In this video Dr. David Perlmutter introduces osmotic laxatives, focusing on polyethylene glycol (Miralax), and explains how they draw water into the gut to facilitate bowel movements. He summarizes a Stanford mouse study led by Dr. Justin Sonnenburg titled “Transient Osmotic Perturbation Causes Long-Term Alteration to the Gut Microbiota,” which found that a brief osmotic disturbance caused lasting changes in gut bacterial composition, immune function, and the intestinal mucus layer. While emphasizing that the research was conducted in mice, Perlmutter cautions that similar adverse effects could occur in humans with chronic laxative use. He advises increasing dietary fiber, staying well‑hydrated, and using laxatives judiciously to avoid potential harm, concluding with a “do no harm” message.
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Well, hello everybody. Dr. David Perlmutter here. Thank you for joining me. So many people seem to take laxatives these days, and one of the types of laxatives that is really common is called an osmotic laxative. What does it mean? It means you're basically taking something that has a lot of particles, and then when those particles are in the gut, that draws lots of fluid into the gut and helps people with their bowel movements. One of the most common chemicals that is used is called polyethylene glycol. Oddly enough, the same thing you put in your car radiator as an antifreeze and coolant. A common form of this is called Miralax, and we know that this represents the 2nd most common digestive-related medication used in America. Well, is it a free ride to get improvement in bowel movements by using this? Well, recently research carried out at Stanford University, a group of individuals including Dr. Justin Sonnenburg, our colleague, reviewed what is the effect of these osmotic changes in the gut brought on by using this type of intervention, these types of medications, in terms of a variety of things that he looked at. And we'll talk about that in just a moment. Let me be clear: this is a study that was done in mice, and what the group found was that there were fairly dramatic changes seen in the gut bacteria that were in fact long-lasting. In addition, they found that there were significant changes in immune function and even changes to the very important mucus layer that lines the inside of the intestines. The study is called Transient Osmotic Perturbation. Causes long-term alteration to the gut microbiota. So what we can at least indicate, maybe the implication of the study, is that perhaps in humans there are some changes that may not be favorable that are brought on when people induce bowel movements by taking this type of laxative. What can we do? We can increase our dietary fiber, for example, drink a lot more fluid. And be careful with various types of medications that are chronically— rather, that are typically associated with constipation when used over a period of time. Again, it does look as if Americans are getting very little fiber in their diets. Fiber, we know, is good because it enhances the contraction of the bowel. It also nurtures the gut bacteria, and that aids Mm-hmm. In digestion as well. So word to the wise here, above all, do no harm. And it looks like if we are to extrapolate to humans from this laboratory study, there may be something to be concerned about in terms of using, uh, this type of laxative medication. I hope this information is helpful for you. I'm Dr. David Perlmutter. Thank you for joining me. Bye for now.
