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Experts say laxatives can be helpful for constipation, but regular use of them is not recommended. Westend61/Getty Images
  • Researchers say regular use of laxatives may increase a person’s risk of dementia by more than 50%.
  • They add the potential increased risk is even higher when osmotic laxatives are used.
  • Experts say there are a number of natural methods for a person to relieve constipation.

People who regularly use over-the-counter laxatives may have more than a 50% increase in the risk of developing dementia.

That’s according to a study published today in the online issue of Neurology, the medical journal of the American Academy of Neurology.

Researchers looked at the medical data of more than 500,000 people in the UK Biobank database with an average follow-up of 10 years. The participants had an average age of 57 and none had dementia at the start of the study.

Of the participants, 18,235 people reported regular use of over-the-counter laxatives. The scientists defined regular use as using laxatives most days of the week in the month before the study.

The findings included:

  • 218 participants (1.3%) who regularly used laxatives developed dementia.
  • 1,969 participants (0.4%) who did not regularly use laxatives developed dementia.
  • The risk of developing dementia increased with the use of two or more types of laxatives.
  • The use of osmotic laxatives resulted in an even higher risk.

After adjusting for age, sex, education, other illnesses, medication use, and family history, the scientists found that frequent laxatives increased the risk of developing all-cause dementia by 51%.

The researchers found that the type and amount of variation of laxative use influenced the risk:

  • People who used one kind of laxative had a 28% increase in risk.
  • People who used two or more types of laxatives had a 90% increase in risk.

The most significant increase in risk occurred in people who used osmotic laxatives.

“Osmotic laxatives, such as PEG 3350 (Miralax), attract water and draw it into the stool, gently resulting in softer stools and more frequent bowel movements,” explained Elena Ivanina, DO, MPH the director of neuro-integrative gastroenterology at Lenox Hill Hospital in New York.

Stimulant laxatives such as senna are harsher laxatives that irritate your gut, stimulating the muscles to move contents forward,” she told Healthline. “They often cause cramping as a side effect. Osmotic laxatives are usually the first-line laxative and are gentle with minimal side effects but could take two or three days to work. On the other hand, stimulant laxatives are much more effective and fast acting, often taking 6 to 12 hours to work but have more significant side effects. Neither should be used chronically without the guidance of a gastroenterologist.”

Constipation and laxative use is common among middle-aged and older adults, pointed out Feng Sha, Ph.D., a study author from the Shenzhen Institute of Advanced Technology at the Chinese Academy of Sciences in Guangdong, China.

“However, regular laxative use may change the gut microbiome, possibly affecting nerve signaling from the gut to the brain or increasing the production of intestinal toxins that may affect the brain,” he said.

The scientists note that laxative use is a modifiable risk factor.

“It’s never a good idea to use laxatives on a regular, long-term basis,” said Anne Danahy, MS, RDN, a dietician and owner of the food and nutrition blog Craving Something Healthy.

“They can worsen constipation problems and you can become dependent on them. Long-term laxative use can also damage your large intestine,” she told Healthline.

“Constipation can be an uncomfortable issue, but there are natural ways to help,” said Dr. Mahmud Kara, an internist with Kara MD.

Dietary fiber is one way to help with new onset constipation or constipation that has only been occurring for a few days and is not the result of narcotic pain medication use,” Kara told Healthline.

The different types of fiber include:

Soluble fiber absorbs water and creates a gel-like substance that helps create smoother stools. In contrast, insoluble fiber “bulks” food and waste together to keep them moving through the digestive tract. You can find this type of fiber in foods like oats, peas, citrus fruits, leafy green vegetables, and beans.

• When it comes to constipation, cellulose (a type of insoluble fiber) is often considered “nature’s laxative.” It is found naturally in nuts, whole grains, wheat bran, seeds, and brown rice.

Danahy provides a step-by-step approach to treating constipation:

  • Gradually increase fiber to about 30 grams daily by eating more fruits, vegetables, legumes, nuts, seeds, and whole grains. Oatmeal, barley, and kiwis are some of my favorite foods for constipation. They act like natural stool softeners. Check the nutrition facts label on bread and cereals because fiber content can vary widely. Choose those with at least 4-5 grams of fiber per serving. Note: if your diet is low in these foods, add them slowly to avoid gas, bloating, or other digestive side effects.
  • Increase your fluids throughout the day. Aim for at least 64 ounces of liquid, ideally from water, unsweetened seltzer, or herbal tea. Many people find a cup of warm water with lemon, tea, or coffee (regular or decaf) has a mild laxative effect in the morning. Staying hydrated is even more critical when increasing fiber because the fluid helps soften your stool and move it through your gut.
  • Ask your healthcare provider about using an over-the-counter stool softener. This is often a safer alternative to laxatives — but Danahy recommends trying fiber and fluid first. Probiotics may also help promote regular bowel movements. These also support the gut microbiome and the gut-brain axis. Ask your healthcare provider for brands designed to help with constipation.
  • Finally, if you have chronic constipation, looking for the root cause is essential. It may be related to certain medications you’re taking or to a functional bowel disorder such as irritable bowel syndrome. Ask for a referral to a gastroenterologist who can help you address the root of the problem.