The most common form of constipation is known as idiopathic or functional constipation. This means that the cause is unclear, therefore the disease can only be defined by the symptoms that it displays. Very often, the first line constipation remedies are preceded by high fiber therapy. However, in the cases that it doesn’t work (which is the majority), patients will often turn toward laxatives.

The general consensus among physicians and researchers is that laxative constipation remedies 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.

There are three kinds of misconceptions about laxative usage. The first is the idea that long term use causes nerves in the gastrointestinal tract to be damaged. The second is the idea that long term use leads to higher chance of cancer. The third is that the gut starts to become “immune” to laxatives and perhaps suffer “rebound” effects that worsen constipation.

Regarding the first, evidence regarding nerve damage first came to light in studies of patients who were taking laxative constipation treatments for a long time and had discoloration in the lining of the bowel. In addition, these patients were found later to have intestinal nerve damage. However, early studies were not double-blinded and controlled, leading many researchers to believe that nerve damage and laxative use was a correlative rather than causal relationship. That is, people with constipation had a higher chance of having nerve damage already, regardless of whether they were taking laxatives.

On the topic of the second, people reported a connection from laxatives to cancer by looking at animal experimentation. Rodents which were given very high doses of laxatives showed more DNA damage and thus propensity toward cancer. Yet the studies used extremely high concentrations of drugs that are never seen in humans. Likewise, studies with such high concentrations of aspartame and artificial sweeteners show a link between consumption and cancer that are rarely realized in epidemiological surveys.

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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