The Many Forms Of Laxatives: Exploring The Options

There are several types of laxatives available, each working in a particular way to treat constipation. Laxatives are medicines that help to relieve constipation by softening stools or stimulating the bowels to get moving. While most laxatives are available over the counter without a prescription, it is important to be sure that constipation is not due to an underlying, undiagnosed condition.

The four main types of laxatives are: bulk-forming laxatives, osmotic laxatives, stool softener laxatives, and stimulant laxatives. Lubricant laxatives and saline laxatives are less common types.

Bulk-forming laxatives

There are four main types of laxatives: bulk-forming laxatives, osmotic laxatives, stool softeners, and lubricants and stimulants. This response will focus on providing a detailed explanation of bulk-forming laxatives.

These laxatives contain soluble fibre, which draws water from the body into the stool, making it larger and softer. This increase in size stimulates the colon to contract and push out the stool. Common bulk-forming laxatives include psyllium (Metamucil), polycarbophil (FiberCon), and methylcellulose (Citrucel).

In summary, bulk-forming laxatives are a gentle and effective treatment option for constipation. They work by increasing the bulk and softness of the stool, stimulating bowel movement. With their gradual improvement of symptoms and lower risk of side effects, they are often recommended as the first-line treatment option.

Osmotic laxatives

Some common osmotic laxatives include:

• Polyethylene glycol (Gavilax®, MiraLAX®)
• Magnesium hydroxide solution (Dulcolax®, Ex-Lax®, Phillips’® Milk of Magnesia)
• Glycerin (Colace Glycerin®, Fleet Pedia-Lax®)
• Lactulose (Duphalac®, Lactugal®)
• Macrogol (Movicol®, Laxido®, CosmoCol®, Molaxole®, Molative®)

Lubricant laxatives

There are several types of laxatives, including bulk-forming laxatives, osmotic laxatives, stool softeners, lubricants, and stimulants. Lubricant laxatives are used to treat constipation by lubricating the intestinal wall and stool mass. They form a waterproof film layer that coats the intestinal wall and stool, preventing the feces from drying out. This lubrication also helps to decrease water absorption by the intestine, allowing the stool to retain moisture and remain soft. Lubricant laxatives include mineral oil, which can be taken orally or as an enema.

Stimulant laxatives

There are five basic types of laxatives: stimulant, osmotic, bulk-forming, stool softeners, and lubricants. This answer will focus on stimulant laxatives.

While stimulant laxatives can be effective in treating constipation, it is important to be aware of their side effects and precautions. They should not be used for more than a week unless specifically advised by a doctor. Prolonged use can lead to habit formation and potential harm to the bowels. Additionally, stimulant laxatives should not be given to children under the age of 6 without the recommendation of a pediatrician. It is always advisable to consult with a healthcare professional before taking any laxative to ensure safe and appropriate use.

When taking stimulant laxatives, it is crucial to follow the directions on the label or as instructed by a doctor. Overuse or misuse of stimulant laxatives can lead to side effects such as brownish-red urine when taking senna-based laxatives. In the case of any adverse reactions or persistent constipation, it is important to consult a doctor for further guidance and alternative treatment options.

Prescription laxatives

There are four classes of prescription laxatives, each working differently and prescribed depending on what is causing your constipation.

Osmotic laxatives draw water into the bowel to help soften stools, making them easier to pass. Osmotic laxatives that are available by prescription include Cholac/Generlac (lactulose), which is approved for constipation, including that related to barium retention.

Prokinetic agents cause the gastrointestinal tract to contract and push materials through. Motegrity (prucalopride) is the only drug in this class currently available in the United States and is approved for chronic idiopathic constipation in adults.

Secretagogues pull water into the bowel to soften stools, like osmotic laxatives, but through a different mechanism. Secretagogues include Amitiza (lubiprostone), which is approved for chronic constipation in adults and constipation from IBS-C in adult women. Lubiprostone softens the stool by adding water to it, allowing it to pass easily. It is taken twice a day with food and may cause side effects such as nausea, abdominal pain, and vomiting.

Opioid antagonists relieve constipation caused by opioid medications by partially blocking their action. These include Relistor (methylnaltrexone), which is approved for opioid-induced constipation in adults with non-cancer pain.

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