Some laxatives are merely stool softeners. They act like soap and break up hard faecal masses. They have little to condemn them, except when combined with the irritant purgatives.
This irritant group is the most commonly abused. These act by stimulating the nerves in the bowel wall causing overactivity of the muscles.
Prolonged use may cause degeneration of the nerves so that they are permanently damaged, impairing the bowel function so that chronic constipation persists.
These irritant purgatives include cascara, senna, phenolphthalein and bisacodyl.
The least harmful of substances which are taken for constipation are those which produce bulk. Natural food which contains indigestable fibre is best and can hardly be regarded as medicine.
Bran is probably now the most often discussed additive to add bulk. However, there are many preparations of cellulose material prepared from a variety of natural plants which swell when mixed with water.
These substances should be taken with several glasses of water so they will swell and add bulk to the diet.
If a patient complains of constipation, the doctor must assure himself that indeed that is the correct symptom. Some people have a normal bowel action, but, because of misinformation, may believe something is wrong. As with any other symptom, a full history will often reveal the diagnosis.
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