As this article will explain, mineral oil for constipation does not constitute a clear-cut case of a constipation remedy that is both natural and safe to use in the long run.
First, we will explain what mineral oil is exactly – a derivative of petroleum. Not exactly what you can call a natural product.
Second, we will see that even though there isn’t clear evidence today that mineral oil is unsafe, common sense dictates that we stay cautious.
Third, we will introduce more natural and nutritive approaches. Yes mineral oil for constipation works by lubricating the bowels, but so does olive oil.
Mineral oil, also called “liquid paraffin”, is a derivative of petroleum. It is a translucent, odorless viscous liquid. It doesn’t have any distinctive flavor, but the texture usually makes it unpalatable to children.
As you know, petroleum distillation is a big business today. Crude oil is distilled into a refined product: gasoline. Mineral oil is a byproduct of that distillation process. It is therefore very cheap to make, and is produced in large industrial quantities.
So I am sorry, but when I read that mineral oil is a natural product, it makes me cringe. Olive oil is a natural product. Mineral oil – NOT!
Mineral oil works in the following way:
Note that mineral oil simply acts as an emollient, slowly softening the stool after absorption.
This needs to be contrasted with osmotic agents that actively modify the exchange of fluids within the gut, or with stimulant laxatives that stimulate peristalsis (the wave-like movement of the gastrointestinal tract that pushes the stools forward). Those act much faster.
Mineral oil is just one of the tools used by doctors to combat constipation. It can be one minor part of a complete constipation protocol. It is very often used in the case of children constipation.
In this section we take the case of children constipation to illustrate what a typical usage might look like.
At one extreme, we have acute bouts of constipation possibly with fecal impaction (a hard fecal plug prevents evacuation).
When a slow disimpaction is acceptable, a doctor may give a large oral dose of mineral oil to your child over the course of 3 to 4 days.
When a quicker disimpaction needs to be achieved, mineral oil given orally won’t be sufficient, it will be too slow acting. More active laxatives will be used by your doctor (stimulant laxatives like bisacodyl for instance), or more “hands-on” methods likely enemas.
Mineral oil can be given rectally as enema to lubricate the passage of the hard fecal plug.
Once the acute episode with potential blockage has been dealt with, a phase of restoration of normal transit and colonic function is undertaken. This is a transition phase if you will.
During that phase, mineral oil can be used as emollient by your doctor. For children, the American Academy of Family Physicians suggests 1 to 3 milliliters of mineral oil per kilogram per day given once daily or in divided doses twice daily.
For adults, the Merck Manual suggests the range 15 to 45 milliliters per day.
This, of course, can be given with other osmotic or stimulant laxatives. It is also given along with a complete set of lifestyle and dietary recommendations.
After a few months of successful return to normal colonic function, the person is then weaned from laxatives and from the mineral oil.
Chronic and sub-acute constipation is treated in a similar way as the previous section, with similar dosages.
Mineral oil is often used alone and self-administered by the constipated person who can buy the oil over-the-counter. It can also be prescribed by the physician, often as part of a more comprehensive protocol including osmotic or stimulant laxatives, and dietary and lifestyle changes.
Take the oil chilled, keep it in the fridge as it will be less viscous when cold. Children will not like the taste. So if you decide to go with mineral oil for constipation, mix it with yogurt or ice-cream. Some sources recommend to mix it with orange juice. I think it makes an odd mix, it blends much better with fatty substances like dairies.
Safety needs to take the following two parameters into account:
One does not replace the other.
Medical research has brought a phenomenal amount of new knowledge during the past centuries, and it has often corrected what appeared to be common sense in the past. As you have seen from my previous writings, I like to build the foundation of a good article on good research data.
However, I like to stay on the cautious side when it comes to a chemical component we ingest, and for which we have not discovered any health issues yet. This is when I use common sense.
Here is what we know about the safety of mineral oil for constipation at this present moment.
Early research(1)(2) published in the 1930’s and 1940’s report that a diet including a certain amount of mineral oil diminishes absorption of fat soluble vitamins.
More recent research(3) argue that those experiments just showed a “slight decrease” and that vitamins concentrations in the “deficient range” were not observed.
Lets simplify this. Yes, studies have observed a reduction of vitamin absorption by mineral oil. Yes those reductions are small, but the interference exist nonetheless.
Back to common sense now. Mineral oil coats the intestinal tract. It thus interferes with absorption of key nutrients. If we deal with a kid for instance, or with a pregnant women, both are in great need of all the vitamins they can get from food.
Why mess up with vitamin absorption when alternatives to mineral oil for constipation are available?
One research report published in 1996(4) clearly spells out the fact that “there is clear evidence that early formulations of mineral oils used in cotton an jute spinning industry and in metal machining were carcinogenic to the skin”.
Another report(3) states that “light mineral oils (the form comprising liquid paraffin medication) do not appear to be carcinogenic in dogs or rodents”.
The report further argues that “for those ingesting liquid paraffin as a medication, there are no studies explicitly examining the potential carcinogenicity of this treatment.”
Lets summarize this. There are different grades of mineral oils, and we know that certain grades are carcinogenic. For the medication grade, there are no studies examining the carcinogenicity of mineral oil, although to date no link has been detected clinically.
Common sense: we do NOT know whether mineral oil can cause cancer in the long run. Again, to me common sense dictates to be cautious with this product.
In my humble opinion, a derivative of petroleum is not supposed to be ingested.
Mineral oil is not supposed to reach our lungs, or it can cause serious tissue damage, a condition called “lipoid pneumonia”. This is a rare incidence, but could happen if mineral oil “goes down through the wrong pipe”.
This is why it is not recommended for children who have issues swallowing. Some medical texts also do not recommend ingesting mineral oil just before going to bed. Although other texts recommend the opposite – taking the oil before going to bed so that the results will be felt the next morning.
Even though the incidence seems to be low, most medical sources list “lipoid pneumonia” as potential adverse effect.
Common sense dictates to be prudent, especially with children at risk of regurgitating and swallowing back the wrong way.
I don't like to play the alarmist. Things are not black or white. Mineral oil is not all good, neither it is all bad.
If you have to take it or give it to your child in the near future, do not panic. Go through the mineral oil process once to get out of the current crisis, then get informed - get to know the alternatives for next time around.
Olive oil is a great alternative. It won’t work as quickly as mineral oil, but it is a much gentler, nutritive, and better tolerated approach.
Here are some tips to give oil seed oil a test drive:
Please refer to the detailed article on olive oil and constipation.
In this article, we have looked at mineral oil for constipation.
First of all, we have set things straight regarding its origin – it is not a natural product, it is a derivative of petroleum.
Second, even though the adverse reactions are not well established and still under discussion by the scientific community, we have used common sense to take a caution approach.
Third, we have introduced olive oil as alternatives to the lubricating effect of mineral oil for constipation. Olive oil is not only lubricating, it is also nutritious, and stimulates the gallbladder to produce more bile, our natural laxative.
Let us finish by what Hippocrates taught us more than 2,000 years ago:"Let food be thy medicine and medicine be thy food"
(1) Curtis AC, Kline EM. "Inﬂuence of liquid petrolatum on the blood content of carotene in human beings". Arch Intern Med 1939;63:54–63
(2) Curtis AC, Ballmer RS. "The prevention of carotene absorption by liquid petrolatum". JAMA 1939:1785–8
(3) Sharif F, Crushell E, O'Driscoll K, Bourke B. "Liquid paraffin: a reappraisal of its role in the treatment of constipation". Arch Dis Child. 2001 Aug;85(2):121-4. Review.
(4) Tolbert PE. "Oils and cancer". Cancer Causes Control 1997;8:386–405
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