Dear Doc Willie:
My problem is constipation and my friend advised me to take a slimming herbal tea, which is very effective to me but some people are saying that it has side effects. Could you please enlighten me?
— Marian
The herbal tea you mentioned contains senna, Shiu Sen tea. and malvae. Senna is a laxative used by doctors to clear the bowels before a bowel examination or surgery. Senna and other laxatives may cause diarrhea, nausea, vomiting, rectal irritation, stomach cramps or bloating. Some patients may also experience rapid heart rate, weakness, dizziness, and fainting. It is not advisable to take them for more than a week.
I personally do not give laxative herbal supplements as they could deplete one’s potassium levels. Low levels of potassium can lead to leg numbness, weakness, and paralysis. If untreated, patients can die. In addition, laxatives are habit-forming and you will end up constipated again once you stop taking the supplement. This is called rebound constipation and laxative dependence.
Many people abuse such laxatives because it helps them lose a little weight. The tried-and-tested method of eating less, exercising more, and choosing healthier foods is safer for your body.
What is constipation?
Constipation is really a subjective complaint and it just means less frequent bowel movements. The feces become small, hard, and are sometimes painful to push out. There is no such thing as a normal bowel movement as this may range from a bowel motion once a week up to three times a day.
A person’s bowel habit depends on many things, including the food you eat and drink, and how much you exercise. Constipation can be caused by a variety of factors: 1) a low-fiber diet, 2) inadequate fluid intake, 3) poor toilet habits (i.e. not going to the toilet when you need to), 4) not enough exercise, 5) pregnancy, 6) side effects of some medications, and 7) old age. Older people, if you noticed, are usually constipated and sometimes get obsessed with talking about their bowel movements.
Constipation can give rise to hemorrhoids, leading to bleeding. Constipation is also potentially harmful for people with heart disease as this can give rise to a heart attack. Did you know that the most common place of a heart attack is the bathroom?
There are many scientists who believe that constipation may also promote cancer of the bowels. If these waste materials are allowed to stay in your bowels for a long time, this might somehow induce cancer.
Drugs for constipation
Laxatives are drugs which help you move your bowels, but these should be used only for a few days. Laxatives come in many forms: liquid, tablets, and anal suppositories.
There are laxatives for quick relief (less safe) and other drugs for slow relief (more safe) from constipation. For fast action (you move your bowels in eight to 12 hours), there is Bisacodyl (brand name: Dulcolax) 5 mg. tablets, taken one or two at night. I only prescribe these sparingly because we don’t want your bowels to become dependent on these chemicals.
For slower and safer relief from constipation (effective in two to three days), you can take Lactulose (brand name: Duphalac) one to two tablespoons every night. Elderly bedridden patients can take Lactulose for months. Another safe option is psyllium (brand name: Metamucil). Mix one sachet in a glass of water, to be taken once or twice daily. Despite the availability of these drugs, I would still prefer to treat constipation through natural and healthier means.
Natural treatment FOR constipation
• Eat more fibrous vegetables. The usual culprit for constipation is lack of dietary fiber. Fiber helps form soft, bulky stool and we need 20-30 grams of fiber per day. Our local vegetables are high in fiber, such as kangkong, patola, okra. Gradually introduce these veggies into your diet. Limit foods that contain little fiber such as ice cream, cheese, meat, snack chips, pizza, and processed foods.
• Eat more fruits. Certain fruits give healthy and natural relief from constipation. Watermelon, papaya, and grapes promote bowel movement.
• Drink plenty of water, from eight to 12 glasses a day. Liquids help keep the stool soft and easy to pass. Many people live unhealthily on just three to four glasses of liquids daily.
• Move your body. Regular exercise helps keep your bowel active and moving. A 20 to 30-minute walk every day is sometimes the best treatment for constipation. Walking, jogging, jumping in the morning can promote bowel movement.
• Laugh away your constipation. We’re not kidding, but a good belly laugh can help relieve constipation by exercising the abdominal muscles. Laughter has a massaging effect, too, on the intestines and it can help fight stress. Be happy, not constipated.
• Schedule your bowel movement. Don’t ignore your body’s urge to have a bowel movement. Toilet train yourself by taking time out for a bowel movement at the same time and place daily.
• For the elderly, consider gentle abdominal massage. This promotes movement of the stool through the intestines and works in the same way as exercise does.
• Check your other medications. Some drugs can cause constipation as a side effect. Common offending drugs are painkillers, anti-depressants, and anti-spasm drugs.
When to consult a doctor
Most constipated people do not need to see a doctor. However, you should see your doctor if you have any of the following: 1) notice blood in your bowel motions, 2) are over the age of 40 and with new symptoms, (3) are losing weight or 4) have a family history of bowel cancer.
In my experience, majority of constipated patients can be treated by natural methods. Discover for yourself what technique works best for you. Good luck!
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