Herbal Help for Constipation

When the makers of Ex-Lax announced the arrival of a "new" formulation of the product a few years ago, herbal remedies took front-runner status in the treatment of common constipation. Of course, it wasn't exactly a hard-to-win competition. The main ingredient of Ex-Lax, phenolphthalein, was taken off the market by the FDA, leaving little choice but to change the formulation. Senna, an herbal stimulant laxative became the "new" Ex-Lax ingredient so that today it has become one of the leading remedies for constipation relief.





There are actually several herbal choices for the treatment of constipation. For the most part they can be divided into two categories: stimulant laxatives and bulk laxatives. Stimulant laxatives act by forcing contractions of the smooth muscle of the colon and by drawing water from the body into the interior of the colon, allowing for looser stools. Bulk laxatives, on the other hand, are products which expand inside the colon when mixed with water. Once expanded, they trigger the colon's natural contractions which attempt to expel the bulky substance. (The trick to bulk laxatives is that you have to drink a lot of water with the laxative product or it won't work.)

Herbal stimulant laxatives include senna, cascara, castor oil, buckthorn and dried aloe juice. Senna is the most readily available of these due to its popularity as an ingredient in brand-name products such as Sennakot and Ex-Lax. The active components of senna are called anthraquinones. All stimulant laxatives contain anthraquinone-like ingredients which give the herbs their cathartic effect.

Stimulant laxatives, whether herbal or not, all carry basically the same risks. When used daily for more than 1-2 weeks they can lead to "laxative-dependency syndrome". This means that the muscles of the colon become lazy and don't contract very well unless you take more of the laxative. Rebound constipation can result from stopping the product after prolonged use.

Bulk laxatives, on the other hand, rely on the colon's normal muscle contractions and don't generally lead to dependency. Herbal bulk laxatives include flaxseed, psyllium and apple pectin. The first two of these are actually seeds and seed parts which swell with the addition of water to form a bulky mass inside the colon. Apple pectin does the same thing except that it's made from apple peels and not seeds. The main risk in using bulk laxatives is that of obstruction of the bowels which can occur when the product/water mixture can't get through. Again, the drinking of water with bulk laxatives is essential-without it, the laxative can become like a hard rock inside the colon. As you may imagine, rocks in the colon aren't easy to pass.
A general rule of thumb would be as follows:

If you suffer from chronic constipation, use a bulk laxative regularly (with water) to help train your system to have regular bowel movements without the use of stimulants. Save the stimulants for occasional use.

If you're still not sure which products to use or if your constipation is a new problem, see your healthcare provider for advice.