Laxative Alternatives

March 30, 2009 Written by JP    [Font too small?]

One of the best types of testimonials I often hear about are from people who are able to stop using medications by adopting a healthier lifestyle or by utilizing a natural alternative. From my perspective, medications should only be used as a last resort. Unfortunately, my view may be in the minority. These days, medications are frequently used because they successfully mask bothersome symptoms and do so in a way that requires little to no effort from those using them. The problem with this philosophy is that every medication has the potential for side effects.

The senior population is a group that I’m especially concerned about. Seniors are often prescribed multiple medications and may often feel as though their options are restricted due to limited access to alternative care and/or a fixed income. Today I’d like to focus on a natural, inexpensive option for a very common problem in the elderly. But I urge my younger readers to consider this information as well. Not only do these same issues affect young and old alike, but the remedy discussed today may have far reaching health benefits beyond just “regularity”.

Fiber Rich Foods

Meet Metamucil

A study was recently published in the February issue of the Journal of Nutrition, Health & Aging. The goal of that trial was to determine whether oat fiber could serve as a viable alternative to laxatives in a treatment facility for the elderly. The rationale for a non-laxative option is that laxatives are known to promote nutritional malabsorption and weight loss in seniors under medical care. Here are some of the specifics of the experiment:

  • 15 elderly patients received 7 to 8 grams of oat bran per day mixed in with their food.
  • Another group of 15 seniors ate the same standardized hospital diet but with no added fiber.
  • Body weight, bathroom habits, eating patterns and laxative usage were monitored at the beginning, middle and end of the 12 week study.

The results of this research showed a few important trends:

  • 59% of the fiber users were able to discontinue their use of laxatives.
  • The group that didn’t have the added fiber actually increased their daily dosage of laxatives by 8%.
  • Those using the fiber did not lose weight. This was considered important because this group of participants was already classified as being “frail” at the start of the study.
  • Those consuming the laxatives did exhibit a decrease in body weight. This is consistent with the previous findings of malabsorption, which could lead to greater frailty and related complications.

A similar study was published in June of 2005 in the journal Gerodontology. In that research, 92 nursing home patients participated in an experiment to see if they could reduce or stop using laxatives by replacing them with a natural fiber supplement. The dosage of fiber used in this study was almost twice that of the first study. Here, 7 grams of fiber were given with a meal twice a day. The duration of this trial was also substantially longer at 2.5 years. Here’s a summary of what that study found:

  • 63 of the 92 patients were able to discontinue use of laxatives. That’s a success rate of about 69%.
  • From a cost standpoint, the hospital involved (New York Methodist Hospital in Brooklyn, NY) determined that providing fiber (in lieu of the laxatives) could save approximately $3.50 a day per patient.

The authors of the study summarized the results in this way, “The fiber supplement was a safe and convenient alternative to laxatives and decreased the cost of medical care.”

Berries Are a Great Source of FiberI support using fiber supplements for managing constipation. But they’re not the only game in town. I’m confident that many of the volunteers who didn’t respond to the fiber therapy would likely benefit from some of the other suggestions I offered in a previous column entitled Constipation No More.

Please bare in mind that drinking extra fluids is a vital component to any fiber-enriched diet. Increasing fiber without drinking adequately can worsen constipation.

I think it’s also important to note that fiber can easily be acquired by making better dietary choices. A few of my favorite high fiber foods include: organic avocados, organic blackberries and raspberries and organic coconut flour. The beauty of using foods as a fiber source is that they provide other nutrients and phytochemicals (healthful plant chemicals) along with the bulking agents. That’s a powerful combination for promoting good health.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


Tags: , ,
Posted in Alternative Therapies, Detoxification, Nutritional Supplements

12 Comments & Updates to “Laxative Alternatives”

  1. Mya Says:

    Hi JP,

    I have recently discovered that my body has been immnue to a axative tea I started taking in the summer and I’ve now had to increase my intake to 2-3 cups a day. I’m tired of trying to get off this aid and giving into it a couple days in. My doctor suggested I take “Apo- lactulose” a very sweet syrup that’s suppose to help instead of the harmful laxative “slim tea”. But because I’m on a very low calorie diet, I don’t think it’s the best thing for my weight loss. What should I do? I eat a lot of fruits and vegetables, drink plenty of water and exercise a lot. I’ve also tried to take an all natural bulk fibre, which is horrible to shove down my throat!

    Please help me!!


  2. JP Says:

    Good day, Mya.

    There are a few options that I would personally consider if I were in your situation:

    1. I might supplement with magnesium. Many people start by taking 250-500 mg of magnesium citrate before going to bed. The desired effect is dose-dependent. So, some experimentation may be required.

    Magnesium is thought to relax intestinal muscles and draw moisture into the colon which both acilitate the smoother passage of stools.

    2. I would consider eating dried plums/prunes as part of my daily caloric intake. Here’s why:

    3. Another good option is adding a reliable probiotic supplement to your daily routine. Many years ago, I knew a gentleman who resolved his nearly lifelong constipation by taking a daily dose of these healthy bacteria.

    4. I’d make sure that I was getting at least some healthy fats daily – fish oil would be on the top of my list. Adequate fat intake supports healthy elimination.

    5. Do you enjoy coffee? There are pros and cons to drinking it. One of the pros is that it can keep things “moving along”.

    Please note that I can’t specifically suggest any treatment to you – even if it’s 100% natural. I’m not a physician and I don’t know your complete medical history. But I hope that what I’ve shared may give you and your doctor more natural options to work with.

    Be well!


  3. Mya Says:

    Hi JP,

    Thanks for the quick response, your suggestions are definately ones I will try, especially because they are all natural! As for my medical history, I am very healthy for the most part, just have about 10-15 pnds to lose before I get to my suggested weight of 135 lbs. This issue has really started affecting my daily life because I feel so dependant and helpless. Hopefully your ideas will assist me in some way. Will it be ok to try a few of these remedies together or should I try these individually? and which do you reccommend I start with.

    Thanks so much!

  4. JP Says:


    You’re welcome. 🙂

    My philosophy is to start with one remedy and then progressively add more, if they’re needed.

    I would personally try out the magnesium first. It’s an essential mineral that is often lacking in our diets and it’s relatively inexpensive. I think I would probably start off with 500 mg prior to retiring at night. If I *didn’t* see results within a few days, I would bump up the dosage by 250 mg (totaling 750 mg).

    If I needed additional support, I would likely include a good probiotic as a secondary step. There’s a product called Culturelle and a yogurt by the name of Activia which may help to move things along. In the case of probiotics, it could take up to a few weeks for the desired effect to become evident.

    My third step would be to eat more fat – healthy fats such as fatty fish (salmon) and/or nuts (almonds, pecans, walnuts). If that’s not an option, I would try supplementing with a good fish oil product. I’d personally start off with 2 (1,000 mg) soft gels twice-daily, taken with meals.

    Forth on my list would be prunes and my fifth choice would be coffee.

    Sometimes success is found using the first thing “you” try. Other times it requires a little bit of experimentation and mixing and matching. The description I’ve laid out today is how I believe I would personally try to solve this issue.

    I hope you find the right strategy that brings you relief. Please let me/us know how it works out for you. Fingers crossed!

    Be well!


  5. Mya Says:

    Hi JP,

    You’re great help 🙂

    I’m starting a few of these methods this weekend….wish me luck!


  6. JP Says:

    Good luck, Mya!

    Please let us know how it works out!

    Be well!


  7. Mya Says:

    Hi JP!

    So I thought I would let you know that I am doing a lot better with my situation 🙂 I haven’t made too many changes to my everyday lifestyele, just increased my intake of raw veggies and fruits and lean protien also started to consume black coffee twice a day. I know it’s not the best solution but it’s working! I need something thats simple and accessable so I can maintain it in my diet. Thanks for the help! I have another question for you, I am considering to add a fat burner pill to my diet, I know it’s usually not the best bet to go with but I have a vacation coming up and I need all the help I can get in order to get a beach body in a month 😉 So any suggestions? I’m willing to try anything quick and effective to add to my healthy eating and routine workouts!

    Thanks so much,

  8. JP Says:


    That’s fantastic news! I’m very happy to hear it! 🙂

    I hate to be a spoil sport but I can’t really recommend much on the fast-track weight loss front. There are certain supplements that may help but they generally bring about modest and rather slow going reductions in weight.

    Adding a standardized green tea supplement *may* give you a bit of an added edge – and it’s generally health promoting. That much I can say. Some experts advise looking for a supplement that provides approximately 100 mg of EGCG per capsule and taking it 3 times a day. Please note the caffeine content varies based on the product you choose.

    When professional athletes need to slim down fast, they often adopt a low carb diet to help reduce weight and to shed excess water weight. This often brings about a more toned appearance. The key is to eat non-starchy, high fiber, nutritious foods that are rich in omega-3 fatty acids (mostly in fish). A moderate protein, low carb and higher fat diet tends to make you feel full which can ultimately help you drop some weight too.

    I hope this helps! Keep up the good work!

    Be well!


  9. JP Says:

    Updated 09/22/15:

    Br J Nutr. 2015 Sep 18:1-9.

    Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial.

    The aim of the present study was to investigate the effect of Bifidobacterium animalis subsp. lactis, BB-12®, on two primary end points – defecation frequency and gastrointestinal (GI) well-being – in healthy adults with low defecation frequency and abdominal discomfort. A total of 1248 subjects were included in a randomised, double-blind, placebo-controlled trial. After a 2-week run-in period, subjects were randomised to 1 or 10 billion colony-forming units/d of the probiotic strain BB-12® or a matching placebo capsule once daily for 4 weeks. Subjects completed a diary on bowel habits, relief of abdominal discomfort and symptoms. GI well-being, defined as global relief of abdominal discomfort, did not show significant differences. The OR for having a defecation frequency above baseline for ≥50 % of the time was 1·31 (95 % CI 0·98, 1·75), P=0·071, for probiotic treatment overall. Tightening the criteria for being a responder to an increase of ≥1 d/week for ≥50 % of the time resulted in an OR of 1·55 (95 % CI 1·22, 1·96), P=0·0003, for treatment overall. A treatment effect on average defecation frequency was found (P=0·0065), with the frequency being significantly higher compared with placebo at all weeks for probiotic treatment overall (all P<0·05). Effects on defecation frequency were similar for the two doses tested, suggesting that a ceiling effect was reached with the one billion dose. Overall, 4 weeks' supplementation with the probiotic strain BB-12® resulted in a clinically relevant benefit on defecation frequency. The results suggest that consumption of BB-12® improves the GI health of individuals whose symptoms are not sufficiently severe to consult a doctor.

    Be well!


  10. JP Says:

    Updated 07/26/16:

    Asia Pac J Clin Nutr. 2016;25(3):487-96.

    Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of functional constipation.

    BACKGROUND AND OBJECTIVES: Constipation affects up to 20% of the world’s population. The aim of this study was to investigate whether supplementation with Ficus carica paste could be used to treat constipation in Korean subjects with functional constipation.

    METHODS AND STUDY DESIGN: We conducted a randomized, double-blind, placebo-controlled trial. Subjects with functional constipation were orally supplemented with either F. carica paste (n=40) or placebo (n=40) for 8 weeks. We measured the efficacy and safety of F. carica paste. Primary outcomes (colon transit time) and secondary outcomes (questionnaire related to defecation) were compared before and after the 8-week intervention period.

    RESULTS: F. carica paste supplementation was associated with a significant reduction in colon transit time and a significant improvement in stool type and abdominal discomfort compared with the placebo. Blood parameters and clinical findings for organ toxicity remained within normal ranges.

    CONCLUSION: These results suggest that F. carica paste may have beneficial effects in subjects suffering from constipation.

    Be well!


  11. JP Says:

    Updated 10/03/18:

    Gastroenterol Nurs. 2018 Sep/Oct;41(5):396-402.

    The Effect of Abdominal Massage on Constipation in the Elderly Residing in Rest Homes.

    Constipation is a health problem commonly seen in the elderly. In the present study, the effect of abdominal massage on constipation in the elderly was examined. The study sample consisted of 22 elderly people residing in a nursing home in the province of Manisa who were suffering from constipation in June 2014 to February 2015. The following were used to collect data: a case identification form; the Rome III Functional Constipation Diagnosis Criteria Form; the Bristol Stool Scale, consisting of the Recall Bias and Visual Scale Analog; and the Standard Diary Constipation Monitoring Form. The comparison of the mean scores obtained before, during, and after the implementation of abdominal massage in the elderly revealed that the number of bowel movements, stool weight, and stool consistency scores increased during and after the implementation. The differences between the mean intra- and postimplementation scores in terms of stool weight and between the pre- and postimplementation mean scores in terms of stool consistency were not statistically significant. There was a statistically significant difference between straining scores except for those obtained during intra- and postimplementation application. It was determined that abdominal massage increased the number of bowel movements, stool weight, and stool consistency, decreased the mean scores for straining, and decreased inability to completely empty the bowels (except on the implementation days).

    Be well!


  12. JP Says:

    Updated 01/28/19:;year=2018;volume=7;issue=5;spage=903;epage=906;aulast=Janani

    J Family Med Prim Care. 2018 Sep-Oct;7(5):903-906.

    The effect of glucomannan on pregnancy constipation.

    Introduction: Constipation is a common complication among pregnant women; it refers to hard and infrequent bowel movements where the stools defected from body becomes hard and dry, as well. various medical interventions are nowadays implemented to treat constipation, Some of which are either banned or not willingly implemented by pregnant women; thus, doctors try to avoid such methods. Glucomannan, a combination of a few simple sugars, is an effective substance for treating constipation. According to the results of studies conducted in this area, glucomannan has been greatly welcomed and approved by pregnant women. Thus, the present study was conducted to investigate the effect of glucomannan on pregnancy constipation and to compare it with other common treatment methods.

    Materials and Methods: This study is a clinical trial in which 64 pregnant women with constipation were investigated in the two groups of intervention and control (32 participants in each group). All participants were in their third trimester of pregnancy. The intervention group was treated with glucomannan, while the control group was treated with magnesium hydroxide. After 1 month, the participants were investigated and the questionnaires were responded to. The collected data were analyzed using the SPSS software and Chi-square tests.

    Results: The post-treatment frequency of bowel repulses increased in both the groups. However, the increase was different in the two groups. About 75% of the participants in the glucomannan group reported having at least 6 times of bowel movements. Moreover, 25% of the participants in the glucomannan group reported having >6 times of bowel movements. Using a Chi-square test, it was found that there is a significant difference between pre- and post-treatment frequency of bowel movements per week (P = 0.002). Moreover, there was a significant difference between the post-intervention frequency of bowel movements in the two groups (P = 0.001).

    Discussion: In the present study, it was attempted to investigate the effect of glucomannan on pregnancy constipation. The findings indicated that glucomannan is likely to improve constipation symptoms in pregnancy and reduce pregnant women’s complaints to a significant level through increasing the frequency of bowel movements and affecting the stool consistency.

    Conclusion: Along with other treatment methods, glucomannan is recommended as a healthy medicinal plant for treating pregnancy constipation.

    Be well!


Leave a Comment