<<Disclaimer: Verify this information before applying it to your situation.>>

There's a lot of information out there about laxatives.  Some is accurate.  
Some is not.  Please forgive me if this is overkill or redundant.  I just 
hate to see anyone suffer with constipation issues when they don't need to.  
I little knowledge can go a long way to making life better for those who 
have this problem.  I really believe I have some useful knowledge that may 
help many of you as I've finally conquered my lifelong battle with 
constipation.  (I have low motility IBS or colonic inertia.)

First off, the term "not-gluten-free" does not mean "contains gluten."  "Not 
gluten free" really means the company is not willing to state something is 
gluten free on the slim chance that gluten may accidentally find it's way 
into their product & some greedy person may decide to sue the maker for 
claiming it's gluten free.  (Remember the McDonald's incident?)  Stating a 
product is "not gluten free" is simply a practice or a tactic manufacturers 
employ to protect themselves from liability.  (Can you really blame them?)  
Greedy people & their attorneys who make a livelyhood through lawsuits make 
life difficult for the rest of us.  So if you read or heard from somewhere 
the EX-Lax brand or Kroger Brand, or Equate Brand is "not gluten free" that 
just means they won't garantee it's gluten free status.  That doesn't mean 
it contains gluten.

I've used EX-Lax, Kroger, Equate brand and other brands of sennocide 
laxatives daily for almost a year.  All the pills from the same strength 
pills of the various brands are identical in size, shape color, results, 
etc.  I believe they are all made by the same one or two manufacturers & 
simply stamped with a different label (Kroger, Equate, Brand X, etc.)  I 
haven't had a gluten reaction from any of these products.  If they contained 
gluten, I'd know it.  I'm one of those celiacs who is exquisitely sensitive 
to gluten.  Exposure causes severe fatigue, depression, neurological 
symptoms & aweful GI problems.  Believe me, if these OTC sennoside laxatives 
contained gluten, I wouldn't feel this great from using it everyday for 10 
months.  In fact, I feel better now than I have since my diagnosis 5 years 
ago.  These products are a godsend for me.  (I'm also personally acquainted 
with another celiac who uses thes products everyday and it's not causing her 
any gluten reactions.)

I  hate to see anyone pay more for the same OTC medication that they need 
daily simply because one brand "certifies" that it's gluten free.  All that 
particular certification means is that this company is gutsier, not the only 
distributor of gluten free OTC laxatives.

Sennosides are the extract of the herb, senna.  Sennoside is a intestinal 
stimulent.  Other stimulent laxatives such as docusate sodium, caster oil, 
cascara sagrada, etc. work by irritating the gut lining.  Senna does not 
work this way.  Senna works by stimulating the nerve centers of the colon 
causing increased motility.  Senna is the best tolerated stimulent laxative 
because it is non-irritating.  For those with chronic constipation, 
paralyzed bowel, taking narcotics, etc. senna is the drug of choice because 
it is non-irritating.  When properly used & dosed, senna's only side effect 
is brown staining of the inside of the colon.

If a person gets sick from taking EX-lax brand sennocide laxative it's most 
likely that they overdosed on it or used it improperly.  They need to 
experiment with different dose strength & time of the dose and diet.  If 
taking the 15 mg or the 25 mg X-lax tablet causes discomfort, that may be 
too strong.  Perhaps brand that contains only 8.6 mg which will be more 
tolerable.

When people get sick after laxative use it could also have been from a large 
dose needed to relieve an impaction.  People often make this mistake.  They 
wait for days & days to use a laxative.  By this time, the colon is overly 
full of firm, impacted stool that takes dynamite to blast out.  Ouch!  
That's enough to make anyone sick, but especially a sensitive celiac.  I've 
found through experience as well as having read a book by a Chris Lahrs MD, 
a constipation specialist, that daily dosing to prevent constipation is the 
best way to deal with this problem.  When your body gets used to the same 
dose at the same time every day, it adapts beautifully producing 
comfortable, daily BMs.  But, in contrast, when a constipated person uses a 
high dose laxative as a last resort after several days of constipation, the 
colon often responds with terrible cramping and diarrhea.  This can feel 
just like a gluten reaction.  So for a person who is proned to frequent or 
chronic constipation, it's best to take smaller doses of sennocide laxative 
on a daily basis to prevent an impaction.

It's hard for a person with a normal colon to understand that anyone could 
actually need a daily laxative dose.  People with a normal colon get results 
from simple solutions such as a couple prunes, an apple a day, a glass of 
orange juice, a walk around the block, a bag of popcorn, etc.  But people 
with partially paralyzed colons & chronic constipation can develop impacted 
bowels in as little as 48 hours no matter what they eat.  Once impacted, 
passage of this stool can be a tramatic experience.

There's a commonly held belief among health care professionals and the lay 
public that daily use of laxatives will cause laxative dependance & reduce 
normal bowel function.  This myth has recently been challenged in clinical 
trials showing that bowel function was not altered in test subjects after 90 
days of daily laxative use.  So people who need laxatives should not be 
afraid to use them.

Another thing important for producing comfortable stools is to include more 
soluble fiber and less insoluble fiber in the diet.  Soluble fibers sooth 
the gut; insoluble fibers irritate the gut.  It's important to include at 
least one of the following with each meal:  apple sauce, corn meal (corn 
bread, tortillas, grits or polenta), rice, cooked carrots, beets & other 
root vegetables, potatoes, yams, etc.  Decrease the following soluble fiber 
foods:  nuts & seeds, lettuce, popcorn, raw fruits & vegetables.  Most 
people are taught that the "roughage" of insoluble foods is the best thing 
for constipation, so they go overboard on insoluble fiber.  In sensitive 
people such as celiacs & those with IBS, this often results in more 
constipation because the constant irritation makes the colon "seize up" & 
cramp causing even more constipation.  It's best to strive for a balance of 
soluble fibers & insoluble fibers.  (See webstie:  WWW.helpforIBS.com)

Some people use herbal blend laxatives with success, such as Swiss Kriss.  
However, I prefer to stick with the sennoside extract type laxatives (X-lax 
& store brand equivalents, etc.).  Because the sennocide extract type 
laxatives are more refined & contain only one active ingredient the 
potential for allergic reactions is greatly reduced.  If someone reacts to 
an herbal blend, there's no way to know which herb caused the problem.

Stool softeners are also a popular choice.  Be aware that stool softeners 
are detergents & can be irritating to a sensitive gut.  (They give me 
heartburn.)  Although, I never recommend stool softeners, I know people who 
have used them successfully for years.

Valerie in Tacoma

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