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February 2014

Beware of Laxative Scare Mongers!

The mother of a child with chronic constipation recently wrote to me in a panic after reading an internet article (though as I note below, it is actually a well-disguised advertisement for the author's product) titled   “Is MiraLAX the Next Vioxx? No, It's Much Worse!” She said that, on Miralax, her daughter is “now pooping every day” and “has made major progress towards pooping on the toilet”. However, having read the article, she decided to stop giving her daughter Miralax. In its place, she said that she was going to try some “natural alternatives”.

In other words, the article scared this mother into not giving her child a laxative that is safe and effective and replacing it with natural remedies which are helpful for occasional constipation but which are largely ineffective for treating chronic constipation (encopresis).

The author of this article very cleverly uses half-truths to deceive readers into believing that Miralax causes a host of neurologic disorders such as autism, dementia, depression, schizophrenia, multiple sclerosis, Alzheimer’s disease and even encopresis!

The active ingredient in Miralax is polyethylene glycol 3350 (PEG 3350), NOT ethylene glycol. However, the author leads people to believe that PEG 3350 is exactly the same as ethylene glycol which, when used in products such as “automotive antifreeze and brake fluid“, can cause neurologic problems.  There is no scientific evidence that laxatives containing PEG 3350 cause neurologic or neuropsychiatric disorders.

When read carefully, this article is no more than a well-disguised advertisement for a scientifically untested and non-FDA approved combination of supplements and probiotics developed by the author for a veritable shopping list of conditions:  “chronic constipation, bloating, diarrhea, irritable bowel disease, diverticulosis, depressed immunity, chronic fatigue, anemia, infertility, amenorrhea, acne, hair loss, graying hair, premature aging, pre-diabetes, diabetes, respiratory and urogenital infections" and on and on.

And, as if this wasn’t enough to scare parents into discontinuing a safe and effective treatment for childhood constipation, the author recommends stopping giving your child FIBER because he says it makes stools so big that they hurt. As any medical professional will tell you, fiber, just like PEG laxatives, may make stools bigger but it also makes them softer so they do not hurt

Do not believe everything people tell you about laxatives, especially on the internet. My advice? When in doubt, ask your pediatric healthcare provider.

Childhood Autism and Constipation

In my last post I talked about how children with ADHD are more likely to have functional constipation/encopresis than children without ADHD. Today’s post focusses on a higher than usual incidence of autism among children diagnosed with functional constipation. A little known fact outside of the autism community is that GI disorders, most notably, chronic diarrhea and constipation, are among the most common medical conditions associated with autism. A recent study published last year in “The Journal of Pediatrics” confirmed this association.

The researchers found that in a group of 242 children diagnosed with functional constipation, a “strikingly high” number (29%) of these children had concomitant symptoms of childhood autism.  These findings do not mean that autism causes functional constipation. As in the case of ADHD, these findings simply mean that there is a relationship of some kind between autism and encopresis.

The researchers speculate that their findings might be related to genetic factors or sensory processing difficulties. As with ADHD, they also speculate that autistic children get so absorbed in what they are doing or thinking that they simply ignore the urge to poop thus causing them to become constipated.  The importance of this study for you and for your healthcare professional is to be “alert” for symptoms of autism when diagnosing or treating functional constipation.