Laxatives: Friend Or Foe For Ibs?

Irritable Bowel Syndrome (IBS) is a common disorder that causes abdominal pain and a change in normal bowel habits. Constipation is one of the most uncomfortable and painful symptoms of IBS. While laxatives can provide temporary relief from constipation, they are typically considered a secondary treatment option. This is because long-term use of over-the-counter laxatives can lead to dependency and decrease the colon's ability to contract, which can worsen constipation.

There are two main types of laxatives: stimulant and osmotic. Stimulant laxatives encourage the muscles in the bowels to contract, aiding the passage of the stool. Osmotic laxatives work by drawing water back into the bowel, loosening the contents and making it easier for stools to pass through the intestines. However, some osmotic laxatives can cause abdominal bloating and wind as they are fermented by bacteria in the bowel.

Stimulant laxatives, such as Dulcolax, can help with IBS-C but are not suitable for long-term use

While laxatives can provide temporary relief from constipation, they are not the first line of treatment for IBS-C. Instead, it is recommended that people with IBS-C make dietary changes, such as increasing their fibre intake, and get regular exercise to help move stool through their bowels. If these strategies are unsuccessful, doctors may then suggest laxatives or medication.

It is important to consult a doctor before taking laxatives, especially if you have IBS. This is because certain types of laxative may be more suitable for you than others.

Osmotic laxatives, such as Movicol, can be bought over the counter and are safer for long-term use

Osmotic laxatives are a type of laxative that can be bought over the counter and are considered fairly safe for long-term use for some people with IBS-C. They include milk of magnesia, polyethylene glycol (found in Movicol), magnesium citrate, and sorbitol. These laxatives pull water into the colon to soften the stool, making it easier to pass. However, it is important to drink plenty of water when taking them to avoid dehydration.

Movicol is a trusted brand of osmotic laxatives that has been shown to be effective in treating constipation. It is available in different flavours, including lemon-lime, chocolate, and flavour-free. Each sachet of Movicol contains 13.125 g of macrogol 3350, 0.3507 g of sodium chloride, 0.1785 g of sodium bicarbonate, and 0.0446 g of potassium chloride. The powder can be dissolved in water and drunk, with the recommended dose being one to three sachets per day, depending on the severity of constipation.

While osmotic laxatives can be effective in treating constipation in IBS-C, it is important to note that they may not help with other IBS symptoms such as stomachaches and bloating. Additionally, they should not be used as a primary treatment option for IBS-C, and long-term use can lead to dependency. It is always recommended to consult with a doctor before taking any laxatives, including osmotic laxatives, to ensure they are the best treatment option for your specific situation.

Linaclotide (Linzess) is a prescription medication that treats both men and women with IBS-C

Linaclotide (Linzess) is a prescription medication used to treat irritable bowel syndrome with constipation (IBS-C) in both men and women. It is also used to treat chronic idiopathic constipation (CIC) in adults and functional constipation (FC) in children and adolescents aged 6 to 17 years. The medication is taken orally as a capsule once daily, at least 30 minutes before the first meal of the day. It is important to note that Linaclotide should not be given to children under 2 years of age as it may cause severe diarrhea and dehydration.

Linaclotide works by softening the stool, making it easier to pass. It helps increase the frequency and completeness of bowel movements and provides relief from belly pain, discomfort, and bloating associated with IBS-C. The most common side effect of Linaclotide is diarrhea, which often begins within the first two weeks of treatment. Other common side effects include gas, abdominal pain, and swelling, or a feeling of fullness in the abdomen.

It is important to consult a doctor before taking Linaclotide, especially if you are pregnant, planning to become pregnant, or breastfeeding. Additionally, inform your doctor about any other medications, vitamins, or herbal supplements you are taking to ensure safe and effective use.

Lubiprostone (Amitiza) is a prescription medication that treats IBS-C in women

Lubiprostone is typically taken as a capsule with food and water twice a day. It is important to swallow the capsule whole and not to open, chew, or crush it. It is also important to continue taking lubiprostone as prescribed, even if you feel well, and not to stop taking it without first consulting a doctor. Lubiprostone may help to relieve symptoms but will not cure the condition.

Lubiprostone is used to treat chronic idiopathic constipation (CIC), which is defined as difficult or infrequent passage of stools that lasts for three months or longer and is not caused by a disease or medication. It is also used to treat IBS-C in women aged 18 or over, and constipation caused by opioid pain medications.

Lubiprostone may cause side effects such as stomach pain or bloating, and swelling of the hands, feet, ankles, or lower legs. More serious side effects include allergic reactions, bowel blockage, low blood pressure, and shortness of breath or difficulty breathing. It is important to consult a doctor if these symptoms occur.

Lubiprostone is not suitable for everyone. People with a history of blockage in the stomach or bowels, severe diarrhoea, or liver disease may be advised by their doctor not to take this medication. It is also important for pregnant women or those trying to conceive to consult a doctor before taking lubiprostone, as it may harm the fetus.

Laxatives can be harmful if used regularly and do not treat all IBS symptoms

While laxatives can provide temporary relief from constipation, they can be harmful if used regularly and do not treat all IBS symptoms.

Laxatives are generally not recommended for long-term use. Over time, they can lead to dependency, requiring higher and higher doses to produce stools. They can also decrease the colon's ability to contract, which can worsen constipation. Additionally, stimulant laxatives, which are not suitable for long-term use, may cause damage to the bowel if used continuously for long periods of time.

Furthermore, laxatives do not address all IBS symptoms. While they can help with constipation, they may worsen other symptoms such as abdominal pain, bloating, and cramping. For example, osmotic laxatives can cause more abdominal bloating and wind due to bacterial fermentation in the bowel.

It is important to note that the use of laxatives should be approached with caution and only under medical supervision. Before taking laxatives, it is advisable to consult a doctor or pharmacist, especially for individuals with IBS or other bowel conditions.

Instead of relying solely on laxatives, a combination of dietary adjustments, lifestyle changes, and other treatments may be more effective in managing IBS symptoms. This may include increasing fibre intake, staying hydrated, exercising regularly, and making dietary changes such as following a low FODMAP diet or a gluten-free diet.

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