Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment specialist Home Care constipation diet warning signs Complications Underlying Cause

Laxative Abuse Constipation

General treatment for constipation in those with laxative abuse includes:

  • Avoid foods that seem to give you constipation. Some cheeses, white flour, and white rice can trigger constipation.
  • Avoid straining on the toilet, this can cause hemorrhoids and complicate things further.
  • Don't ignore the urge to move your bowels -- this can throw off your schedule and cause you problems.
  • Drink more water.
  • Eat more fiber.
  • Get regular exercise.
  • Try mild caffeine-containing beverages. These often have a mild laxative effect.

Fiber works by increasing the amount of stool in your colon (large intestine). The most well known fiber is bran. Common fiber supplements include Citrucel and Metamucil. Regular use of these high-fiber products is safe. They are also more effective when used regularly. Drink plenty of water when taking extra fiber.

Dietary fiber is a plant material that humans cannot digest. Fiber is made of large carbohydrate molecules that pass through the intestinal tract without being used by the body.

Fiber comes in two forms, based on whether it will dissolve in water. These are called soluble and insoluble fiber. Most experts believe that about 3/4 of fiber intake should be the insoluble form.

Water soluble fiber
ExamplesDietary Sources
Pectins, gums, & mucilagesfruits, vegetables, oats, bran, barley, legumes

Insoluble fiber
ExamplesDietary Sources
Cellulose, hemicellulosevegetables, wheat bran, & whole grains

Fiber tends to bind water, which leads to softer stools and a more rapid passage of material through the intestines. This rapid transit may reduce the exposure of the bowel to toxic substances and improve overall bowel health. Fiber can also bind fats and cholesterol. As an added benefit, high fiber foods usually contain important vitamins and minerals.

General Guidelines
In general, fruits, vegetables and whole grains are high in fiber. Check food labels of prepared products to see if there are at least 3 grams of dietary fiber per serving. Look for the term 'whole grain' as a major part of the food.

Raw foods tend to have more fiber than cooked, canned or pureed items. Even chopping and peeling skins removes some fiber. Dried fruits are especially high in fiber. Beans, black-eyed peas, brans and oatmeal are very high in fiber.

Unprocessed wheat bran can be added to many home meals and most baked foods. Bran is the outer layer of the wheat grain, and is present in 'whole grain' foods. Adding 2-3 teaspoons of bran per serving is a great way to increase the fiber content of casseroles, meat loaf, and baked goods. Whole grain flour has 6 times the fiber of standard, bleached flour. Oat bran can be used in place of about 1/3 of regular flour when baking.

Try adding nuts or bran to dairy foods such as yogurt or cottage cheese, which normally have very little fiber. Avoid white bread and flour pasta.

Change your diet slowly and drink plenty of fluids to allow the fiber to do its work. Rapid changes in the diet can cause bloating, gas and diarrhea. A varied, high-fiber diet is much better than taking fiber supplements.

Example High-Fiber Diet
Breads and Grains
Eat at least 3, and as many as 10 servings each day of various whole grain foods. Any grain food should say 'whole grain' and contain at least 3 grams of fiber per serving.

Examples include:
  • Barley
  • Brown rice
  • Oatmeal or oat bran
  • Rye bread
  • Wheat germ
  • Whole grain bagels
  • Whole grain breads
  • Whole grain muffins
  • Whole grain or bran cereals
  • Whole grain pita bread
  • Whole wheat crackers
  • Whole wheat pasta

Eat at least 3-4 servings each day. All fruits are good, and dried fruits are especially high in fiber.

Examples include:
  • Apple
  • Banana
  • Berries
  • Grapefruit
  • Nectarine
  • Orange
  • Peach
  • Pear

Eat at least 3-5 servings per day, preferably raw and unpeeled

Examples include:
  • Asparagus
  • Broccoli
  • Cabbage
  • Carrots
  • Green beans
  • Green pepper
  • Onions
  • Peas
  • Potatoes with skin
  • Snow peas
  • Spinach
  • Squash
  • Sweet potatoes
  • Tomatoes
  • Zucchini

Meat substitutes:
Meat has no fiber and contains various amounts of cholesterol and saturated fats. There are many high-fiber foods that can partially or completely replace meat in the diet. Using several servings of meat substitutes each day will greatly increase total fiber intake.

Examples include:
  • Almonds
  • Brazil nuts
  • Cashews
  • Garbanzo beans
  • Kidney beans
  • Lentils
  • Lima beans
  • Peanut butter
  • Peanuts
  • Pinto beans
  • Sesame seeds
  • Soybeans, but not tofu
  • Split peas
  • Sunflower seeds
  • Veggie burgers
  • Walnuts

  • Bean dip
  • Cookies made with oatmeal, whole wheat flour, fruit and nuts
  • Popcorn
  • Tortilla corn chips (baked)
  • Trail mix
  • Whole wheat pretzels

Continue to Laxative Abuse Diet

Last Updated: Mar 13, 2009 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Laxative Abuse References
  1. Baker EH, Sandle GI. Complications of laxative abuse. Annu Rev Med. 1996;47:127-34. [8712767]
  2. Phillips SF. Surreptitious laxative abuse: keep it in mind. Semin Gastrointest Dis. 1999 Oct;10(4):132-7. [10548406]
  3. Pryor T, Wiederman MW, McGilley B. Laxative abuse among women with eating disorders: an indication of psychopathology? Int J Eat Disord. 1996 Jul;20(1):13-8. [8807348]
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