Can laxatives help bloating
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Can Laxatives Help Bloating?
Introduction to Laxatives and Bloating
Laxatives are commonly used to treat constipation, but their effects on bloating are more complex. Bloating is a common gastrointestinal symptom characterized by a feeling of fullness and distension in the abdomen. This article explores whether laxatives can help alleviate bloating, based on recent research findings.
Types of Laxatives and Their Effects on Bloating
Bulking Agents and Nonabsorbable Compounds
Bulking agents, such as psyllium, and nonabsorbable compounds like lactulose, are generally safe but can cause bloating as a side effect. These types of laxatives work by increasing the bulk of the stool, which can lead to gas production and bloating1.
Osmotic Laxatives
Osmotic laxatives, including polyethylene glycol (PEG) and magnesium-based products, draw water into the bowel to soften stools. While effective for constipation, they can also cause bloating, especially if used frequently or in high doses1 3. However, when used intermittently and in the absence of conditions like bowel obstruction, they have few adverse effects1.
Stimulant Laxatives
Stimulant laxatives, such as senna and bisacodyl, are effective for constipation but can also lead to bloating and other gastrointestinal symptoms like cramps and gas1 3. Despite their efficacy, these side effects can negatively impact the quality of life for users5.
Traditional Medicine and Bloating
Daikenchuto (TJ-100)
A study on the traditional Japanese medicine Daikenchuto (TJ-100) found that its addition to stimulant laxatives significantly improved bloating and abdominal pain in patients with chronic constipation. The improvement was attributed to a decrease in bowel gas volume, suggesting that TJ-100 could be a beneficial adjunct therapy for bloating2.
Over-the-Counter Therapies and Bloating
A systematic review of over-the-counter (OTC) therapies for chronic constipation highlighted that while products like PEG and senna are effective for constipation, they often come with side effects such as bloating and abdominal pain3. This indicates that while these laxatives can relieve constipation, they may not be the best option for those primarily seeking relief from bloating.
Laxative Use in Older Adults
Older adults often use laxatives to manage constipation, but this can lead to persistent bloating and other unpleasant symptoms. The reliance on laxatives for short-term relief can ignore underlying causes and result in a cycle of bloating and discomfort4.
Laxatives and Opioid-Induced Constipation
In patients with opioid-induced constipation, laxatives are frequently used but are often ineffective in relieving bloating. Instead, they can exacerbate symptoms like gas and fullness, further impacting the patient's quality of life5.
Conclusion
While laxatives are effective for treating constipation, their role in alleviating bloating is less clear. Many types of laxatives, including bulking agents, osmotic, and stimulant laxatives, can cause bloating as a side effect. Traditional medicines like Daikenchuto (TJ-100) show promise in reducing bloating when used alongside stimulant laxatives. However, for those primarily seeking relief from bloating, alternative treatments or adjunct therapies may be more effective.
Sources and full results
Most relevant research papers on this topic
Adverse effects of laxatives
Laxatives are generally safe when used judiciously, intermittently, and in the absence of contraindications, but caution is advised when using stimulant laxatives due to potential neoplastic potential and hepatotoxicity.
Highly CitedEffect of Traditional Japanese Medicine, Daikenchuto (TJ-100) in Patients With Chronic Constipation
Adding Daikenchuto (TJ-100) to stimulant laxatives significantly reduced bloating and abdominal pain in patients with chronic constipation, possibly by decreasing bowel gas volume.
RCT
Rigorous JournalEfficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review
Polyethylene glycol and senna are effective first-line treatments for chronic constipation, while fiber supplements, fruits, stimulant laxatives, and magnesium-based products show moderate evidence.
Systematic ReviewOlder people and laxative use: literature review and pilot study report.
Older adults often use laxatives to manage constipation, highlighting the need for nurses to work within a "wellness" framework to address underlying causes and promote bowel function.
Literature ReviewLaxatives Do Not Improve Symptoms of Opioid-Induced Constipation: Results of a Patient Survey
Laxatives are often ineffective and associated with side effects, negatively impacting quality of life for patients taking opioids for chronic pain.
Observational Study
Very Rigorous JournalLaxative Abuse
Laxative abuse is prevalent among individuals with eating disorders, middle aged or older individuals, athletes, and those aiming to cause diarrhoea for weight loss.
Highly CitedConstipation—modern laxative therapy
Macrogol is the first choice for chronic constipation treatment in palliative care patients, as it effectively hydrates, increases stool volume, and reduces colon passage duration.
Highly CitedLaxatives: an update on mechanism of action.
Laxatives cause rapid transit of material through the bowel by causing myoelectric alterations in intestinal smooth muscle and causing fluid accumulation in the intestinal lumen, with potential mucosal and muscle sites of action.
Highly CitedEffect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis
Laxatives, prucalopride, lubiprostone, and linaclotide are all more effective than placebo for treating chronic idiopathic constipation.
Meta-AnalysisRigorous JournalHighly CitedThe status of vitamins B6, B12, folate, and of homocysteine in geriatric home residents receiving laxatives or dietary fiber
Oat-bran supplementation improves constipation management and B12 bioavailability in elderly nursing home residents with multiple chronic diseases.
RCT