Gentle Lax (Excess)™

TCM herbal formula for acute and excess-type constipation with red tongue, yellow tongue coat, and red face; food stagnation and indigestion with abdominal distension and pain — strong laxative; purgative; osmotic; emollient; increases intestinal peristalsis; purges accumulation of stagnant heat; disperses lower abdominal distension and pain. Also effective for drug-induced constipation from opioids and antipsychotics.

⚠️ Strong formula — reserve for severe constipation. Stop taking when desired effect is achieved. Do not use at large dosage or for prolonged periods — may cause diarrhea and dehydration. Contraindicated during pregnancy and nursing. Patients with intestinal obstruction should be referred to a physician immediately — surgical intervention may be necessary. Patients with hemorrhoids: use only to relieve constipation — if more bleeding occurs, stop immediately and switch to Notoginseng 9. Suspect a more serious etiology if constipation is accompanied by vomiting, blood in stools, weight loss, or distended tympanitic abdomen — refer to a physician. May be irritating to intestinal mucosa — start with lower dosage or take with food. Prolonged use of Da Huang is not recommended — may increase risk of habitual constipation and fluid/electrolyte imbalance. California Prop 65 warning: "This product contains Da Huang (Radix et Rhizoma Rhei) and Fan Xie Ye (Folium Sennae). Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because Da Huang (Radix et Rhizoma Rhei) and Fan Xie Ye (Folium Sennae) may worsen these conditions and be harmful to your health. Consult your physician if you have frequent diarrhea or if you are pregnant, nursing, taking medication, or have a medical condition."

CLINICAL APPLICATIONS

* Constipation

* Excess-type constipation with red tongue, yellow tongue coat, and red face

* Food stagnation or indigestion with abdominal distension and pain

Background: Constipation is the infrequent or incomplete passage of stools — usually dry and hard, difficult to pass even with straining, with two or fewer bowel movements per week and feelings of incomplete evacuation. Common causes include lack of exercise, insufficient water and fiber intake, stress, overuse of laxatives, and use of certain drugs (opioids, antipsychotics, antidepressants, anticholinergics). Excess-type constipation is defined as acute and severe constipation, constipation in young adults, constipation with abdominal distension or pain, or constipation in patients with a red tongue, red face, and yellow tongue coat.

Key herb-level clinical data:

— Da Huang (Radix et Rhizoma Rhei / Rhubarb Root): strong purgative — clears heat and detoxifies; works mainly on the transverse and descending colon by inhibiting re-absorption of water and causing evacuation of stool; increases peristalsis of the large intestine without interfering with nutrient absorption in the small intestine; synergistic "push" effect with Mang Xiao; clinical study: 72 patients with constipation from hospitalization — great success; clinical study: 44 patients with intestinal obstruction treated with Da Huang + Feng Mi (Mel) — 97.7% effectiveness; see California Prop 65 warning above

— Mang Xiao (Natrii Sulfas / Mirabilite / Sodium Sulfate): osmotic agent — increases water content and pressure in the intestines, inducing peristalsis and bowel movement; works best when taken with plenty of fluids; synergistic "pull" effect with Da Huang — together they have a powerful and reliable effect to treat all types of acute and/or severe constipation

— Fan Xie Ye (Folium Sennae / Senna Leaf): stimulant effect on the large intestine — increases contraction and peristalsis; clinical study: 276 post-surgical patients — 95.6% effectiveness; see California Prop 65 warning above

— Zhi Shi (Fructus Aurantii Immaturus / Immature Bitter Orange): stimulant effect on the large intestine — increases contraction and peristalsis; dissipates stagnation; reduces distension and abdominal pain

— Hou Po (Cortex Magnoliae Officinalis / Magnolia Bark): excitatory effect on smooth muscles of the GI tract — promotes strong, forceful, and rhythmic peristalsis; dissipates stagnation; reduces distension

— Bai Shao (Radix Paeoniae Alba / White Peony Root): nourishes blood; relieves abdominal and intestinal pain associated with constipation; clinical study: 60 patients with chronic habitual constipation treated with Bai Shao + Gan Cao and others — great success

— Tao Ren (Semen Persicae / Peach Seed): emollient — lubricates the Large Intestine; facilitates passage of stool

WESTERN THERAPEUTIC ACTIONS

* Strong laxative / purgative — Da Huang (transverse and descending colon; water reabsorption↓; peristalsis↑ without interfering with small intestine absorption); Da Huang + Mang Xiao (synergistic "push and pull" — 72 patients hospitalization constipation)

* Osmotic — Mang Xiao (water content and pressure↑ in intestines; peristalsis↑; bowel movement↑; take with plenty of fluids)

* Stimulant laxative — Fan Xie Ye (large intestine contraction↑, peristalsis↑; 276 post-surgical patients: 95.6% effective); Zhi Shi (smooth muscle stimulation, peristalsis↑)

* Emollient / lubricant — Tao Ren (Large Intestine lubricant); Hou Po (strong forceful rhythmic peristalsis)

* Analgesic / anti-bloating — Bai Shao (abdominal and intestinal pain relief); Zhi Shi + Hou Po (stagnation↓, distension↓)

CHINESE THERAPEUTIC ACTIONS

* Relieves constipation; purges accumulation of stagnant heat (Da Huang, Mang Xiao, Fan Xie Ye)

* Disperses lower abdominal distension and pain (Zhi Shi, Hou Po, Bai Shao)

* Lubricates the Large Intestine; facilitates passage of stool (Tao Ren)

* Nourishes blood; relieves intestinal pain (Bai Shao)

DOSAGE

Standard: 3–4 capsules three times daily with warm water. For sensitive GI tracts: take with meals, or start at 2 capsules four times daily and adjust as needed. Stop when desired effect is achieved — do not use long-term. Take Da Huang-containing formulas with meals to avoid stomach irritation.

Note on long-term laxative use: Prolonged use of laxatives wipes out normal intestinal flora and leads to frequent constipation and/or secondary infections. If purgatives must be used for a prolonged period, also use acidophilus to replenish "good" intestinal flora.

Supplementary formulas: Deficient-type constipation — use Gentle Lax (Deficient). Colon detox — use GI DTX. Constipation due to stress — add Calm. Acid reflux or ulcers — use GI Care. Irritable bowel syndrome — use GI Harmony. Ulcerative colitis — use GI Care (UC). Hemorrhoids and pain — use GI Care (HMR) + Herbal ANG. Hemorrhoid bleeding — use GI Care (HMR) + Notoginseng 9. Hypertension — add Gastrodia Complex. Detoxification — add Liver DTX. Constipation due to neurodegenerative disorders (Alzheimer's, Parkinson's, stroke) — use Neuro Plus. Excess fire — add Gardenia Complex. Severe blood stagnation — add Circulation (SJ). Acne — add Dermatrol (Clear).

Nutrition: Eat plenty of high-fiber foods — fresh fruits, green leafy vegetables, cabbage, peas, sweet potatoes, and whole grains. Drink at least 8 glasses of water daily. Honey with grapefruit relieves dry stool. Prunes or prune juice regulate bowels and relieve mild constipation. Increase nourishing cooling roots: Mexican yam, yam, radishes, potatoes, carrots, melons, cucumbers, beets, turnips, malanga, celeriac, taro, rutabaga. Avoid deep-fried, fatty, and spicy foods. Avoid spicy/pungent/aromatic vegetables: pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, wasabi.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease): Recommended foods: bananas, apples, walnuts, figs, spinach, peaches, pears, pine nuts, sesame seeds, mulberries, grapefruit, yams, honey, apricot kernel, milk, yogurt, alfalfa sprouts, beets, cabbage, bok choy, cauliflower, and potato. Eat 2 bananas on an empty stomach followed by a glass of water. Drink a glass of lukewarm water with 2 teaspoons of honey on an empty stomach. Drink blended beets and cabbage on an empty stomach. Eat 5–10 figs on an empty stomach followed by a glass of water. Eat a fresh apple on an empty stomach daily. Drink mulberry juice. Eat lightly steamed asparagus and cabbage at night before retiring. Avoid spicy foods, fried foods, and meat.

Lifestyle: Avoid stress, anxiety, and tension. Exercise regularly to increase intestinal peristalsis — walking massages the intestines and regulates bowels. Do not suppress the urge to relieve the bowels — suppressing is one of the main causes of chronic constipation; empty bowels whenever there is a desire, especially in the morning when the digestive system is most active. Massage the abdomen clockwise along the directional flow of the large intestine. Patients with hemorrhoids should not lift anything heavy.

CASE STUDIES

— 63-year-old retired male: Lower abdominal pain, abdominal swelling, foul-smelling flatulence, and constipation for almost 3 days; diet of large amounts of chili; red tongue with thick white dry coating; deep rolling wiry pulse; pain on abdominal palpation; excess heat in the Large Intestine. Gentle Lax (Excess). Result: bowel movement induced after 3 doses. Continued for 1 week at smaller doses — daily bowel movement achieved.

— 50-year-old female: Bowel obstruction and constipation for 5–6 days; severity 10+/10; qi deficiency with internal heat. Gentle Lax (Excess) 4 caps 4x daily. Result: bowel movement the next day. Reduced to 3 caps 3x daily until bowel function normalized.

Related Reading

Also see: Gentle Lax (Deficient) – for chronic, habitual, and deficient-type constipation | GI DTX – for colon detox | GI Care – for acid reflux and stomach ulcers | GI Harmony – for irritable bowel syndrome | GI Care (UC) – for ulcerative colitis | GI Care (HMR) – for hemorrhoids | Notoginseng 9 – for hemorrhoid bleeding | Gardenia Complex – for constipation with excess fire | Gastrodia Complex – for constipation with hypertension | Liver DTX – for detoxification | Neuro Plus – for constipation with neurodegenerative disorders | Calm – for constipation due to stress | Digestive Health & GI Support Collection.