Long-Term Use of Laxatives: Risks and Kidney Health Concerns

Q: Long-Term Use of Laxatives: Risks and Kidney Health Concerns

Hello： The process of defecation typically involves several components. <br>First, the ascending colon and sigmoid colon push the stool into the rectum, which triggers the rectal and anal reflexes, leading to the relaxation of the sphincter muscles and the sensation of urgency. <

Constipation..?

It might be due to my constitution, but I have been suffering from constipation since childhood.
At one point, I was concerned that constipation would lead to weight gain, so I started buying stool softeners from the pharmacy on my own.
Since they were very effective, I ended up using them long-term.
Now, I can't have a bowel movement without taking stool softeners, and the dosage I need has increased over time due to prolonged use.
I have seen doctors, but because I have been using over-the-counter stool softeners for so long, none of the medications prescribed by the doctors have worked.
Even the oil used for bowel preparation before a colonoscopy didn't help, as I used 3 to 4 bottles without any effect.
I would like to ask if long-term use of stool softeners could put a burden on my kidneys and potentially lead to a situation where I might need dialysis in the future.
I genuinely believe that my constipation is due to my constitution, as I drink over 3000cc of water daily and consume a large amount of vegetables, especially leafy greens and broccoli, along with fish.
I have also tried fiber supplements, but nothing seems to work...

Kiwi, 10~19 year old female. Ask Date: 2004/03/08

Dr. Wang Qichao reply Surgery

Hello: The process of defecation typically involves several components.
First, the ascending colon and sigmoid colon push the stool into the rectum, which triggers the rectal and anal reflexes, leading to the relaxation of the sphincter muscles and the sensation of urgency.
The external anal sphincter and pelvic floor muscles then coordinate with abdominal pressure to expel the stool.
If there is a problem in any of these steps, it may result in constipation.
When evaluating a patient with constipation, organic issues are generally ruled out first (through endoscopy or colonography), followed by the administration of fiber supplements and prokinetic agents.
If treatment is ineffective, further assessment of stool transit time in the colon, defecography, and anorectal physiology tests are necessary to determine the underlying cause.
Sincerely, Dr.
Wang Qi-Chao, Department of Surgery, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2004/03/08

More Info

Long-term use of laxatives, particularly stimulant laxatives, can lead to several health concerns, including potential risks to kidney health. Your situation, where you have developed a dependency on laxatives to have a bowel movement, is not uncommon among individuals who have used these medications for an extended period.
Laxatives work by stimulating bowel movements or softening stool, but over time, the body can become reliant on them. This dependency can lead to a condition known as "laxative abuse," where the normal function of the intestines is impaired, and the individual finds it increasingly difficult to have a bowel movement without the aid of laxatives. This can create a vicious cycle, requiring higher doses of laxatives to achieve the same effect, which can further exacerbate the problem.

In terms of kidney health, while most laxatives are not directly nephrotoxic (toxic to the kidneys), there are indirect risks associated with their long-term use. For instance, excessive use of laxatives can lead to dehydration, especially if they cause diarrhea. Dehydration can strain the kidneys and potentially lead to acute kidney injury, particularly in individuals who may already have underlying kidney issues or are at risk for them. Furthermore, certain types of laxatives, such as magnesium-based ones, can lead to electrolyte imbalances, which can also affect kidney function.

Moreover, if you are consuming high doses of laxatives, there is a risk of developing metabolic alkalosis or other electrolyte disturbances, which can have systemic effects, including on the kidneys. Chronic electrolyte imbalances can lead to complications such as kidney stones or impaired kidney function over time.

Given your description of drinking plenty of water and consuming fiber-rich foods, it seems that you are making efforts to manage your constipation through dietary means. However, if these strategies are not effective, it may be beneficial to consult a healthcare professional for a comprehensive evaluation. They can help identify any underlying issues contributing to your constipation and suggest alternative treatments that do not involve long-term laxative use.
In some cases, a healthcare provider may recommend a gradual tapering off of laxatives, allowing your bowel to regain its natural function. They may also suggest other interventions, such as probiotics, dietary adjustments, or even medications that promote bowel regularity without the risks associated with stimulant laxatives.

In conclusion, while laxatives can be effective for short-term relief of constipation, their long-term use can lead to dependency and potential risks to kidney health, primarily through dehydration and electrolyte imbalances. It is crucial to work closely with a healthcare provider to develop a safe and effective plan to manage your constipation without compromising your overall health.

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