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Why Constipation Is No Laughing Matter

One of my secret shames is that I love very stupid slapstick comedy. I know that it is beneath me, but when I see Kramer slide through Jerry’s door, or watch Mr Bean attempting to get changed without a towel, my sides nearly split. However, I do take issue with a certain kind of joke that gets trotted out all too often: The ‘laxatives in your drink’ prank. The most iconic moment is Jeff Daniels in the 1994 cult classic Dumb and Dumber. It’s the one moment of the film I don’t find funny, because it takes a really helpful and useful medical treatment and relegates it to the ridiculous, the comical. But there is nothing funny about constipation.

I know, this is a very pharmacist hill to die on, but I want to make sure the people know why laxatives are wonderfully useful, and are not just a trope for stoner comedy movies.

What are laxatives?

Laxatives are a broad name for the kinds of medicines which would help you to pass a bowel movement with more ease. In layman’s terms, they help you to poo without having to strain so much.

How do they work?

Often, we find it hard to poo if there isn’t enough liquid in our bowels. So the poo in your stomach becomes solid, and it is harder to squeeze it out. A laxative usually functions to draw as much liquid as possible towards your bowel so that the poo becomes less dense, and it is easier to pass. The added liquid in your bowels means that when you do finally make a bowel movement, it is generally more frequent and more liquidy than normal. But if there is a build up in your stomach, it becomes imperative that we empty the bowels before further health concerns begin to arise. If we don’t pass the stool regularly, it can have pretty serious health concerns:

  • Faecal impaction: This is when the stools begin to move into our abdominal cavity and begin poisoning our body, much like if we just injected faecal matter orally. This can make you extremely unwell, or in some cases it can be fatal.
  • Haemorrhoids: When you need to strain too hard to poo, you can put too much pressure on the veins in and around your anus. They can become engorged, swelling out so that it becomes difficult not only to poo, but to sit down. It is probably something you’d like to avoid if possible, and a laxative might be your best chance
  • Anal fissure: If the stoll you are attempting to pass is too hard and won’t break up, it can actually gouge a trench the whole way down your anus. You will end up with unsettling amounts of blood in the toilet after you finish, and every subsequent bowel movement will feel like you are passing razor blades. 0/10, would not recommend.
  • Rectal Prolapse: This is about as fun as it sounds. Undue pressure from a bowel movement can actually cause some of your rectum to stretch and hang out of your anus.

When would I need a laxative

You would need a laxative when you are severely out of rhythm for what is natural for you. Medically speaking, it becomes very important if you have failed to successfully pass a bowel motion in about 3 days. Here are a list of symptoms which might get alarm bells ringing.

  • If you have made two or fewer bowel motions in a week
  • The stools that you are passing are lumpy, hard or dry
  • You really need to push and strain to get anything out
  • Cramping in your abdominals
  • Feeling bloated
  • Feeling as though you haven’t really emptied your bowel after you have been to the toilet
  • Any blood in the stool or when you wipe. Sometimes we strain so hard that we can tear part of our anus in the attempt

If you have experienced any of the above, it might be time for you to consider taking a laxative to help nature run its course.

Bristol Stool Chart

Doctors use a resource called the Bristol Stool Chart to determine whether someone might need a laxative to help restore normal bowel function. It reads thusly:

Type 1 – Separate hard lumps – Severe constipation

Type 2 – Lumpy and sausage like – Mild constipation

Type 3 – Sausage with cracks in the surface – Normal

Type 4 – Smooth soft sausage of snake – Normal

Type 5 – Soft blobs with clear cut edges – Lacking fibre

Type 6 – Mushy consistency with ragged edges – Mild diarrhoea

Type 7 – Liquid consistency with no solid piece – Severe diarrhoea

If you are anywhere in types 1 or 2, you might need to consider using a laxative.

Any recommendations?

One of the most popular choices is a product called OsmoLax. It uses an active ingredient called macrogol 3350 which is considered to be gold standard to assist the treatment of constipation in children and adults. OsmoLaxcomes in a liquid form, and is virtually tasteless when you mix it with your favourite drink. In hindsight, it is easy to see why this makes it a go-to for stoner comedies… While some laxatives cause the bowel to contract, OsmoLax just draws liquid there in a process known as osmosis to make sure that the effects are immediately felt, and that it doesn’t cause unnecessary cramping that can happen if the bowel is made to contract.

What can I do to minimise the chances of becoming constipated?

  1. Include plenty of foods rich in fibre into your diet: Beans, veggies fruits, whole grain cereals
  2. Avoid processed foods, dairy and meat. These are all lower in fibre
  3. Make sure you are staying hydrated. This minimises your chances of getting hard rock like stools forming in your bowel
  4. Get regular exercise to keep your body running as normally as possible
  5. Cut down on stress. Easier said than done, right?
  6. Poo when you need to poo. Sometimes holding it in can compact the stools in your stomach which can eventually lead to constipation

There you have it. Laxatives like OsmoLax play an integral part in maintaining our health. Shame on you Jeff Daniels, shame on you…

Insincerely yours,

Floyd