Healthy Alternatives to Laxatives
Do you know how your elimination is doing?
A recent review of scientific literature looked at the state of modern digestion and elimination. Researchers found reports of sluggish elimination common, but inconsistent from country to country. Americans, in particular, seem unsure how to classify their bathroom habits, with survey results ranging from 2% to 27% of the population reporting problems with sluggish, slow, or incomplete elimination.1 One report found 26% of Americans have these issues, but do not seek medical help for them and depend on fiber and OTC fiber supplements to get by.17
It’s no wonder we visit the doctor an estimated 2.5 million times and spend an estimated $800 million dollars every year on laxatives.2 Laxatives have become commonplace.
Are Herbal Laxatives Good for You?
Most of us know we should avoid synthetic laxatives, but herbal laxatives are often considered healthy and actually good for you. Unfortunately, the science begs to differ.
A handful of longitudinal studies, with over 40,000 and 80,000 volunteers, respectively, reveal long-term laxative use is linked to great risk of serious intestinal health concerns.11,12 That said, other studies suggest long-term use of laxatives is well-tolerated, which makes this an important and confusing topic.15
For example, most folks think using magnesium as a laxative is 100% safe. In this article, we will drill into these misconceptions. According to Ayurveda, long-term laxative use of any kind is unacceptable and needs to be addressed.
Seemingly safe herbal laxatives, such as senna, can be effective, but, according to Ayurveda, only for short periods of time. They are habit-forming and trigger a bowel movement by irritating the intestinal wall.
Short-term irritation from stimulating laxatives can cause structural damage to the intestinal wall.14 Long-term irritation can lead to the need for more and more bowel-irritating laxative.13
How Often Should I Poop?
Many medical experts still suggest three bowel movements a week is normal.15
According to Ayurveda, this is a really bad idea. While the medical definition of normal elimination is considered to be at least three bowel movements a week,1Ayurveda encourages one to three bowel movements per day, based on your body type, including a complete elimination within the first hour of waking for all types.
The newest studies on the gastrointestinal system are showing correlation, if not causation, between irregular bowel movements and many serious health issues.3
Ayurveda maintains 85% of the body’s overall health depends on the digestive tract. It is the seat of the mind, emotions, physical health, and the ability to naturally detoxify.
Balance Gut Flora Rather than Taking Laxatives
Microbes, who make up 90% of all cells in the body, reside in what is referred to as our microbiomes, primarily in the large intestine, digestion system, lungs, urinary tract, and outer skin. The environment for these microbes must be precise to support optimal health.
Sluggish or loose stools are indicators the environment may be out of balance, and that a risk exists for proliferation of opportunistic microbes that can negatively impact healthy elimination.
Probiotic supplementation, which boosts beneficial gut bacteria, is used to support the frequency and consistency of stool. Probiotics are quickly gaining support in the larger medical community. In one recent study, Bifidobacterium lactis was particularly effective in supporting normal transit time, as well as healthy consistency and frequency of bowel movements.4
To address imbalances of the intestinal microbiome that manifest as slow, sluggish, or incomplete elimination, I suggest restoring a healthy intestinal environment with a decoction of slippery elm, marshmallow root, and licorice taken for a month. At LifeSpa, we call it Slippery Elm Prebiotic. This is taken in combination with a combination of colonizing probiotics, which means they adhere to the intestinal wall and increase proliferation of more diverse permanent beneficial bacteria by 40-60%.16 LifeSpa’s Gut Revival probiotic is rich with microbes that are healthy for the gut lining, but antagonistic to undesirable intestinal bacteria. I have been using this one-two punch to reset intestinal function for decades with great success.
Enhance Bile Flow Rather than Take Laxatives
Healthy bowel function, which supports stability and proliferation of good gut bugs, depends on complete digestion of foods upstream in the stomach, pancreas, gallbladder, and small intestine.
New research points to the regulation and production of adequate bile from the liver as a key component in healthy, normal elimination.5
After digestion, leftover toxins in the large intestine are re-absorbed back into the bile, which ends up in the liver. Over time, the liver can become congested and production of bile will slow down. This can lead to congestion of the gallbladder and poor bile flow into the intestines. Bile is the ultimate upstream regulator of the stool’s consistency, frequency, and intestinal transit time.5
Maintaining healthy production of bile is key to regular elimination. Herbs and foods that boost bile flow are called cholagogues and can be easily found.
Bile-Boosting Foods aka Cholagogues
Download my free Safe Liver Cleansing eBook.
Eat Fiber Rather than Take Laxatives
Fiber-rich foods, such as fruits, green veggies, whole grains, beans, nuts, and seeds (like chia and flax) are key to healthy and regular bowel movements. Fiber scrubs the gut of excess mucus and toxins, attaches to toxin-carrying bile, and escorts it to the toilet, providing food for good microbes that proliferate in the intestines. The goal is to reach 50 grams of fiber each day.
We RecommendEat the Right Fiber
What Type of Laxative is Worst?
There are four basic types of laxatives:6
1. Bulking agents
Bran and other bulking agent products, such as Citrucel, Metamucil, and Fibercon, are typically psyllium-based and can ease occasional constipation by absorbing more fluid into the intestines. This makes the stool bigger, which gives you the urge to pass the stool. These are safe in the short term and with minimal dosing.
Risks: Bulking agents attract water, so regular use can pull excess water off the intestinal wall. Over time, this can dehydrate the bowel and cause more chronic elimination concerns. In addition, most bulking agents expand greatly inside the intestines and, if used excessively, can potentially distend the intestines, reducing their ability to contract and move fecal matter to the toilet. This can eventually result in a chronically sluggish, overly distended, and dehydrated bowel. Many complain of stomach cramps, abdominal bloating, and gas from psyllium products.17
2. Stool softeners
Products such as Colace and Ducolax Stool Softener lubricate and soften stool in the intestine, making it easier to pass. Stool softeners are effective, but overly aggressive and they don’t work as well if you don’t drink enough water.
Risks: The side effects from stool softeners can include dizziness, weakness, gas, bloat, mild diarrhea, rectal irritation, sweating, sore throat, nausea, and skin rashes associated with dehydration. Stool softeners are potentially habit-forming and are not considered safe to use for more than one week without a doctor’s supervision.7
3. Osmotic laxatives
Products such as Fleet Phospho-Soda, magnesium, milk of magnesia, Miralax, and non-absorbable sugars, such as lactulose or sorbitol, hold fluids in the intestine and draw fluids into the intestine from other tissue and blood vessels. This extra fluid makes stool softer and easier to pass. Drink plenty of water if you use this type of laxative.
Risks: Once again, the mechanism for somatic laxatives is pulling water off the stool. Long-term use can dehydrate the bowel, making it more challenging for natural regular elimination, leading to dependency.8
Is Magnesium Citrate Safe?
For most people, there are minimal side effects from taking magnesium citrate as a natural laxative. However, side effects like mild diarrhea and stomach discomfort are common with more serious side effects, like fainting, stomach pain, blood in stool, dizziness, sweating, weakness, respiratory allergies, low blood pressure, low calcium, and mood concerns, also reported.19
I consider magnesium a safe short-term solution for slow, sluggish, or incomplete elimination. While most folks do not experience the above side effects, studies do show that long-term use of seemingly harmless magnesium supplements can include malabsorption of key minerals, electrolyte disturbances, and kidney strain.8
In the same way magnesium sulfate (Epsom salt) pulls toxins and extra fluid from your joints, magnesium can pull excess water from the intestinal wall and dehydrate the gut while also pulling excess minerals off the intestinal wall, over time demineralizing you. This can happen insidiously with long-term use.
4. Stimulant laxatives
Products such as Correctol, Dulcolax bisacodyl Ex-Lax, Feen-a-Mint, and Senokot speed up how fast a stool moves through the intestines by irritating the intestinal lining. Regular use of stimulant laxatives is not recommended, as it can compromise absorption of vitamin D through the intestinal wall.
Herbal stimulant laxatives include Cascara sagrada, senna, Aloe latex, frangula, and prunes. Herbal laxatives that stimulate or irritate the bowel employ a constituent called anthranoids, which induce gut motility, stimulating a decrease in transit time. They also reduce fluid absorption and increase secretion in the colon, with the end result of softer stools.
Risks: Stimulant laxatives change the tone and feeling in the large intestine and can easily and quickly create chemical dependency. Large doses can result in cramping and watery stools. Additionally, studies are inconclusive as to their overall efficacy.8
As bowel irritants, long-term use can irritate and inflame the intestinal wall. Controversy exists as to whether this causes severe or lasting harm to the gut, but Ayurveda clearly says to be kind and gentle to the intestinal skin.8
Healthy Alternatives to Laxatives
The first step in supporting healthy elimination is to tone the bowel muscles and lubricate the intestinal villi and gut wall. Triphala is a classic Ayurvedic formula that consists of three fruits, which safely and effectively treat occasional constipation:9
- Haritaki tones the muscular gut wall.
- Amalaki supports health of intestinal skin and villi.
- Bibhitaki boosts removal of mucus and toxins from the gut wall.
Triphala is not a harmful, bowel-irritating laxative like senna, cascara sagrada, and others, which can be habit-forming. Clinically, I find it useful as a bowel sweep for short-term eliminative support when traveling, during times of stress, and to help reset lower digestive function.
For Dry Stools + Intestines
For elimination issues where stress causes intestinal dryness, a combination of triphala, licorice, slippery elm, and psyllium in a LifeSpa formula called Elim I can be a very effective non-habit forming bowel toning and lubrication agent.10
Slippery elm and licorice are soluble fibers, which help form a viscous layer between the intestinal wall and potential irritants. When the gut gets stressed and dry, it must be shielded and lubricated naturally and gently. These slimy fibers, in combination with triphala, support resetting healthy bowel function and are easy to quickly wean off of once elimination is balanced. Learn more about LifeSpa’s Elim 1 formula.
To activate the other herbs, an old Ayurvdic technique is to add a very small amount of psyllium to a formula that needs water to be activated. The small amount of psyllium in Elim I attracts just enough water to the other herbs to activate and allow them to effectively lubricate the intestinal mucosa and gut.
I am not a big fan of psyllium as a bulking agent for regulating stool. It sucks water off the gut wall and dehydrates the bowel, potentially turning sluggish bowels into a chronic concern. But a very small, non-bulking dose of psyllium used to attract water works brilliantly.
Four major factors must be addressed when supporting healthy bowel function.
- The liver makes bile and bile regulates how well you move your bowels. If you have issues eating hard-to-digest fats, like greasy fried foods, then you may not be providing enough bile for healthy digestion and elimination.
- Next is the environment of the gut—the intestinal skin. As mentioned above, it is key to restore the health of the intestinal lining and repopulate the gut with beneficial bacteria, while ridding undesirable bacteria.
- Finally, elimination is based on the food we eat. Processed and refined foods are a disaster for your intestinal environment and beneficial bacteria, who regulate gut immunity (70% of overall immunity).
- Finally, elimination it is about fiber, which feeds the microbiome. Modern humans eat 1/4 the fiber of our hunter-gatherer ancestors. To poo like a pro, we can all eat much better.
How is your elimination? How are you taking care of it?