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Laxatives are compounds, foods, drugs or substances that help increase bowel movements. Doctors usually prescribe them to relieve constipation, or difficulty passing stools, or to prevent it when needed. However, laxatives may also be bought over-the-counter, which has often led to their indiscriminate use and abuse.

How Do Laxatives Work?

There are different types of laxatives or purgatives, which differ in their mechanisms of action:

  • Bulking agents are substances that increase the size of the stools and attract more fluids to the intestines, thus promoting passage of stools. These agents include insoluble dietary fibers such as bran, soluble dietary fibers such as psyllium husk, and methylcellulose such as Citrucel. Doctors often advise taking these laxatives with plenty of water to maintain regular bowel movements in people who are prone to constipation.

  • Stool softeners or surfactants such as docusate lubricate and soften stools by increasing the fat and water content of stools, thus making them easier to pass. They are effective when a sufficient amount of water is ingested.

  • Osmotic laxatives such as Milk of Magnesia, lactulose or glycerin work by promoting water retention in the intestines, making stools softer and easier to eliminate. They are often used to cleanse the intestines to prepare them for certain surgical procedures.

  • Stimulant, irritant or contact laxatives are the most powerful type and they work by irritating the intestinal surface and promoting water and electrolyte excretion. These can change the tone of the muscles of the intestine when used regularly, causing them to weaken over time (lazy bowel).

Can Laxatives be Used to Lose Weight?

Many over-the-counter weight loss supplements contain laxatives. Some people also take laxatives directly to purge, cleanse and detoxify their bodies.

Aside from relieving constipation, laxatives have been used and abused to manage weight problems, but many experts advise against this practice.

Some people use these compounds to hasten elimination and reduce fat absorption from food. However, weight management experts like Michelle May, MD believe that laxatives used for colon cleanses may cause weight loss by increasing water loss and stool weight rather than from calorie reduction.

Side Effects of Laxatives

Although dieticians and doctors recommend increasing fiber intake to help promote regular bowel movements, reduce the risk of diabetes and manage weight problems, they warn against abusing laxatives, which can cause side effects such as:

  • dehydration

  • bloating

  • flatulence

  • abdominal cramps

  • electrolyte imbalance

  • nutritional deficiencies

Prolonged use of laxatives can lead to reduced calcium absorption, which can lead to weakening of the bones. Another undesirable effect of laxative abuse is chronic constipation, or lazy bowels, when one cannot defecate naturally without purging. On the other hand, a study shows that some people who abuse the use of laxatives can manifest symptoms similar to inflammatory bowel disease, such as chronic diarrhea.

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