Combining Laxatives: Safe Or Risky?

can I combine laxatives

Combining laxatives can be done safely, but it is important to proceed with caution. Laxatives are often used to treat constipation, and there are many different types available, including bulk-forming laxatives, stool softeners, lubricant laxatives, and stimulant laxatives. It is generally recommended to start slowly when combining laxatives, beginning with one type and then increasing the dose or adding another kind over time until the desired effect is achieved. A common combination is a stimulant laxative, like senna, with an osmotic laxative, such as polyethylene glycol, and/or a stool softener like docusate. However, it is important to remember that laxative use should be guided by a healthcare provider to ensure proper use and avoid unwanted side effects.

Characteristics Values
Combining laxatives It is safe to combine different types of laxatives for a greater effect.
Laxatives to combine A common combination is a stimulant laxative, like senna, with an osmotic laxative, like polyethylene glycol, and/or a stool softener, like docusate.
Laxative abuse Can lead to serious dysfunction of bowel motility such as intestinal paralysis, cathartic colon, lazy or laxative gut, irritable bowel syndrome, pancreatitis, and other problems.
Laxatives and medication Laxatives may impact how your body absorbs medications. As a result, you shouldn’t take any medication within two hours of taking a laxative.
Laxatives and diet It is recommended to eat a high-fibre diet and drink plenty of fluids to prevent constipation.

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Combining stimulant laxatives with osmotic laxatives

Stimulant laxatives and osmotic laxatives are two different types of laxatives that can be combined for treating constipation. However, it is important to understand how they work and the possible side effects before combining them.

Stimulant laxatives, such as senna and bisacodyl, trigger contractions in the bowels that push the stool along. They are usually taken when other over-the-counter laxatives haven't helped. However, taking stimulant laxatives too often can lead to dependency, as the bowel may stop functioning normally.

Osmotic laxatives, on the other hand, draw water into the stool, making it softer and easier to pass. They are often recommended as a next step if stool softeners aren't providing enough relief. Common osmotic laxatives include polyethylene glycol (found in brands like MiraLAX or Gavilax), magnesium hydroxide solution (found in brands like Dulcolax or Milk of Magnesia), and glycerin (found in brands like Colace Glycerin or Fleet Pedia-Lax).

Combining Stimulant and Osmotic Laxatives

When combining stimulant and osmotic laxatives, it is important to follow the instructions on the medication to prevent side effects. Both types of laxatives can cause dehydration if they draw too much water into the stool, so it is crucial to drink enough liquids while taking them. Additionally, taking stimulant laxatives for longer than directed can lead to a loss of muscle tone in the colon, worsening constipation. Therefore, it is important to be cautious and consult a healthcare provider before combining stimulant and osmotic laxatives.

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Laxatives and stool softeners

Laxatives are products that help people empty their bowels, and there are many types. Stool softeners are a type of laxative called an emollient laxative. This means all stool softeners are laxatives, but not all laxatives are stool softeners.

Stool softeners work by adding moisture to the stool to make it softer and easier to pass. They can be in capsule, tablet, liquid, and syrup form and are usually taken at bedtime. They are gentle medications with a relatively mild effect. They typically contain docusate sodium and docusate calcium as the active ingredients.

Stool softeners are the gentlest and safest option for occasional constipation. They are best for people with temporary constipation or mild, chronic constipation. They are also useful when a person experiences constipation after major surgeries, such as heart surgery or hernia repair.

However, they are the least effective option for treating constipation. They are not suitable for people who need immediate relief. Stool softeners usually take 24 to 48 hours to work.

If stool softeners are not providing enough relief, osmotic laxatives are a good next step. Osmotic laxatives, such as polyethylene glycol (MiraLAX or a generic version), draw water into the stool to soften it and increase bowel movements. They usually contain polyethylene glycol and glycerin as their active ingredients.

Bulk-forming laxatives are another option. They form a gel in the stool that helps hold more water in the stool, making it bigger and easier to pass. They can be used for longer periods and with little risk of side effects. They are a good option for people with chronic constipation. However, they take longer than other laxatives to work, usually 12 to 72 hours.

Saline laxatives are magnesium-based laxatives that pull water into the intestines. They are useful for short-term constipation but are not suitable for long-term use. Using them for extended periods may lead to dehydration or cause an imbalance in other minerals.

Stimulant laxatives are fast-acting laxatives that can stimulate the intestines into having a bowel movement. They are a good option for fast relief from painful constipation. However, they are not safe for regular use. Using them regularly may cause the body to become dependent on them to have a bowel movement.

Lubricant laxatives, such as mineral oil, coat the intestines to help move stool through quicker. They are good for immediate relief of short-term constipation but are not suitable for regular use. They can interfere with the absorption of fat-soluble vitamins.

A person should take only one type of laxative at a time and consult a healthcare professional before switching between them to avoid any interactions or complications.

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Laxatives and mineral oil

Mineral oil is a lubricant laxative that has been used for many years to treat constipation. It is generally considered safe and effective. It works by coating the stool and the inside of the bowel with moisture, preventing the stool from drying out and making it easier to pass. It can be taken orally or as an enema.

When taking mineral oil orally, it is important to follow the instructions carefully. The recommended dose for adults is 15 to 45 milliliters (ml), but this may vary depending on the product, so it is important to ask your doctor about the appropriate dose. It should be taken on an empty stomach, as it can interfere with the absorption of certain vitamins, such as vitamins A, D, E, and K. It should also be taken at least two hours apart from other medications to avoid interfering with their effectiveness. Mineral oil should not be used for more than seven days unless directed by a doctor.

Mineral oil enemas usually come in a squeezable tube that allows for direct delivery into the rectum. It is important to follow the instructions carefully when using a mineral oil enema.

Mineral oil is meant to provide short-term relief from constipation. It is not recommended for extended use. If constipation persists despite using mineral oil, it is important to consult a doctor.

There are some side effects associated with mineral oil. It may leak from the rectum, especially at high doses, causing mess and irritation. Lowering or dividing the dose may help reduce this problem. Mineral oil can also cause respiratory problems if inhaled, especially in children and older adults. Therefore, it is important to be careful when giving it to children. In rare cases, mineral oil may cause an allergic reaction, with symptoms such as itching, swelling, or breathing difficulties.

It is important to note that mineral oil should not be taken at the same time as stool softeners. It should be taken on its own, following the recommended dosage and instructions.

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Laxatives and diet

Laxatives are medicines for constipation, which your doctor will recommend only if you have problems passing stool and only after you have tried other methods, such as eating more fibre, exercising regularly, and drinking more water.

There are five types of laxatives, and they act on your intestines in different ways. It's important to note that laxatives should not be used for weight loss, as this is dangerous and can make you sick.

Bulk-forming laxatives

These add soluble fibre to your stool. Soluble fibre breaks down easily in water and becomes a gel, which helps your colon hold onto water. This softens your stool and helps you pass it more easily. Commercial options include Metamucil and Citrucel, available in powder and capsule form.

Stool softeners

These laxatives help mix water in with the stool so that it becomes soft enough to pass. They include docusate sodium and docusate calcium and are available in pill or tablet form.

Lubricant laxatives

These coat your stool and make it slippery so that it can pass out easily. They are sometimes called glycerine suppositories. Mineral oil is an example of a lubricant laxative available in liquid or enema form.

Osmotic laxatives

These pull water from the rest of your body into your bowel and help it hold onto water. This softens your stool and helps you pass it easily. Examples include milk of magnesia and glycerin, available as a liquid, caplet, enema, or suppository.

Saline laxatives

These draw water into the small intestine to encourage a bowel movement. Liquid magnesium citrate is one type of saline laxative.

Natural laxatives

Many natural laxatives can help your digestive health by increasing stool frequency and improving its consistency. They can be safe and inexpensive alternatives to over-the-counter products and have minimal side effects.

Foods that contain a lot of fibre and other substances that help them function as natural laxatives include:

  • Chia seeds
  • Berries
  • Legumes (beans, chickpeas, lentils, peas, and peanuts)
  • Flaxseeds
  • Kefir
  • Apples
  • Prunes
  • Kiwi
  • Leafy greens (spinach, kale, and cabbage)
  • Senna
  • Rhubarb
  • Oat bran
  • Coffee
  • Psyllium
  • Sugar substitutes
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Laxatives and pregnancy

Constipation is a common issue during pregnancy, affecting 11% to 38% of pregnant women. This is due to hormonal changes that slow down the normal movement of the digestive system, as well as reduced physical activity and increased vitamin supplementation. While increasing fibre and fluid intake, as well as daily exercise, are recommended first-line treatments, these methods are sometimes ineffective. In such cases, laxatives can be considered.

Bulk-forming laxatives, such as calcium polycarbophil (FiberCon) and psyllium (Metamucil), are often recommended as a first-choice treatment option during pregnancy. These laxatives are generally safe to take throughout pregnancy as they are not well absorbed by the body. However, they may cause side effects such as gas, bloating, and cramping. It is important to note that psyllium may cause a serious allergic reaction and difficulty breathing.

Stool softeners, such as docusate sodium (Colace), are also considered safe for short-term use during pregnancy. Docusate has not been associated with adverse effects in pregnancy, and there is no evidence of side effects linked to its use during pregnancy.

Osmotic laxatives, such as polyethylene glycol (Miralax), are considered a second-choice treatment option. While they are generally safe, they may cause side effects such as bloating, gas, and nausea. Prolonged use of osmotic laxatives may also lead to electrolyte imbalances.

Stimulant laxatives, such as bisacodyl (Dulcolax) and senna (Senokot, Ex-Lax), should be used with caution during pregnancy. These laxatives are recommended for short-term use only due to the lack of evidence of their effects on pregnancy. They may also cause side effects such as low potassium and sodium levels.

It is important to consult a healthcare provider before taking any laxatives or other medications during pregnancy, especially during the first trimester, as many drugs can harm the unborn baby.

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Frequently asked questions

Yes, it is possible to combine different types of laxatives for a greater effect. However, it is important to consult a doctor or pharmacist before doing so, as some combinations may be unsafe or cause unwanted side effects.

Combining laxatives can provide a greater effect than using a single laxative, which may be beneficial for those with severe or chronic constipation. It can also help to prevent medication-induced constipation from worsening.

A common and safe combination is a stimulant laxative, like senna, with an osmotic laxative, like polyethylene glycol, and/or a stool softener, like docusate.

It is important to start slowly when combining laxatives, beginning with one laxative and then increasing the dose or adding another medication gradually until the desired effect is achieved. It is also crucial to stay well-hydrated when taking laxatives, as they can draw fluid into the digestive system.

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