The U.S. Food and Drug Administration (FDA) issued a consumer update warning people that some over-the-counter laxatives could be potentially dangerous.  This consumer update came after the FDA received notice of 13 deaths associated with the use of sodium phosphate laxatives.  Specifically, these products can be dangerous when the dosing instructions or other warnings that can be found on the Drug Facts Label were not followed.

Labels on over-the-counter laxatives warn consumers that the laxatives should be used as a single dose taken once a day and, also, that the products should not be used for more than three days.  Equally important, labels warn that consumers who do not have a bowel movement after taking an oral or rectal dose should not take another dose of the product.  Additionally, adults and children that have kidney disease, heart problems or dehydration need to consult a health care provider before they use the products.

The Boston Globe notes that the FDA warning specifically asks adults over the age of 55 that have any of the concerning coexisting conditions to speak to a doctor before use.  Laxatives of particular concern are sodium phosphate laxatives like Fleet or generic versions of the phospho-soda or enema product.  There are alternative laxatives that pose fewer risks, including psyllium, a soluble fiber, mineral oil, or methylcellulose (another plant fiber) and glycerin suppositories.

According to the Mayo Clinic, laxatives work in a variety of ways, with some methods being harsher on the body than others.  Oral and rectal stimulants work to trigger rhythmic contractions of intestinal muscles to eliminate stool, while oral bulk formers are gentler and absorb water to soften stool and prompt normal muscle contractions.  Before choosing laxatives, it is advisable to try natural remedies such as regular exercise, drinking plenty of water, and eating foods that are high in fiber content.

Laxatives may also pose a risk because of abuse.  The National Eating Disorders Association points out that laxatives may be overused in order to rid the body of excess calories and shed weight.  Often, laxatives are misused following eating binges, when the individual mistakenly believes that the laxatives will work to rush food and calories through the gut and bowels before they can be absorbed.  The belief that laxatives are effective for weight control is a myth.  Most foods and calories have already been absorbed by the small intestine before going to the large intestine, where laxatives do their work.  The “weight loss” caused by a laxative-induced bowel movement contain little actual food, fat, or calories.  Instead, laxative abuse causes the loss of water, minerals, electrolytes and indigestible fiber and wastes from the colon.