Medicine: By Bulk

Every year the colon-conscious U.S. public spends $100 million on laxatives—the biggest seller, after vitamins, in the drug field. Most of the laxatives people buy and take are intestine-irritating chemicals which many doctors denounce: cascara, aloes, resins, castor oil, phenolphthalein and salts. Such concoctions often aggravate digestive trouble, or start trouble if none exists.

Doctors themselves were mostly to blame for making the U.S. a nation of laxative-takers. A generation ago, they spread the word, with the help of patent-medicine advertisers, that waste matter retained in the colon causes self-poisoning. Current medical belief denies this. Furthermore, most so-called constipation is nothing of the sort; daily elimination is not necessary to everybody’s health. Fof some people, an interval of two days or more may be natural.

The modern theory of a “colon corrective” is expounded by the Mayo Clinic’s Dr. J. Arnold Bargen in the current Gastroenterology. Dr. Bargen recommends methylcellulose, which will correct either constipation or diarrhea. It can also do much, he says, to repair the harm done by laxative chemicals. Dr. Bargen concedes that “constipation is probably the most common of all physical complaints.” In modern smooth diets, often deficient in fruits and vegetables, most food is absorbed in the small intestine and not enough bulk reaches the colon to cause automatic muscle contraction (peristalsis). The thing to do, says Dr. Bargen, is to get more bulk into the colon. Thus far, the job has been done awkwardly by sprinkling agar-agar, kelp and psyllium seeds on breakfast foods.

Methylcellulose, Dr. Bargen found, is a bulking substance which can be taken handily in tablet form. In lukewarm water or in the digestive tract it forms a suspension of “innumerable tiny translucent gelatinous particles 0.5 mm. or less in diameter.” It goes through most of the digestive tract unchanged, but loses water and turns to a bulky jelly about the time it reaches the colon. Dr. Bargen checked on its progress at regular intervals—through abdominal openings in patients who had had intestinal operations.

Some of the patients on whom Dr. Bargen tried methylcellulose had taken, as they said, “barrels of laxatives,” and were still constipated. One 6g-year-old woman had been taking daily doses as long as she could remember. A girl of 19, her mother testified, had taken a laxative nearly every day since early childhood. Methylcellulose straightened them out.

After the bowel recovers from laxative irritation, it can get along with very little help: the methylcellulose can be cut down from 16 tablets to two a day.