6 Important Tips To Stay Safe On Laxatives

By Suzy Cohen, R. Ph.

Laxatives are intended to stay in the gut, however, some can affect the central nervous system indirectly by impacting electrolyte balance or stripping away the body’s natural gut microflora.

One in particular called MiraLAX® (PEG 3350) is an “osmotic” laxative. It draws water into the colon which softens the stools and stimulates peristalsis and ultimately a bowel movement. Like all other osmotic laxatives, it has the potential to mildly alter electrolyte balance in the bloodstream, although that effect is rare if it is used properly according to label directions.

MiraLAX is FDA-approved to treat constipation in adults only and is only supposed to be used for a week. It is recommended for opiate-induced constipation in adults. In a short time frame like these scenarios, you should not experience any untoward effects.

But what if you took it for several months? What if you gave an adult-only drug to a small child? What if your doctor told you to keep taking it beyond a week?

Overusing, misusing or abusing laxatives is common and leads to unwanted side effects. The electrolytes that were in homeostasis in the bloodstream become altered unnaturally when laxatives are used chronically.

The FDA has received reports of behavioral changes over the years, especially in children taking PEG 3350. These include agitation and aggression and other behavioral issues. The relationship between PEG 3350 and these side effects hasn’t been formally tied together with a clinical trial. It’s what’s called “anecdotal” and these types of laxatives remain popular all over the world.

But are psychiatric/emotional problems even possible? Impacting the water-to-mineral balance with laxatives, or any drug for that matter may cause the following shifts in any person, which can cause dozens of problems.

Laxatives notoriously cause:

Hypokalemia - low potassium in the blood

Hyponatremia - low sodium in the blood

Hypermagnesemia - high magnesium in the blood

Gut problems - the destruction of healthy gut microflora

Symptoms from these electrolyte imbalances may cause headaches, teary eyes, depression, anxiety, aggression, confusion, dizziness, muscle cramps, nausea, and more. Part of the problem is that laxatives are flushing things out of you including your gut microflora! That’s not good long-term because poor probiotic status causes low GABA and B12, and that alone may lead to emotional problems and even more gut problems than you started with.

6 Tips to Using Laxative Properly

Do not take laxatives longer than the label states, follow directions

Stay hydrated by drinking water or Pedialyte® which will help restore some balance to your potassium and other electrolytes.

Drink enough fluids each day while taking this medication in order to offset dehydration and electrolyte imbalances.

Don’t combine laxatives.

Take a probiotic to restore gut flora. Change your diet so you won’t be so reliant on laxatives.

See a gastroenterologist and do the tests required to determine the root cause. An endocrinologist can test you for hypothyroidism, an overlooked but primary cause for chronic constipation. Laxatives are not intended for long-term use, or for children.

(This information is not intended to treat, cure or diagnose your condition. Suzy Cohen is the author of “The 24-Hour Pharmacist” and “Real Solutions.” For more information, visit www.SuzyCohen.com) ©2022 SUZY COHEN, RPH. DISTRIBUTED BY DEAR PHARMACIST, INC.