Laxatives: Dementia Trigger?

can laxatives cause dementia

There is a potential link between the regular use of laxatives and an increased risk of dementia, according to a study published in the journal Neurology in February 2023. The research, which involved over 500,000 participants from the UK, found that people who regularly used laxatives had a 51% higher risk of developing dementia compared to those who did not. The risk also increased with the number and type of laxatives used. However, it is important to note that the study only shows an association and does not prove causation. Further research is needed to confirm the link and understand the underlying mechanisms.

Characteristics Values
Risk of dementia 51% increased risk
Type of laxatives Osmotic laxatives have a greater risk
Number of laxatives Risk increases with the number of laxatives used
Usage Regular use of laxatives
Alternative treatments Lifestyle changes such as drinking more water, eating more fibre, and adding more activity



Laxatives are a common treatment for constipation, but recent studies have found a potential link between their regular use and an increased risk of developing dementia. This has sparked concerns about the safety of these widely used medications and raised questions about their potential long-term effects on brain health.

The Research

A team of researchers from Harvard University, China, and the UK conducted a large-scale observational study involving over 500,000 participants from the UK Biobank. The study, published in the journal Neurology, found that people who used laxatives regularly were 50% more likely to develop dementia. This risk increased with the number of laxative types used, with those taking two or more types of laxatives having a 90% higher risk compared to non-users.

The Gut-Brain Connection

The exact mechanisms underlying the link between laxatives and dementia are not yet fully understood. However, one possible explanation lies in the gut-brain connection. It is suggested that regular laxative use may alter the gut microbiome, affecting nerve signalling from the gut to the brain. This disruption in the gut microbiome may also lead to an increased production of intestinal toxins that can impact the brain and contribute to neural damage.

Recommendations and Further Studies

While the study did not prove causation, it highlights the importance of cautious laxative use. Experts recommend that individuals treat constipation by making lifestyle changes, such as increasing water intake, dietary fibre, and physical activity. Further studies are needed to confirm the link between laxatives and dementia, as well as to explore potential contributory factors and specific mechanisms involved.

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The impact of laxatives on the gut microbiome

The gut microbiome is a complex ecosystem that mediates the interaction of the human body with its environment. It is the balance of bacteria in the body, with billions of bacteria playing vital roles in digestion, elimination, and other functions. When this balance is disrupted, it can result in a range of diseases and disorders, including mental disorders due to the gut-brain health link.

Laxatives, which are fast-acting remedies for constipation, can disrupt the gut microbiome. They work by drawing water into the intestine to make the stool softer and easier to pass. Recent studies have shown that laxatives can negatively impact the gut microbiome, with one study on mice finding that a common component of over-the-counter laxatives, polyethylene glycol, caused certain microbes to flourish while hampering the growth of other microbes essential for good health. This led to a less diverse range of gut bacteria, which is a problem for bowel health and can lead to issues like Crohn's disease.

In humans, a study found that changes in the gut microbiome after a pre-colonoscopy enema persisted for a month, indicating long-term changes. The study also found a decrease in Lactobacilli bacteria, which may affect immune function and increase the risk of chronic diseases like diabetes, metabolic syndrome, and obesity. Additionally, the numbers of bacteria like enterobacteria and streptococcus were significantly higher than normal, with streptococcus bacteria four times the normal amount a month after the enema.

To mitigate the potential negative impacts of laxatives on the gut microbiome, it is recommended to:

  • Take probiotics containing Lactobacilli cultures to support a natural gut bacteria balance.
  • Eat gut-healthy foods, such as oily fish, whole grains, fruits, vegetables, and pulses, to encourage a diverse range of good bacteria in the body.
  • Increase water intake to ensure stool softness and lubrication, as dehydration is a common cause of constipation.
  • Exercise regularly to promote healthy bowel movements, although individuals with AFS should consult a medical professional before increasing physical activity.
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The role of toxins in dementia development

Research has shown that regular use of laxatives may increase the risk of dementia by up to 51%. However, it is important to note that the studies only show an association between laxative use and dementia, and do not prove causation.

The exact mechanisms by which laxatives may contribute to dementia risk are not yet fully understood. One possible explanation is that laxatives can disrupt the gut microbiome, leading to changes in nerve signalling from the gut to the brain. Additionally, laxatives may increase the production of intestinal toxins that can affect the brain. These toxins are associated with inflammation, neural damage, and amyloid deposition, which is a biomarker for dementia.

The risk of dementia was found to be higher among individuals who used multiple types of laxatives or only osmotic laxatives. Osmotic laxatives work by drawing water into the colon to soften the stool, and their use was associated with a 64% increase in the risk of dementia compared to non-users. On the other hand, stimulant laxatives, which are also not recommended for regular use, encourage muscle contractions to move the stool mass.

Further studies are needed to confirm the link between laxative use and dementia and to identify potential contributory factors or specific mechanisms. While constipation can be a frustrating condition, it is recommended that individuals focus on lifestyle changes, such as increasing fluid intake, dietary fibre, and physical activity, rather than relying solely on laxatives for relief.


The importance of further research

Additionally, the study did not account for personal factors that influence laxative use, such as dietary fiber intake and constipation severity. Further research should also focus on understanding the specific mechanisms underlying the potential link between laxatives and dementia. This includes investigating the role of the gut-brain axis, gut microbiome changes, and the production of neurotoxic metabolites. Understanding these mechanisms will help develop improved treatment and prevention strategies for dementia.

Furthermore, the study did not differentiate between different types of laxatives and their long-term effects on dementia risk. Bulk-forming, stool-softening, osmotic, and stimulant laxatives may have varying impacts on cognitive function and should be studied independently to determine their individual effects. Finally, the validity of dementia subtype diagnoses, particularly for vascular dementia, is not high, which may influence the risk estimates. Therefore, further prospective cohort studies with larger and more diverse populations are necessary to confirm and expand upon the findings of the initial study.

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Alternative treatments for constipation

Constipation can be uncomfortable and stressful, but there are many at-home treatments that can help relieve it.

Dietary Changes

  • Increase your intake of fibre through your diet. The recommended daily fibre intake is 22 to 34 grams for adults, but this varies by age and sex.
  • Fibre supplements such as Metamucil, All-Bran, and Citrucel can be used to enhance a low-fibre diet.
  • Eat more soluble, non-fermentable fibre, such as psyllium, which is 3.4 times more effective than insoluble wheat bran for constipation.
  • Consume more probiotic-rich foods, such as Bifidobacteria and Lactobacillus, or try a probiotic supplement.
  • Try a low FODMAP diet, which can help treat IBS and may relieve IBS-related constipation.
  • Eat prebiotic foods, such as oligosaccharide and inulin, which improve digestive health by feeding beneficial bacteria in the gut.
  • Try magnesium citrate, an over-the-counter osmotic laxative that can help relieve constipation.
  • Eat prunes or drink prune juice, which contain the sugar alcohol sorbitol, a natural laxative.
  • If you have a dairy intolerance, removing dairy from your diet may help relieve constipation.

Drink More Water

  • Dehydration can cause constipation, so it is important to drink enough water and stay hydrated.
  • Drinking carbonated water may be more effective than drinking tap water at relieving constipation.


Exercise may help reduce the symptoms of constipation in some people.


Coffee can help relieve constipation by stimulating the muscles in the gut.


Senna is a safe and effective herbal laxative that helps treat constipation. It is available over the counter and online, in both oral and rectal forms.

Other Treatments

  • Biofeedback therapy can help retrain your muscles to have a bowel movement.
  • Massage your own abdomen in a certain pattern to encourage bowel movements.
  • Try adjusting your toilet posture; squatting, raising your legs, or leaning back may make it easier to poop.
  • Give yourself enough time to have a bowel movement and try to relax your muscles.
  • Check if any medications you are taking could be causing constipation, and ask your doctor if there is an alternative.
  • If constipation persists, your doctor may prescribe medication or, in rare cases, surgery to treat the condition.
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