Constipation : Supplements

Aloe vera , a member of the lily family, is a spiky, succulent, perennial plant. It is indigenous to eastern and southern Africa, but has been spread throughout many of the warmer regions of the world, and is also popularly grown indoors. There are about 300 identified species, but Aloe vera ("true aloe") is the most popular for medical applications. It has also been known as Aloe vulgaris ("common aloe") and Aloe barbadensis . The plant has yellow flowers and triangular, fleshy leaves with serrated edges that arise from a central base and may grow to nearly 2 ft (0.6 m) long. Each leaf is composed of three layers. A clear gel, that is the part of the plant used for topical application is contained within the cells of the generous inner portion. Anthraquinones, which exert a marked laxative effect, are contained in the bitter yellow sap of the middle leaf layer. The fibrous outer part of the leaf serves a protective function.

Transparent gel from the pulp of the meaty leaves of Aloe vera has been used topically for thousands of years to treat wounds, skin infections, burns, and numerous other dermatologic conditions. Dried latex from the inner lining of the leaf has traditionally been used as an oral laxative. There is strong scientific evidence in support of the laxative properties of aloe latex, based on the well-established cathartic properties of anthroquinone glycosides (found in aloe latex). However, aloe's therapeutic value compared with other approaches to constipation remains unclear. There is promising preliminary support from laboratory, animal, and human studies that topical aloe gel has immunomodulatory properties which may improve wound healing and skin inflammation.

Phosphorus is a mineral found in many foods, such as milk, cheese, dried beans, peas, colas, nuts, and peanut butter. Phosphate is the most common form of phosphorus. In the body, phosphate is the most abundant intracellular anion. It is critical for energy storage and metabolism, for the utilization of many B-complex vitamins, to buffer body fluids, for kidney excretion of hydrogen ions, for proper muscle and nerve function, and for maintaining calcium balance. Phosphorus is vital to the formation of bones and teeth, and healthy bones and soft tissues require calcium and phosphorus to grow and develop throughout life. Inadequate intake of dietary phosphate can lead to hypophosphatemia (low levels of phosphate in the blood), which can lead to long-term potentially serious complications. Conversely, excess phosphate intake can lead to hyperphosphatemia (high blood phosphorus levels), which can occur particularly in people with impaired kidney function, and can lead to potentially serious electrolyte imbalances, adverse effects, or death. In adults, phosphorus makes up approximately 1% of total body weight It is present in every cell of the body, although 85% of the body's phosphorus is found in the bones and teeth. Phosphates are used clinically to treat hypophosphatemia, hypercalcemia (high blood calcium levels), as saline laxatives, and in the management of calcium-based kidney stones. They may also be of some benefit to patients with vitamin D resistant rickets, multiple sclerosis, and diabetic ketoacidosis.

Phosphorus (chemical symbol P) is a mineral discovered by the German alchemist Henig Brand in 1699. It plays an essential part in multiple biochemical reactions for both plants and animals and is essential to all life. Phosphorus is found in living things, in soil and rock, mostly as chemical compounds known as phosphates. Rock and soil phosphorus are mined extensively throughout the world, but especially in the Peoples' Republic of China and the United States. Phosphorus extracted from rock is classified as either white, red or black. White (also called yellow or common) phosphorus is a wax-like substance created by heating phosphate rock until it vaporizes and the condensation solidifies. One of this form's characteristics has given the English language the adjective phosphorescent , from white phosphorus's capacity to glow in the dark when exposed to air. White phosphorus is highly toxic, causes burns if it comes in contact with skin, and is so combustible that it has to be stored underwater for safety. Red phosphorus is a rust-colored powder created by heating white phosphorus and exposing it to sunlight. It is not as combustible as the white form. Black phosphorus is made by heating white phosphorus under extremely high pressure until it resembles graphite. In plants, phosphorus is necessary for photosynthesis to take place. In the human body, phosphorus works in tandem with another element, calcium , in much the same way that two other electrolyte components, sodium and potassium , do. Though phosphorus is found in every cell of the human body and accounts for 1% of the body's total weight, its primary function is working in conjunction with calcium to form teeth and bones. Eighty-five percent of the phosphorus found in the body is located in these structures. In a delicately balanced chemical reaction, substances known as PTH (parathyroid hormone), Calcitonin, and 25-Dihydroxy vitamin D regulate the absorption of both calcium and phosphorus from the intestinal tract, thus making it available for the production of bones and teeth. If an excessive amount of phosphorus is absorbed, this will result in the phosphorus combining with all available calcium and preventing the calcium's efficient use in making and maintaining bones and teeth. PTH balances the proportions of calcium and phosphorus in the body by increasing the release of calcium and phosphate from bone and the loss of phosphorus via the kidneys while limiting the excretion of calcium. PTH also increases the activity of the 25-Dihydroxy v25-Dihydroxy vitamin D , which, in contrast, increases the absorption of both phosphorus and calcium from the intestinal tract.

Phosphorus (chemical symbol P) is a mineral discovered by the German alchemist Henig Brand in 1699. It plays an essential part in multiple biochemical reactions for both plants and animals and is essential to all life. Phosphorus is found in living things, in soil and rock, mostly as chemical compounds known as phosphates. Rock and soil phosphorus are mined extensively throughout the world, but especially in the Peoples' Republic of China and the United States. Phosphorus extracted from rock is classified as either white, red or black. White (also called yellow or common) phosphorus is a wax-like substance created by heating phosphate rock until it vaporizes and the condensation solidifies. One of this form's characteristics has given the English language the adjective phosphorescent , from white phosphorus's capacity to glow in the dark when exposed to air. White phosphorus is highly toxic, causes burns if it comes in contact with skin, and is so combustible that it has to be stored underwater for safety. Red phosphorus is a rust-colored powder created by heating white phosphorus and exposing it to sunlight. It is not as combustible as the white form. Black phosphorus is made by heating white phosphorus under extremely high pressure until it resembles graphite. In plants, phosphorus is necessary for photosynthesis to take place. In the human body, phosphorus works in tandem with another element, calcium , in much the same way that two other electrolyte components, sodium

Psyllium, also referred to as ispaghula, is derived from the husks of the seeds of Plantago ovata . Psyllium contains a high level of soluble dietary fiber, and is the chief ingredient in many commonly used bulk laxatives, including products such as Metamucil® and Serutan®. Psyllium has been studied as a "non-systemic" cholesterol-lowering agent, with generally modest effects seen on total cholesterol and low-density lipoprotein levels. Several psyllium-containing cereals such as Heartwise® and Bran Buds® have appeared in the United States marketplace during the last 15 years, and have been touted for their potential lipid lowering and "heart health promoting" effects. Allergic reactions, including anaphylaxis have been reported, particularly in healthcare workers with previous experience preparing psyllium-containing bulk laxatives. Obstruction of the gastrointestinal tract by such laxatives has also been reported, particularly in patients with prior bowel surgeries or anatomic abnormalities, or when mixed with inadequate amounts of water.

Cellulose derivatives (methylcellulose), calcium polycarbophil, malt soup extract, and psyllium preparations are bulk-forming laxatives.

Psyllium is a seed used for medicinal purposes taken from the common fleawort, Plantago psyllium . There are about 250 species of the genus Plantago found worldwide; they belong to the Plantaginaceae family. The most common species producing seed for medicinal use, in addition to P. psyllium, are P. afra, P. isphagula, P. ovata , and P. indica . Psyllium is extensively cultivated in many parts of the world. Shrubby perennial plants with narrow green leaves put up spikes of small flowers that mature into seedpods. The seeds and husks are harvested and used in healing. The seeds are small (1.5–2 cm) and brown or reddish-brown. Psyllium has been used in Ayurvedic medicine in India and in traditional Chinese medicine for thousands of years. It has also been used in Europe for many years, but it has become common in North American healing only near the end of the twentieth century.

Cascara is obtained from the dried bark of Rhamnus purshianus (Rhamnaceae), both a medicinal and poisonous plant. It is found in Europe, western Asia, and in North America from northern Idaho to the Pacific coast in mountainous areas. In Spanish, cascara sagrada means "sacred bark," perhaps because this woody shrub has provided relief for several constipated individuals. Cascara has been used as a tree bark laxative by Native American tribes and Spanish and Mexican priests since the 1800s. The cascara sagrada bark is aged for a year so that the active principles become milder, as freshly dried bark produces too strong a laxative for safe use. Cascara possesses purgative, toxic, therapeutic, and tonic activity. It is most commonly used as an anthraquinone stimulant laxative for bowel cleansing. Stimulant and cathartic laxatives are the most commonly abused laxatives and have the potential for causing long-term damage.

Chinese herbalists have relied on rhubarb rhizomes and roots for thousands of years. The rhizomes and roots contain powerful anthraquinones and tannins that act as stimulant laxatives and astringents, respectively. In traditional Chinese medicine, rhubarb is also used to treat gastric ulcers, chronic renal (kidney) failure, and pregnancy-induced hypertension (high blood pressure), pre-eclampsia and eclampsia. European herbalists have recommended rhubarb as a laxative, diuretic, and to treat kidney stones, gout (foot inflammation), and liver diseases. Externally, it is recommended to heal skin sores and scabs. The current practice of using rhubarb to treat cancer (as an ingredient in the herbal Essiac® formula) lacks the support of controlled clinical trials. However, rhubarb is being tested for multiple other conditions, including hyperlipidemia (high cholesterol) and obesity. Use for gingivitis, chronic renal failure and upper gastrointestinal bleeding seem to be the most promising, although more research should be done in these areas, specifically with rhubarb as a monotherapy.

Rhubarb, also called sweet round-leaved dock or pieplant, is usually thought of as a fruit, but it is actually one of the few perennial vegetables in existence. Ordinary garden rhubarb carries the botanical name of Rheum rhaponticum , though there are other members of this botanical group that are also used for medicinal purposes. Chinese rhubarb, which is called da huang in traditional Chinese medicine , has the botanical name Rheum palmatum . Chinese rhubarb has a much stronger taste and properties than the common American variety. Rhubarb is a member of the same family as buckwheat, the Polygonaceae family. It originally came from Mongolia in northern Asia, but was long ago introduced to both India and Turkey. It was formerly called India or Turkey rhubarb. In the 1760s, in England, an Oxfordshire pharmacist named Hayward began developing and growing the type of rhubarb most commonly grown today. Records indicate that rhubarb was first grown as a market crop in England in 1810. But because it was unknown, few people purchased it. In the next one hundred years, its popularity grew tremendously. The average life expectancy of rhubarb plants is five to eight years. Although rhubarb produces seeds, they can give birth to plants remarkably different from the parent plant. For this reason, rhubarb cultivation is usually done by cutting and replanting pieces of its large storage root. Rhubarb is an early plant that is extremely hardy. It is relatively immune to attack by insects or disease. It puts out smaller feeder roots in early spring; even in colder regions, reddish bud-like projections appear in early April. These develop rapidly into long thick succulent stalks that can grow from 1–3 ft (approximately 30–90 cm) in length. Rhubarb stalks are generally ready for harvesting by late May. One very large spade-shaped leaf with curled edges grows at the tip of each stalk. There is considerable evidence that these leaves should be considered poisonous due to their high content of salts of oxalic acid. Oxalic acid is a powerful but toxic cleaning agent. Although M. Grieve reports that people have eaten both the leaves and the newly formed rhubarb buds without any problem, she also mentions several sources that listed several cases of death by rhubarb leaf poisoning around 1910. Rhubarb stalks have a tangy, sweet-sour taste much prized for the making of desserts, especially pies. Rhubarb stalks are a good source of ascorbic acid ( vitamin C ). Chinese rhubarb produces a yellowish root with a distinctive network of white lines running along the outer surface. Chinese rhubarb root is much larger and more firmly textured than its Western relatives, and has much stronger laxative qualities, but it is also less astringent. The root of Western garden rhubarb is smaller, spongier, and is usually pinkish in color. It has sporadic star-shaped spots evident along its transverse sections.