid or frankly liquid consistency. If taken in high doses, they have a rather rapid effect, but certainly not without contraindications.
Side effects
Osmotic laxatives taken in excess can cause kidney problems (linked to excessive magnesium intake) and electrolyte imbalances. For this reason, they are contraindicated in patients with kidney disease and generally not recommended for the elderly and children.
)We conclude by recalling that before taking laxatives of any kind, even if sold in the form of natural remedies or drugs that do not require a prescription to be dispensed, it is of fundamental importance to ask for the preventive advice of your doctor.
