Thread by @hyderabaddoctor

Regular laxative use is associated with a higher risk of dementia

1. A recently reported study looked at association between #laxative use and new-onset #dementia in >5,00,000 UK Biobank participants.
#MedTwitter
n.neurology.org/content/early/…

2. Regular use of laxative was associated with 51% higher risk of all-cause dementia and 65% higher risk of vascular dementia. There was no significant association with risk of #Alzheimers disease.

3. The risk of dementia increased by 28% in people using one type of laxative, as compared to 90% in people using two or more types of laxatives.
Only osmotic type of laxative use was associated with higher risk of dementia.

4. Osmotic laxatives are medications that draw water into the stool, resulting in softer stools and more frequent, easier to pass bowel movements. Some commonly used osmotic laxatives to treat constipation include polyethylene glycol (PEG), milk of magnesia, and lactulose.

5a. One possible explanation is that laxatives can influence gut microbiome composition and
cognitive function in the microbiome-gut-brain axis. The alteration of gut microbiota may affect the production of numerous neurotransmitters for normal cognitive function, and

5b. increase the production of intestinal toxins that are associated with inflammatory response. *Laxatives may also disrupt intestinal epithelial barrier and facilitate passage of gut microbial-derived neurotoxic metabolites into the central nervous system.

6. Take home message
Instead of regular use of laxatives, #constipation can be mitigated in most cases by lifestyle changes,
such as increasing fluid intake, dietary fibre, and activity levels, which may also benefit brain health.