‘…Oh, and I take senna regularly, of course.’ Patients will say this some time after I’ve asked them what medications they use, as though it somehow didn’t count. Constipation is so common that it often isn’t really seen as a health issue, like spots in your teens or the occasional headache. To be sure, laxatives like senna will prod your bowel into action, but does that solve the problem?
‘Normal’ can be anything from a bowel movement every couple of days, to two or three times a day, but if you have to strain, if you feel bloated and uncomfortable or produce a lot of wind, you’re probably constipated. It means the normal peristaltic flow is not working. Usually, eating more roughage is the answer, together with moderate exercise and maybe drinking more. Simply taking a laxative puts off dealing with these issues. In the long term, a poor diet and not enough exercise will have more serious effects on your health, and your bowel will become lazy because of the senna, and not move at all unless you use it.
There’s a psycho-emotional side to constipation, too. Holding on is one of the earliest things we learn to do in childhood, and a lot of people will react to stress in this way all their lives. If stress becomes chronic, constipation can become chronic as well. Herbs that give nervous system support, like Verbena and Liquorice, can be far more useful here than the more stimulating laxatives, and they don’t create dependency. But really changing the pattern can be a long, slow process. If the patient is already taking senna, then there are two habits to kick rather than just one.