Colon Cleansers are not for everyone

Is Colon Cleansing really healthy?

We in the pharmacy are used to the yearly desire for mothers to purge their child before a new school year starts, as a habit to clean the body and blood. Nowadays we are also confronted with the new promoted health of regular colon cleansing. “Build your health with a healthy Colon” it says. Time to investigate more on this (fecal) matter.

Daily Activity in the Colon

Aided by enzymes and muscular action, the mouth, stomach and small intestine perform their individual jobs of breaking down food and absorbing nutrients. The liquid that these organs generate is called chyme. However, when it passes to the colon, the liquid that is leftover is mostly waste matter, called feces. The colon lining contains epithelial cells that absorb fluids and other substances such as vitamins and electrolytes. It is the absorption of fluids and bacterial processing that transforms the soupy fecal matter into a stool.

Bacteria live and grow along the colon lining. Using the fluids and foods you intake, bacteria actually manufacture the nutrients that sustain their environment and their food supply. Bacteria change proteins into amino acids and break these amino acids down further into indole and skatole (which gives stools their odor), hydrogen sulfide, and fatty acids.

Bacterial action also synthesizes some vitamins (K and some B), electrolytes, and breaks down bilirubin into a pigment that gives stools their brown color. Bacteria ferment soluble fiber into a lubricating gel.¬† This gel helps to make stools soft and flexible. Healthy intestinal bacteria help to groom the colon and keep it clean so that infections do not develop. They also help to fight the growth of infectious bacteria.

Bacteria can also help some medications work better because they create what is called an entero-hepatic cycle. ie the estrogen from the birthcontrol pill gets reabsorbed after processing by bacteria. That is also why antibiotics may have a negative effect on the protection from OAC by killing the ‚Äúgood‚Äù bacteria. Diarrea can also be a result of this action. Because fluid absorption is one of the main jobs of the colon, stools that remain in the colon too long can become dry and hardened. We notice this with tourists that have been traveling 12-24 hours and have postponed their regularity.

Why not the natural way!

Colon Cleansers

Colon cleansing is based on the theory that waste collects in the colon over time and stagnates there, causing toxins to form and spread throughout the body — a phenomenon known as ‚Äúautointoxication.‚Äù Many 19th century doctors accepted autointoxication as fact. Although scientific research conducted as early as the 1920s failed to confirm it, the misconception persists. Other colon cleanser advocates insist that the accumulated stool blocks the colon, preventing the proper elimination of waste.

The body was designed to cleanse itself quite well. The kidneys, liver and lungs remove toxins and by-products from the blood stream, and regular bowel movements remove any waste products from the gastrointestinal tract. Experts say there is no such thing as autointoxication, and that the human body is very good at taking care of itself.

High colonics are often touted as a way to cleanse the colon of¬† adherent stool that has been there for years. Still a gastro-enterologist that does regular colonoscopy will prescribe¬† a preprocedure purge the day before which is sufficient to clean out the stool and leave a pristine looking colon.

Colon Cleanser and Laxative Cautions

Using coloncleansers on a repetitive basis is not a great idea, as mentioned above your intestines aren‚Äôt just a waste disposal unit; they‚Äôre also a place where nutrients from food are absorbed to the bloodstream. Washing out the intestinal tract could potentially interrupt this absorption and natural balance, leaving you with a vitamin or mineral deficiency.¬† In addition, frequent use of some types of laxatives can have a boomerang effect, so that cleaning your colon could leave it less able to do its job the way nature intended.

Another pitfall of colon cleansers is that they can lead to dehydration. Moreover, high colonics, where a large amount of fluid is inserted, can potentially harm the colon, causing small tears or internal damage.

A healthy diet that includes enough fiber and water is nature‚Äôs way of cleansing your colon. A diet that is low in fiber and water, on the other hand, usually results in constipation. You can think of fiber as acting like a “toothbrush” passing through your colon. So every day that you meet your recommended daily dose –between 21 and 25 grams per day for adult women and 30 to 38 grams for adult men– you‚Äôre literally consuming a colon cleanser.

Up your fiber intake slowly by making room in your diet for foods like fruit, vegetables, beans, and high-fiber cereals. Keeping your body moving as much as possible is important, too. Physical activity increases blood flow throughout the body, and the better your blood flow, the easier it is for your colon to work efficiently.

If your reason for colon cleansing is constipation consider the following:

There are many causes of constipation including:

Diets that are low in fiber,as mentioned above.
Side effects of medications such as narcotic pain killers (codeine, morfine, antidepressants (Prozac, amitryptilin), iron supplements, calcium channel blockers (diltiazem, nifedipine), anti-epileptics. (dilantin, carbamazepin)
Narrowing or blockage of the large intestine (colon) due to colon cancer or advanced diverticulosis.
Ineffective contraction or spasm of the colon’s muscles due to irritable bowel syndrome or other diseases of the colon’s muscles.
Parkinson’s disease, multiple sclerosis, and other neurological conditions.

Most OTC (over the counter) laxatives are safe, effective, and well tolerated. There are distinct classes of laxatives, which function differently and have varying degrees of effectiveness and potential side effects.

Bulk-forming laxatives are the most commonly recommended initial treatments for constipation, they are soluble or insoluble fibers. They may work as quickly as twelve hours or take as long as three days to be effective. Examples are methylcellulose (Citrucel), polycarbophil (Fibercon), psyllium (Metamucil). They are safe for long-term use, also for elderly patients with constipation. They are helpful in patients with irritable bowel syndrome, diverticulosis, and colostomies. Make sure to drink enough water.

Stool Softeners

Stool softeners prevent hardening of the feces by adding moisture to the stool. The active ingredient in most stool softeners is docusate. They are more for use in preventing constipation than in treating it. Stool softeners are recommended for patients who should avoid straining while defecating, including: Patients who are recovering from abdominal or rectal surgery, childbirth, and patients with painful hemorrhoids and/or anal fissures. Softening the stool in these patients can help reduce pain during defecation.

Lubricant Laxatives like mineral oil (liquid petrolatum) coats and softens stool. Like stool softeners, mineral oil is used by patients who need to avoid straining. Mineral oil decreases the absorption of vitamin K (important in forming clotting factors in the blood) from the intestines. Mineral oil should only be used for short periods of time.

Stimulant Laxatives

Stimulant laxatives induce bowel movements by increasing the contraction of muscles in the intestines. Stimulant laxatives are effective when used on a short term basis. Examples of stimulant laxatives include aloe, cascara sagrada, senna compounds, bisacodyl, and castor oil.

Bisacodyl is theoretically the preferred choice and available OTC (ie Dulcolax). It is available in oral pill form and as a suppository or enema. The oral form takes six to ten hours to work. Stimulating laxatives are only recommended for short term use. Long term use can create dependance (lazy colon). The intensity of the action of stimulant laxatives is dose related. A large enough dose of any stimulant laxative can produce serious adverse effects, like severe cramps, excess fluid loss and dehydration.

Saline Laxatives

Saline laxatives are mostly magnesium, sulfate, citrate, and phosphate ions. These ions draw water into the intestines. The additional water softens the stool, increases pressure within the intestines, and increases intestinal contractions. Fleet Phosphosoda, milk of magnesia, and magnesium citrate are examples. They should be taken with one to two glasses of water.

The onset of bowel response is usually within one-half to three hours. Small doses are sometimes recommended for the treatment of occasional constipation, while larger doses can produce complete evacuation of the intestine. Patients who have impaired kidney function should not use laxatives that contain magnesium or phosphate salts. Excess accumulation of¬† salts in the blood of these patients can lead to toxicity.

Enemas and Suppositories rectally administered enemas and suppositories are commonly used to cleanse the rectum and the sigmoid colon (the part of the colon closest to the rectum) prior to surgery, child delivery, and flexible sigmoidoscopy. Enemas and suppositories are also used to relieve constipation and rectal fecal impaction (blockage of the rectum by hard, compacted stool). These products are intended for occasional use and are not recommended as a chronic laxative regimen unless directed by a physician.

Bottom line? Your colon knows its job; leave it alone and it will take care of itself.

The Pharmacist – www.philipsburgpharmacy.com

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