Laxatives And Piles: Understanding Safe Usage And Relief

Laxatives are an effective treatment for piles, helping to regulate digestion and prevent constipation and diarrhoea, the two main causes of piles. However, laxatives are habit-forming and can create dependency, so they should be used as a last resort. Before turning to laxatives, it is recommended to try lifestyle changes such as increasing fibre intake and drinking more fluids.

There are many different types of laxatives, which work in different ways and take different amounts of time to take effect. Some laxatives take effect within 15-30 minutes, while others can take 48-72 hours. Suppositories are the fastest-acting laxatives, while bulk-forming laxatives are the gentlest and safest option.

Bulk-forming laxatives

Some common bulk-forming laxatives include:

• Psyllium (Metamucil)
• Polycarbophil (FiberCon)
• Methylcellulose (Citrucel)
• Fybogel (ispaghula husk)

While bulk-forming laxatives are generally safe, some people may experience side effects such as mild stomach pain, bloating, or gas. It is important to follow the dosage instructions on the label and consult a doctor if you experience any adverse reactions or if your constipation persists despite the use of laxatives.

Stimulant laxatives

While stimulant laxatives can provide relief for constipation, they should be used with caution. Some possible side effects of stimulant laxatives include abdominal pain, diarrhoea, and nausea. More serious side effects that require immediate medical attention include rectal bleeding, severe stomach pain, and vomiting. It is important to note that stimulant laxatives can be habit-forming, and prolonged use can be harmful to the bowels. Therefore, they should not be used for more than a week unless specifically advised by a doctor. Additionally, stimulant laxatives should not be given to children under the age of six without the instruction of a pediatrician.

Before using stimulant laxatives, it is crucial to consult with a doctor, especially if you have certain health conditions, are pregnant, or are breastfeeding. If constipation persists or becomes chronic, it is recommended to see a doctor for further evaluation and treatment options.

Saline laxatives

Side effects of saline laxatives can include mild abdominal discomfort, cramps, gas, nausea, and diarrhoea. If diarrhoea occurs, it is important to drink plenty of clear liquids to avoid dehydration, which can cause serious side effects to the kidneys and heart. Saline laxatives can also cause an electrolyte imbalance, particularly in those with kidney or heart problems, and should be used with caution. They may also affect the absorption of other medications.

Natural laxatives

Types of Natural Laxatives

• Bulk-forming laxatives: These move through the body undigested, absorbing water and swelling to form stools. Examples include Metamucil and Citrucel, available in powder and capsule form.
• Stool softeners: These increase the amount of water absorbed by stools, making them softer and easier to pass. Examples include docusate sodium and docusate calcium, available in pill or tablet form.
• Lubricant laxatives: These coat the intestinal lining and stools to retain moisture, allowing for softer stools and easier passage. An example is mineral oil, available in liquid or enema form.
• Osmotic-type laxatives: These help the colon retain more water, increasing bowel movement frequency. Examples include milk of magnesia and glycerin, available as a liquid, caplet, enema, or suppository.
• Saline laxatives: These draw water into the small intestine to encourage bowel movements. An example is liquid magnesium citrate.
• Stimulant laxatives: These speed up the movement of the digestive system to induce a bowel movement. They are available in various forms, such as tablets, pills, powders, chewables, liquids, and suppositories, under brand names like Ex-Lax, Senokot, and Dulcolax.

Natural Laxative Foods

• Chia seeds: High in insoluble fibre, with 9.6 g per ounce (28.4 g). Can be added to yoghurt, smoothies, oatmeal, or salads, or mixed with water.
• Berries: Relatively high in fibre, with blueberries providing 3.6 g per cup (150 g).
• Legumes: Include beans, chickpeas, lentils, peas, and peanuts. High in fibre, with 1 cup (180 g) of boiled lentils containing 14.2 g. Also help increase the body's production of butyric acid, which may act as a natural laxative.
• Flaxseeds: Contain both insoluble and soluble fibre, acting as a natural stool softener. One tablespoon provides 5 g of fibre.
• Kefir: A fermented milk product containing probiotics, which improve stool consistency and speed intestinal transit.
• Leafy greens: Include spinach, kale, and cabbage, which are rich in fibre and magnesium. Magnesium helps draw water into the intestines to aid stool passage.
• Prunes and prune juice: Contain sorbitol, a sugar alcohol that has a laxative effect.
• Fruits: The skins of fruits like apples, pears, and mangoes contain insoluble fibre. Kiwi skin is also edible and provides 50% of the fruit's fibre content.
• Coffee: Contains caffeine, which stimulates the muscles in the digestive system. Both caffeinated and decaffeinated coffee stimulate the hormone gastrin, which contracts stomach muscles.

Other Tips for Constipation Relief

• Drink plenty of water: Dehydration can cause constipation.
• Exercise regularly: A sedentary lifestyle is linked to an increased risk of constipation.
• Probiotics: Consuming probiotic-rich foods or supplements may help treat constipation by improving gut bacteria balance.
• Avoid dairy: Dairy intolerance can cause constipation.
• Low FODMAP diet: This elimination diet may help relieve constipation associated with irritable bowel syndrome (IBS).
• Glucomannan: A type of soluble fibre that may be effective against constipation. Found in shirataki noodles or as a supplement.
• Prebiotic foods: Improve digestive health by feeding beneficial gut bacteria. Examples include Jerusalem artichokes, garlic, and onions.

It's important to note that natural laxatives may not provide instant relief and can take up to a few days to work. Additionally, they should be used sparingly, and if constipation persists beyond a week, it's recommended to consult a doctor.

Suppositories

OTC suppositories are available in several types, each containing different medications for different results. Some suppositories can relieve swelling, burning, pain, and itching caused by hemorrhoids. Others may relieve constipation, which can worsen hemorrhoids. Suppositories are typically used two to four times per day for a week, preferably after a bowel movement to prolong their effect.

To use a suppository, first empty your bowels if possible, as the longer the medicine remains in place, the better. Next, remove any wrappings and moisten the suppository with a few drops of water to soften it. Stand beside a chair with one foot propped up, or lie on your side with your bottom leg straight and your top leg tucked toward your stomach. Relax your buttocks, and gently but firmly push the suppository into your body, ensuring it is at least one inch past the anal sphincter. Remain lying down or seated for at least 15 minutes to allow the body's heat to melt the suppository and for the absorption process to begin.

It is important to note that suppositories should only be used for a limited time to prevent possible complications. If your symptoms do not improve within a week, or if you experience bleeding or worsening pain, consult your doctor promptly.

Frequently asked questions