Laxatives

[BlackHatGuy]

What an exciting thread title! I think it’s the sh…. never mind.

Anyway, for those of you who use a laxative daily, do you also take one daily while backpacking?

[David Thomas]

I’m doing 1 teaspoon in 8 ounces of water, three times a day of (Walmart’s Equate version of) Metamucil to try dropping my cholesterol which is borderline (large studies indicate an average 10% drop when taking fiber supplements regularly).  My hiking buddy runs a medical lab and I’m his guinea pig – he ran my blood 2 weeks ago, and will in another 2 weeks and we’ll see if there’s an improvement.  It also is working as a modest appetite suppressant (dropped 4 pounds in 2 weeks) and, although constipation wasn’t usually an issue for me (unless I did 1-2 days of meat&potatoes&no-veggies), it is also keeping things moving along.

And there’s a UL benefit – I’m using less toilet paper, which I also observed on a BPing trip with a bunch of vegans when I was pooping rabbit pellets (because I was eating like one).

If this becomes a long-term thing, I’d look at the pill options for BPing trips and other travel.  Not because there’s anything wrong with the powder stuff (and it provides 4 calories per gram, so it’s not horrible as sustenance per weight) but for the convenience of not measuring out a teaspoon from a baggie of “unknown white powder”.

[Roger Caffin]

No, never.

[Pedestrian]

For years I struggled with muscle cramps/spasms after hard runs/hikes that would come on very suddenly and would leave me in pain. I tried all kinds of electrolytes (gatorade, various versions of Gu, Saltstick and other capsules) without much success. I saw a physician for an unrelated issue and somehow I mentioned the cramps. He suggested trying magnesium (especially the Natural Calm powder, unflavored); it was almost immediately helpful. So now I take some  Natural Calm powder at bedtime in a cup of water and also during long hikes/runs.

Magnesium happens to have a pretty strong laxative effect. Just go easy and work up to a dose you can tolerate without an accident…..

I understand magnesium deficiency is pretty common among the population at large.

YMMV.

And yes it IS a white powder….

 

[Alice Hengst]

I like the calcium polycarbophil fiber pills (FiberCon or equivalent) when backpacking. It helps draw water into your bowel. Otherwise it seems that when I’m hiking, no matter how much I drink, my body wants to use the water elsewhere.

Oatmeal and coffee for breakfast is good.  And come to think of it, when backpacking I do take a cal-mag supplement pill in the evening,  but I’ve never noticed a laxative effect.

[Pedestrian]

“but I’ve never noticed a laxative effect”

“The dose makes the poison”….most magnesium pills don’t deliver enough to cause a laxative effect. The powder on the the hand…..you could do yourself some damage….

Magnesium hydroxide is perhaps the most potent form for laxative effect (Google “Milk of Magnesia”).

Natural Calm is magnesium citrate; there are many variants…..(glycinate, oxide…..); each one is absorbed somewhat differently by the body.

NB: I don’t take the magnesium citrate as a laxative but because it helps with cramping…..but the laxative effect is pronounced especially at higher doses.

 

 

[Jeff Y]

FWIW I always thought oatmeal was generally pretty low in fiber, despite what one would think.

[Roger Caffin]

One goes to the web for answers.

Is Oatmeal a Good Fiber Food?. Getting more fiber in your diet is easier than you think. Much of the fiber in oatmeal is soluble — a type of fiber that is especially beneficial for your heart. Oatmeal is an excellent source of fiber on its own,
web site A

Yes oat fiber has carbs, but the body is not able to process the carbohydrates into accessible calories. Oat fiber is almost entirely insoluble dietary fiber and contains a minimal amount of soluble fiber. Oat fiber lacks any nutrients for the body to process as calories.
web site B

So much for the web as a reliable source of dietary information.

Cheers

[BlackHatGuy]

But there is a difference between oatmeal and oat fiber. They are two different animals.

[Jeff Y]

I got my information from my PCP, so I didn’t go online and try to contradict her, a doctors favorite ;) Doesn’t the nutrition facts state how much fiber is present?

Jeff

[BC Bob]

A daily laxative?  Yikes. Doesn’t that tell you that your keto diet might not be a good thing?

Here’s an excellent podcast on the importance of fiber and how critical it is to have a healthy gut microbiome. Lots of new science in the last 10 years.

https://plantproof.com/building-a-healthy-gut-with-dr-will-bulsiewicz/

 

[HkNewman]

I’ve learned to limit even the amount of beans on a backpacking trip on any length, as the next mornings coffee can prove to be as explosive as a Saturn rocket launch.

On the flip side, fiber intake ontrail needs to be maintained since humans are more prone to diverticulosis type ailments as we age.  So it’s a whole wheat cereal for breakfast, and at least nuts sometime after lunch.

The first night and maybe the next day may be ok for fresh vegetables and/or fruit.

 

[AK Granola]

I’m honestly a little horrified by laxatives. The idea of taking them regularly makes me think that the regular diet is messed up, and I would worry about potential harm or dependency from regular use. Then again, David’s wife is a doctor, so I guess he knows what he’s doing and maybe it’s no big deal.

If you’re eating properly shouldn’t the digestion be working pretty well? If it’s not working it’s perhaps a sign that the diet needs to be modified rather than medications added? But everyone is different. If I had an issue on trail, which I haven’t, I guess I’d add more fresh vegetables and fruits. Seems worth the weight to me. An apple a day…

I typically have oatmeal with flax seed, walnuts, dried fruit, and dried milk for breakfast, plus coffee or black tea, while on hikes. Snacks include nuts and seeds, and dried apricots or apples. I frequently have reconstituted dried hummus for lunches, and dinners always include reconstituted veggies like shaved carrots and beets, or dried potatoes, in soups or other dishes. I often bring fresh carrots and cucumbers for the first day or two. Hydration is key for me also. And not eating too much; I have to give it all time to rest. Overeating really messes things up.

I guess you’re looking for people who do use laxatives, instead of those who don’t.  You’ve already tried a higher fiber diet? Ginger tea? Good luck!

[BlackHatGuy]

I’m not really looking just for people who do use laxatives, I’m always interested in hearing most other voices, even those who disagree. Sometimes pushes me to do a bit more research.

“Doesn’t the nutrition facts state how much fiber is present?”

Yes, it should. And hopefully also state how much soluble vs insoluble.

“A daily laxative?  Yikes. Doesn’t that tell you that your keto diet might not be a good thing?”

No, not at all. I know you’re not a fan of the keto diet, but there is a lot of science behind it. Of course, that doesn’t mean I always do it well. I’ve gotten much better about eating more veggies while still staying within the diet (I really dislike that word diet, it’s a lifestyle choice for me and ‘diet’ has a certain connotation that doesn’t apply to that connotation), I have a tendency to skip the veggies, which is of course, not good. And I love those veggies, (the low carb ones, including broccoli, spinach, cauliflower, asparagus, etc.). I just get lazy when in a hurry and such, like many folks.

“If it’s not working it’s perhaps a sign that the diet needs to be modified rather than medications added?”

I don’t consider taking a fiber supplement as medication, but more of a food. I use straight psyllium husk powder with no fillers or flavorings, nothing synthetic. I think of it as my veggie in the morning. I’ve never been so regular in my life, and I don’t suffer what some people do with it: bloating, gas, etc. My doc has no issue with it either.

“On the flip side, fiber intake ontrail needs to be maintained since humans are more prone to diverticulosis type ailments as we age.”

I’ve had an issue with diverticulitis that well predates my keto lifestyle. Clear liquid diets are not fun. Since I’ve generally too often been lazy about my diet (including a horrendous (what seems to have become) standard western diet for much of my life, the psyllium husk powder has really been a huge boon.

All that is not to discount what anyone else has said, we’re all different and I appreciate different perspectives. So thanks for the comments.

 

[d k]

We use psyllium husks – I carefully down a spoonful, with a big glass of water as a chaser (I found early on you have to be really careful not to inhale any, or you’ll choke and spew out the whole mouthful!).  L mixes it in with his morning cereal.  He’s been using it for years; I started a few years ago just for traveling and backpacking, but as I’ve aged my gut has slowed down, so now it’s every day.

And yes, way less TP needed.

[Jerry Adams]

“A daily laxative? Yikes. Doesn’t that tell you that your keto diet might not be a good thing?”

Good line.  From a humor perspective.  It’s taken all my self control not to say it.  Or am I forgetting that I’ve already used it?

I’m skeptical of keto, but if it works for someone, great.  There are indigenous cultures that eat mostly meat and are healthy.  A “Mediterranean”  diet seems like a better way.  I definitely do not need any extra fiber, maybe a bit less at times.

Something that makes me constipated on some trips is getting dehydrated.

Another thing is sometimes I eat a lot less.  If I eat more, then material is flowing through the system, pushing material out the end.  Or so it seems.

One thing that concerns me about some diets is too much weight loss.  I have read that if you have a little extra body weight you’re able to survive health events better.  I have seen two examples of that in person.  But that’s not scientific.  There’s also evidence less body weight will result in hormones that extend lifetime and have other health improvements.  The big problem in the U.S. is obesity which is clearly very unhealthy.  Being a little underweight is a second order problem.

[BlackHatGuy]

“I carefully down a spoonful, with a big glass of water as a chaser (I found early on you have to be really careful not to inhale any, or you’ll choke and spew out the whole mouthful!).”

I just mix mine (a tablespoon, though now that things are, well, running well…., I’m going to decrease that to half a tablespoon) with water in a shaker bottle with one of those little balls inside. Then I down it quickly. Works really well. It’s the first thing I do in the morning as I’m making my coffee.

[d k]

I’ve done it that way, but I’m all about washing fewer dishes.  And that psyllium can really stick if it dries on…

 

My method doesn’t really work with the powder, only the husks.

[Jerry Adams]

Oat bran is keto friendly?

[BlackHatGuy]

some people say so

[Adam Kilpatrick]

Something you learn about week 2 of nursing school, is that, immobility is a leading factor in constipation. We want to get patients moving. There are so many benefits, including peristalsis of the bowel. Immobile, bed bound patients, almost always need to have regular aperients (what we call “laxatives”).

Another major factor is hydration. A dehydrated patient is much more likely to become constipated. Its not hard to think why. The stool basically dries out and can’t be sqeezed along the bowel with peristalsis (muscles of the bowel moving).

Chances are if you need something mild on a daily basis at home, if you then started hiking all day long, you will have less issues with constipation due to the mobility. If, however, you are in a constant state of dehydration, your stools with harden up and be much harder to pass. Drink water.

Completely changing your diet is also an issue. Pro tip if you want to loosen up; insert a Nasoenterric tube and tube feed yourself. “WH BO” (witheld, bowels open) is the common notation written by Nurses on those Patient’s med charts against their aperient orders.

I would take your aperients with you if you are taking them regularly at home. It doesn’t neccessarily mean that you need to take them as often. Managing aperients is always a balancing act, that you get better at over time. Nurses are pro’s at judging it. You’ll learn to judge yourself. Of course, if your doctor has prescribed you something and you have an existing GI issue then I would seek their advice. Particularly if you have had GI surgery in the past.

Oh yes Metamucil. MAKE SURE YOU DRINK PLENTY OF WATER. Seriously, you need to be properly hydrated. Otherwise it actually makes you more constipated…people seem to not know that…

If all else fails I guess you could do a backcountry home brew GNO. GNO is pretty much the last resort to get a patient’s bowels moving in hospital without manual extraction or surgery to remove bowel impaction. Basically the formula varies, but in my hospital its 100ml of olive oil, 100ml glycerine, 100ml water. You could definitely skip the glycerine (or just add a few teaspoons if sugar, that will do it). Stick it in your hydration bladder. Lay on your left side. Insert tube rectally, about 80-100mm. I’d recommend a lube on the tube. Have someone hold bag up, let it all flow in with gravity. Watch everything flow out. E.v.e.r.y.t.h.i.n.g. (seriously don’t do this unless you are a nurse. Not that I think you’ll hurt yourself. You can’t handle it).

[Roger Caffin]

Thank you Adam.
I think we can forego the pictures.
:)

Cheers

[BlackHatGuy]

FWIW, my issue is not constipation, that’s not something I suffer at all. Nor am I immobile, I don’t hike every day (nor do I want to) but I do exercise and move about. Appreciate the information though.

[Kevin Babione]

Adam – the patient would have to have extraordinary control of their sphincter muscles to squeeze the bite valve on the end of the hydration tube…

Seriously though, thanks for the post.  Mike Clelland! had a story about a woman who was so worked up about pooping in the woods that her bowels became impacted.  Your hydration hose solution seems much more pleasant than the “butter on a finger” technique Mike described in his book.

Since I do all of my hiking in the northeast US I don’t think I’m ever more than 6-8 hours (including hiking time to a road) from emergency medical care.

[BlackHatGuy]

“the patient would have to have extraordinary control of their sphincter muscles to squeeze the bite valve on the end of the hydration tube…”

Everything is possible with practice….. :-)

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