Looking for Lewis and Clark, constipation and the joy of Thunderclappers.

As I walked out the door I ran into my neighbour shouting at me I hope you’ve got your bags, he was talking about dog bags, and I proudly waved them at him, shouting yes, he’s a 3-5 dog bag a day dog. He laughed but I’m as bothered about his bowels as I am about everyone’s when they come to see me.

Constipation was estimated to cost the NHS £165m a year, in 2014/15 66,000 or 182 people a day were being admitted to hospital just for this condition, and most people think that it’s such a minor condition that they don’t see a GP or natural practitioner for it. The bowels though play a critical role in our health, and it shouldn’t be underestimated the impact constipation and gut issues can have later on in life. With 2m people in the UK likely to have constipation, it’s no wonder that in the UK we spend £101m a year on laxatives

The Americans spend $725m a year on laxatives, 15% of the population are estimated to have IBS, over 2.5m visits to the Dr. are for constipation, and 48% of Americans are on an Rx drug that has digestive issues as a side effect. Whichever way you look at it that is a lot of digestive distress. Screaming Jay Hawkins an artist who created the song Constipation Blues sums the issues up people are having musically very well sadly, you can watch him on YouTube.

Let’s not roll our eyes and shake our heads thinking this is just about modern diets and medications being the creators of this problem. I found out that Lewis and Clarke the expedition team that Jefferson sent to explore the Louisiana Territory, not only carried supplies they would need to survive during their time whilst trekking during the mapping of the territory, but they also carried 600 mercury laxatives with them! This obviously started making me wonder what on earth was going on with their bowels to need so many, well it was all down to their poor diet which consisted of 120 gallons of whiskey they are documented as carrying, and dried strips of animal meats. You could loosely refer to it as a paleo diet I suppose….

These laxatives were the famous Dr. Rush’s Bilious Pills, or Thunderclappers or Thunderbolts as they were affectionately known. Dr. Rush was actually a Founding Father of the United States, apparently also keen on bowel cleanliness. He was a proponent of public health as a whole though who also promoted personal hygiene, mind you these Bilious Pills were 50% mercury, 10g of calomel and 10g of jalap, definitely designed to clear the bowel out, I can’t imagine there was anything left of the bowel after taking these. The whole active ingredients weighed in at 1295mg so not for the faint hearted amongst us, if you could swallow them the earth would be guaranteed to move, if you didn’t die from getting them stuck in your throat. That whiskey chaser now makes sense you may agree.

Calomel started being used internally in the 1600’s in medical practise, after many hundreds of years of documented external mercury usage on wounds. With its quick response as a laxative it was felt that this response was its positive actions, the fact that along with mercury poisoning which it effectively was causing, also came the loss of teeth, bleeding and sore gums, and discoloured stools, never mind the potential for madness and death. With most of Lewis and Clarke’s party having syphilis these Thunderclappers or Thunderbolts were being used for 2 purposes not only to clear the bowels from the poor quality foods but to also resolve the syphilis that was rife amongst them and they depended on them by the sounds of things as many people still do now.

If laxatives weren’t causing mental health issues due to mercury content then in the late 1700’s they were being used by Dr.’s in asylums with the mentally ill. The Radcliffe Infirmary in 1796 documents purging patients with laxatives for all sorts of ailments from including swollen legs.

Regular cleansing of the bowels has links to spiritual as well as physical well being going back to Ancient Greek times, the word katharsis is from the Greeks meaning cleansing, and purgo from Latin is to purify. So the history of them goes back at least 2000 years as does the abuse or overuse of them.

There is a report in the BMJ in 1974 which outlines to Dr.’s the extent of laxative abuse they need to be aware of, and at that point, there were 200 over the counter preparations available. At the time they found that 15-30% of people over the age of 60 were taking at least 1 dose a week, the gender breakdown of usage was 90% women.

Chronic constipation is more common than you probably realise, observational studies worldwide show that it affects 14% of the population with a higher prevalence in women and those with lower socio-economic status. More than 2,500 years ago, Hippocrates noted that “the intestines tend to become sluggish with age”. About 75% of elderly patients that are hospitalised or in care use laxatives for bowel regulation. Many people who start using laxatives in their early lives never wean themselves off and continue to use them into later life.

Wonder Woman hit our screens this year, but Linda Carter the original Wonder Woman actress actually is a spokeswoman for IBS in the States because her mother suffered from IBS for over 30 years. Elvis is said to have had 30 pounds of faeces in his intestines when he died, an astonishing weight of waste to be carrying.

When was the last time you moved your bowels?