Epsom salts safer for constipation
10 May 2002
A colorectal surgeon has advocated returning to Epsom salts as a safe, effective treatment for constipation after warning about the safety of stimulant and lubricant laxatives.
Associate professor of surgery at Sydney's St George Hospital, Professor David Lubowski, will tell the Royal Australasian College of Surgeons conference in Adelaide next week that bulk and osmotic laxatives should be the therapies of choice.
'Bulking agents such as Metamucil and other psyllium products can be first-line treatments as they are generally very safe, but they do produce bloating which many don't tolerate,' he said.
He recommends a combination first-line treatment of a bulking agent with an osmotic agent (Epsom salts, lactulose).
Osmotic agents were generally the safest, with Epsom salts very effective, minus the bloating, he said.
'Stimulant laxatives, including senna-based [Coloxyl, Durolax], are often used as first-line treatments because they are easy-to-take pills, and senna is advocated as a natural substance,' Professor Lubowski said.
'This is wrong because we don't know much about their side-effects, although there is some evidence that frequent long-term use of senna-based laxatives can damage nerves in the colon and potentially make constipation worse.'
He said lubricant (liquid paraffin, mineral oil) laxatives could cause lipoid pneumonia if aspirated and should not be used in elderly people who may regurgitate, at night, or in those with severe reflux.
Long-term use could also lead to vitamin deficiency through malabsorption of fat-soluble vitamins.
Last Reviewed: 13 May 2002
- 1. Medical Observer Weekly 10/5/02
