Blame it on our ancestors. They were convinced that regularity was the key to good health. To achieve this, they often relied on laxatives.
We should know better. Gastroenterologists recommend high-fiber foods with lots of liquids and regular exercise to keep most people on track. Nevertheless, Americans consume enormous amounts of laxatives. It is estimated that 1 out of 5 frequently uses such a product.
We are, after all, an impatient people and we love quick results. Stimulant laxatives offer fast relief from constipation, but questions have recently been raised about their safety.
The maker of the top-selling product, Ex-Lax, is about to change its formula. After more than 90 years on the market, Ex-Lax will no longer contain phenolphthalein.
The Food and Drug Administration has proposed a ban on this widely used ingredient because studies by the National Toxicology Program found "clear evidence of carcinogenic activity" in laboratory animals. There are no reports that phenolphthalein has caused cancer in humans, but the agency is especially concerned that this chemical may damage the crucial p53 gene, which protects the body from many different kinds of cancer.
Dr. Robert Temple, drug chief for the FDA, warns that long-term use may carry a risk: "What we're saying is, find another laxative" that does not contain phenolphthalein.
Novartis Consumer Health, the manufacturer of Ex-Lax, reacted to the FDA's proposed ban: "We are obviously disappointed. . . . Based on all available data, including nearly 100 years of human use, we continue to believe that phenolphthalein products are safe and effective." But "to avoid consumer confusion," the company is voluntarily withdrawing its phenolphthalein-containing laxatives. Reformulated Ex-Lax is expected to contain senna.
This herb has been used for centuries and is a strong laxative in its own right. But there are concerns about senna as well. Back in May 1996, the FDA issued a letter indicating that senna might also cause gene or chromosome abnormalities. The agency also raised questions about the safety of similar herbal ingredients, aloe and cascara sagrada.
Until further research clears these stimulant laxatives, people may wish to consider more conservative solutions. Remember, regularity varies from person to person. Some are normal with one bowel movement every three or four days, while others may visit the bathroom two or three times daily.
Fiber, fluids and daily exercise are the best ways to stay regular. Preoccupation with constipation is counterproductive.
A Band-Aid approach
Q. My mother always told me that the best way for a scrape or a skinned knee to heal was to let it scab over. The hard part (for me) was not picking at the scab.
My daughter fell and scraped her knee during recess. The school nurse put on a special bandage and told her to have it changed every day for a week. Wouldn't it heal faster if we let the air get at it so it can scab over?
A. The school nurse is right. Experts now believe that wounds heal faster, with less scarring, if they are kept moist. To do this, they must be kept covered.
Antibiotic creams and even plain petroleum jelly help promote healing, presumably because they keep moisture in and air out.
There are also gel-based moist wound coverings that promote healing. We are impressed with Second Skin for burns, blisters and scrapes. Curad's new bandages, Sof-Gel and Blister-Care, should also be beneficial.
Write to Joe and Teresa Graedon in care of The Buffalo News, P.O. Box 100, Buffalo, N.Y. 14240.