Laxative Reset: Getting Back On Track With Gentle Relief

how to use laxatives to get back on schedule

Laxatives are a type of medicine used to treat constipation and can be bought over the counter or with a prescription. They work by softening stools or stimulating the bowels to get moving. While they can be effective, they should only be used occasionally and for a short period of time. It's important to drink plenty of fluids when taking laxatives to avoid dehydration. They are not suitable for everyone, so it's recommended to speak to a healthcare professional before use.

Characteristics Values
Purpose To treat constipation
Types Bulk-forming, osmotic, stool softeners, lubricants, stimulants, saline, prokinetic
Forms Pills, powders, liquids, suppositories, enemas
How they work Softening stools, stimulating bowels, increasing bulk of stools
When to take First thing in the morning, last thing at night
How to take With food or drink, without food or drink, with other medications
Side effects Bloating, gas, stomach cramps, dehydration, diarrhoea, intestinal obstruction, electrolyte imbalance
Precautions Not suitable for children, pregnant women, or those with certain health conditions
Alternatives Lifestyle changes (high-fibre diet, probiotics, fluids, exercise), natural laxatives (high-fibre foods, bran)

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When to use laxatives

Laxatives are a type of medicine that can help treat constipation. They are typically used when lifestyle changes, such as increasing fibre intake, drinking more fluids, and exercising, have not helped.

Laxatives are available over the counter without a prescription, but they are not suitable for everyone. They are usually not recommended for children unless advised by a doctor. Pregnant women should also check with their healthcare provider before taking laxatives. Additionally, those with certain health conditions, such as Crohn's disease or ulcerative colitis, should consult a doctor before using laxatives.

There are several types of laxatives, including:

  • Bulk-forming laxatives: These increase the bulk or weight of stools, stimulating the bowel to push the stools out. They typically take 2-3 days to work and are often recommended as a first-line treatment for constipation.
  • Osmotic laxatives: These draw water into the bowel, softening the stools and making them easier to pass. They also take around 2-3 days to work.
  • Stool softener laxatives: These increase the water and fat content of stools, making them softer and easier to pass.
  • Lubricant laxatives: These coat the colon, preventing water absorption and making it easier for stools to pass.
  • Stimulant laxatives: These stimulate the nerves controlling the muscles in the colon, forcing it to move the stools along. They usually work within 6-12 hours but can cause more side effects, such as stomach cramps and diarrhoea.

When deciding to use laxatives, it is important to consider the potential side effects, which can include bloating, gas, stomach cramps, and dehydration. It is recommended to start with a lower dose and increase if needed. Laxatives should only be used occasionally and for a short period, and they should be stopped once constipation improves. If constipation persists or occurs frequently, it is important to consult a healthcare professional.

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Types of laxatives

There are several types of laxatives available, and they can be categorised in various ways. Here is a breakdown of the different types:

Bulk-forming Laxatives

Bulk-forming laxatives are one of the most common types and are often recommended as the first option to try. They work by increasing the bulk or weight of stools, which stimulates the bowel to push the stools out. These laxatives usually take 2-3 days to work and include fibre supplements such as psyllium, polycarbophil, and methylcellulose. They are considered gentle and are the least likely to cause side effects. It is important to drink plenty of water when taking bulk-forming laxatives to avoid dehydration.

Osmotic Laxatives

Osmotic laxatives draw water from the body into the bowel, softening the stool and making it easier to pass. They usually take 2-3 days to work, but some types, such as saline laxatives, act quicker (within 30 minutes to 6 hours). Examples of osmotic laxatives include lactulose, macrogol, polyethylene glycol, and magnesium hydroxide solution.

Stool Softener Laxatives

Also known as emollient laxatives, these laxatives increase the water and fat content of the stool, making it softer and easier to pass. An example of a stool softener laxative is docusate.

Lubricant Laxatives

Lubricant laxatives coat the colon with a slick layer, preventing water absorption from the stool and making it slippery for easier passage. Mineral oil is an example of a lubricant laxative. While effective, they are best used as a short-term cure as long-term use can lead to the absorption of fat-soluble vitamins and interfere with the absorption of certain prescription medications.

Stimulant Laxatives

Stimulant laxatives are often recommended if other over-the-counter types have not helped. They stimulate the nerves controlling the muscles in the colon, forcing it into motion. Examples include bisacodyl and senna. Stimulant laxatives usually work within 6 to 12 hours but may cause abdominal pain and other side effects. They should not be used daily or regularly as they may weaken the body's natural ability to defecate.

Prescription Laxatives

In some cases, over-the-counter laxatives may not be effective, and a prescription laxative may be needed. These are typically used for chronic constipation or constipation associated with conditions like irritable bowel syndrome (IBS) or when constipation is induced by opioid use. Examples of prescription laxatives include lactulose, linaclotide, lubiprostone, and prucalopride.

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How to take laxatives

Laxatives are a type of medicine used to treat constipation. They are available over the counter in pharmacies and supermarkets, and in some cases, they are available on prescription from a doctor. They work by either softening stools or increasing the bulk of stools with additional fibre, making it easier to pass.

  • Consult a healthcare professional: Before taking laxatives, it is important to consult a healthcare professional, such as a doctor, pharmacist, or a gastroenterologist, especially if you are experiencing constipation along with severe symptoms such as abdominal pain, inability to pass gas, or unexpected weight loss. They will be able to advise you on whether laxatives are suitable for you and recommend the best type for your needs.
  • Read the instructions: It is important to carefully read the instructions on the medication before taking laxatives. This includes information on the correct dosage, timing, and any potential side effects.
  • Take the laxative as directed: Laxatives come in different forms, including pills, powders, liquids, suppositories, and enemas. They should be taken as directed to prevent side effects such as bloating, gas, and stomach cramps. Some laxatives need to be taken with food or drink, while others need to be taken on an empty stomach.
  • Drink plenty of fluids: Laxatives can cause dehydration, so it is important to drink plenty of water or other non-caffeinated, non-alcoholic fluids throughout the day. Aim for around eight 8-ounce glasses of water daily.
  • Be mindful of the timing: Some laxatives need to be taken at certain times of the day, such as first thing in the morning or last thing at night.
  • Avoid taking more than the recommended dose: Do not take more laxatives than instructed, as this can be harmful and cause side effects. Overuse of laxatives can lead to an imbalance in electrolytes, contributing to heart and kidney problems.
  • Be patient: Laxatives can take different amounts of time to work, depending on the type. For example, enemas and suppositories work within 15 minutes to an hour, while bulk-forming laxatives can take 12 hours to three days.
  • Be aware of side effects: Laxatives may cause side effects such as bloating, gas, dehydration, and diarrhoea. If you experience any side effects, stop taking the medication and consult a healthcare professional.
  • Make lifestyle changes: Instead of relying on laxatives, consider making lifestyle changes to prevent constipation. This includes drinking plenty of water, exercising regularly, and including more fibre in your diet.
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Side effects of laxatives

Laxatives are among the most commonly used drugs or additives. While most are quite safe when used judiciously and intermittently, they can cause some side effects. It is important to drink at least 2 litres of water per day when taking laxatives to avoid dehydration.

Common Side Effects

  • Cramps in the abdomen and bloating
  • Dehydration, which can cause lightheadedness, headaches, and darker urine
  • Bloating and passing gas

Serious Side Effects

Serious side effects are rare, but may include:

  • Diarrhea or intestinal obstruction, where stools become large and dry
  • Electrolyte imbalance, which can lead to tremors, weakness, blurry vision, and kidney damage
  • Laxative dependency, where the colon stops reacting to usual doses, requiring larger and larger doses
  • Internal organ damage, including stretched colon, thin and flaccid muscle wall, and hepatotoxicity
  • Increased risk of colorectal cancer (more research is needed to confirm this)
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Natural alternatives to laxatives

Natural laxatives can be as effective as over-the-counter products at preventing constipation. They are also inexpensive and have minimal side effects. Here are some natural alternatives to laxatives:

  • Chia seeds: These are high in fibre, with 9.6 g in just 1 ounce (28.4 g). They are mainly insoluble fibre, but about 7–15% of the total fibre content comprises soluble fibre.
  • Leafy greens: Spinach, kale, and cabbage are high in fibre and magnesium. Eating them can help improve regularity and prevent constipation.
  • Flaxseeds: These have natural laxative properties. Flaxseeds also contain a good mix of both soluble and insoluble fibre.
  • Berries: Most varieties of berries are high in both soluble and insoluble fibre.
  • Legumes: These include beans, chickpeas, lentils, peas, and peanuts. They are high in fibre and can help increase your body’s production of butyric acid, which may act as a natural laxative.
  • Kefir: This fermented milk product contains probiotics, which can help increase regularity while improving stool consistency and speeding up intestinal transit.
  • Aloe vera: Aloe vera contains natural laxative compounds called anthraquinones, which up the amount of water in your intestines, help your body produce more mucus, and increase the contractions that keep food moving through your GI system.
  • Probiotics: Probiotics are "good bacteria" in your gut that balance out "bad bacteria". They help create a healthy environment in your gut and can help keep you free of digestive problems, including constipation or diarrhoea. Probiotic foods include kefir, kombucha, sauerkraut, kimchi, and probiotic yoghurt.
  • Water: Staying hydrated can help alleviate constipation by improving the consistency of stool, making it easier to pass.
  • Coconut water: Coconut water is a natural hydration booster due to its high electrolyte content, especially potassium.
  • Prunes: Prunes contain 7.7 g of fibre in a 1-cup (248-g) serving. They also contain sorbitol, a sugar alcohol that acts as a laxative when consumed in large amounts.
  • Oats: Oats are high in fibre, especially soluble fibre, which has a water-absorbing and gel-forming capacity, making stools softer and easier to pass.
  • Jerusalem artichokes: These are high in inulin, a type of soluble fibre that can help promote bowel movements.
  • Coffee: Coffee is a stimulant that can increase motility in the gut.

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