Laxatives not as harmful as once thought

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DEAR DR. DONOHUE: Would you say something about laxatives? I suffer from constipation, and the only way I can deal with it is to take a laxative. I use three or four different ones, not all at the same time. I switch between them so I don’t get used to one. My wife says I’m asking for trouble. I’ll get the laxative habit, whatever that is. What is your opinion on laxatives? — R.S.

ANSWER: What I am about to say is contentious to many doctors and nondoctors. I expect a spirited response. Constipation is a common complaint, especially among elderly people. Defining it is difficult. One criterion is having less than three stools a week. A daily bowel movement isn’t necessary for health. Another criterion is straining to evacuate hard stool regardless of the frequency of bowel movements. Older people face the prospects of constipation because they eat less fiber, are less physically active and drink smaller quantities of fluid.

Adopting a diet with lots of fruits, vegetables and whole grains is one way to prevent constipation. Those foods are fiber sources. Fiber is the indigestible part of food that keeps stool soft because it retains water. Whole grains are grains that haven’t been refined. They keep their outer coat, bran. Caffeine is a stimulant of the digestive tract, and eating sets in motion reflex contractions of the intestine. Taking a walk after breakfast, when you’ve had a high-fiber cereal, whole-grain bread and some caffeine or other fluid will work in concert with that reflex to evacuate the digestive tract. Other natural remedies are eating six daily prunes or drinking 6 ounces of prune juice, and possibly yogurt.

Laxatives have their place. The “deleterious” laxative habit is a doctrine most authorities have discarded. It’s the belief that laxative use makes the digestive tract lose its normal, propelling forces to pass along undigested food. That has never been proven. The colon doesn’t become a slave of laxatives. Laxatives don’t cause major health problems. Mineral oil can decrease the absorption of vitamins A, D, E and K.

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The booklet on constipation provides details not discussed here. To order a copy, write: Dr. Donohue — No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: You’re probably too young to have seen children who had water on the brain. I don’t hear this spoken of anymore. Why? Has improved care during pregnancy caused it to disappear? I asked my daughter about this, and she told me to write to you. — B.K.

ANSWER: I’m too young? A million thanks. Hydrocephalus, water on the brain, hasn’t gone away. It still happens. About seven out of 10,000 newborns have it. The brain has hollow spaces called ventricles. Spinal fluid circulates through those ventricles and over the surface of the brain and spinal cord. Eventually, it is absorbed into the circulation. If there’s an obstruction to the flow of spinal fluid, water remains in the brain’s ventricles and distends them and the brain. The head expands. All of this is correctable by shunting the fluid out of the brain and into other body cavities, like the abdominal cavity. That prevents destruction of brain cells. If possible, the neurosurgeon corrects whatever is causing the fluid obstruction.

DEAR DR. DONOHUE: Since I am concerned about the number of calories and the grams of sugar in orange juice, I dilute it with water — 8 ounces of orange juice with 8 ounces of water. Does this change the calories and sugar content (and other nutrients) in the orange juice to half? — M.R.

ANSWER: You have not destroyed any calories or any sugar. You’ve got the exact same amount you had before you added the water. If you mean you drink only 8 ounces of the diluted mix, you have cut the calories and sugar in half.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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