Melanosis Coli
Some foods act as laxatives, hurrying food and faeces through the bowel. These include prunes and prune juice, molasses, liquorice, chocolate, citrus, black coffee, alcohol and spices. You will know what works for you. However, many people rely not on food but on common commercial laxatives. An enormous amount of money is spent each year on laxatives in the western world. Much of this laxative use is not necessary and long term use must be on the advice of your doctor. Laxatives may be given orally in tablet or liquid form, or rectally by suppository or microenema. Laxatives are classified into different groups depending on how they work. These include:
Simple bulking agents – e.g. Psyllium and Normacol.
Faecal softeners – e.g. Coloxyl.
Osmotic agents – e.g. Epsom salts.
Stimulants which act on the nerves and muscles of the bowel wall - these are often found in herbal or natural laxatives such as Frangula.
Parrafin and Castor Oil.
There may be a combination of these substances in oral and rectal laxatives. Simple small doses of bulking agents are usually safe as these make stools ‘teflon-coated’ and easier to pass.
Much has been said about natural products. Senna and Cascara are commonly used preparations found in herbal laxatives. Both are refined from plants and act as stimulants. Over a long period of continued use, they deposit a brown discolouration on the normal, healthy bowel lining. In time, the bowel muscle relies on this stimulation to continue to squeeze the contents along. This is called Melanosis Coli. The fact that a product is natural doesn’t necessarily mean it is harmless and without side effects, so you should consider carefully before taking herbal laxatives, particularly long term. Always check with your doctor and be sure that you read and understand the label before taking any medication.
Many people may require long-term combinations of laxatives to treat their symptoms of slow transit constipation or obstructed defecation. This must be strictly under medical supervision. Suppositories are used to help poorly contracting rectums to empty properly. To be effective, the suppository must be inserted into the rectum, that is, past the anus. It must be placed next to the rectal wall, not in the faecal contents.