Laxatives: Safe Or Not?

Laxatives are a type of medicine that can help you empty your bowels if you're having trouble going to the toilet. They are widely used to treat constipation if lifestyle changes, such as eating more fibre, drinking enough fluids, and exercising regularly, haven't helped. While laxatives are available over the counter without a prescription, they are not suitable for everyone. For example, laxatives are not usually recommended for children unless advised by a doctor, and some types may not be safe for people with certain conditions, such as Crohn's disease or ulcerative colitis. It's important to carefully read the patient information leaflet that comes with the medication to ensure it's safe for you.

Laxatives should only be used occasionally and for short periods of time

Laxatives are a type of medicine used to treat constipation. They are available over the counter and by prescription. They work by softening stools or stimulating the bowels to get them moving. However, laxatives should only be used occasionally and for short periods of time.

Laxatives are not a long-term solution to constipation. They are meant to provide temporary relief and should be used sparingly, only when necessary. This is because the body can become dependent on them, and they can even worsen constipation if overused. Long-term use can also lead to health complications such as dehydration, intestinal obstruction, and electrolyte imbalances.

The overuse of laxatives can cause side effects such as abdominal cramps, bloating, gas, and diarrhoea. In some cases, it may also lead to more serious complications such as colon cancer, diabetes, or hypothyroidism. It is important to follow the instructions on the medication and not exceed the recommended dosage. If constipation persists or becomes chronic, it is important to consult a doctor.

Lifestyle changes, such as increasing fibre intake, drinking plenty of fluids, and regular exercise, are often the best way to prevent constipation and reduce the need for laxatives. A healthy diet, regular physical activity, and adequate fluid intake can help keep the digestive system functioning properly and reduce the occurrence of constipation.

Bulk-forming laxatives are the first treatment option

Bulk-Forming Laxatives: The First Treatment Option

Bulk-forming laxatives are the go-to treatment option for constipation. They are often recommended as the first line of defence against constipation before other types of laxatives are used. They are also the gentlest option, with the lowest likelihood of causing side effects.

Bulk-forming laxatives work by drawing water into the stool, making it softer, bulkier, and easier to pass. They contain soluble fibre, which increases the water content and bulk of the stool, stimulating the colon to contract and push out the stool.

Benefits

These laxatives are a good option for those who experience chronic constipation due to diet, lifestyle, recent surgery, or medication. They are also beneficial for:

• Pregnant women or those who have recently given birth
• People preparing for surgery
• Bedridden individuals
• People with constipation caused by medication
• Preventing strain after surgery
• Restoring normal bowel function after a period of poor diet or physical inactivity
• Reducing cholesterol
• Treating diarrhea

Side Effects and Precautions

While generally safe for healthy people, bulk-forming laxatives can cause side effects such as mild stomach pain, bloating, gas, and allergic reactions. It is important to drink enough water with these laxatives to prevent bowel obstruction. People with kidney disease or diabetes should consult a doctor before use due to the risk of electrolyte imbalances.

Examples

Common bulk-forming laxatives include:

• Psyllium (Metamucil)
• Polycarbophil (FiberCon)
• Methylcellulose (Citrucel)

Osmotic laxatives are used if stools remain hard

Osmotic laxatives are medications used to treat or prevent constipation. They are typically used when stools remain hard and are infrequent, usually dry and difficult to pass. Osmotic laxatives work by drawing water into the colon, softening the stools, and making them easier to pass. The term "osmotic" refers to the movement of fluid through a membrane to equalise concentration on both sides.

Osmotic laxatives are particularly useful when dealing with hard stools because they utilise substances like salts, sugars, and other organic compounds to encourage the movement of water into the colon. This process helps to soften the stools, making them easier to pass. Osmotic laxatives are also used for bowel preparation before a colonoscopy to ensure the colon is clear of stools.

There are several types of osmotic laxatives available, including:

• Polyethylene glycol (PEG): Derived from petroleum and can be safely ingested to manage constipation. Brand names include Miralax and GlycoLax.
• Lactulose: A type of sugar that sits and ferments in the intestines, producing fatty acids that draw water into the colon. Available by prescription, with brand names like Cephulac, Duphalac, and Kristalose.
• Sorbitol: A non-absorbable sugar with similar effects to lactulose. Available over the counter and by prescription, with brand names such as Arlex and GeriCare.
• Magnesium citrate: Magnesium in salt form combined with citric acid, drawing water into the colon. Over-the-counter options include Citrate of Magnesia, Citroma, and LiquiPrep.
• Magnesium hydroxide: A milder form of magnesium, sold as Milk of Magnesia, which is also used as an antacid.

Osmotic laxatives can cause side effects like nausea, bloating, cramping, flatulence, and diarrhoea. Overuse can lead to dehydration and the loss of essential electrolytes like sodium, calcium, and potassium, which are crucial for regulating heartbeats and muscle contractions. Therefore, it is important to follow the dosing instructions carefully and only use laxatives when needed.

Stimulant laxatives are used if bowel movements are soft but still difficult to pass

Laxatives are medicines that treat constipation by softening stools or stimulating the bowels to get moving. They are available over the counter in pharmacies, grocery stores, and online, and they come in various forms, including pills, capsules, liquids, suppositories, and enemas. While laxatives can be effective in relieving constipation, they should be used with caution and only when necessary.

Stimulant laxatives are a type of laxative that activates the nerves controlling the muscles in the colon. They stimulate contractions in the bowels that push the stool along, making it easier to pass. This type of laxative is typically used when other over-the-counter options, such as bulk-forming laxatives or stool softeners, have not provided sufficient relief.

Stimulant laxatives are generally safe for occasional or short-term use. However, they should not be used daily or regularly. Overuse of stimulant laxatives can lead to laxative dependency, as the bowel may become accustomed to their effects and stop functioning normally. As a result, an individual may find it challenging to have a bowel movement without the aid of these laxatives.

Additionally, stimulant laxatives may cause side effects such as cramping and diarrhoea. They can also affect the body's ability to absorb certain vitamins and minerals, such as vitamin D and calcium. Therefore, it is important to follow the instructions on the medication and not exceed the recommended dosage. If stimulant laxatives are not providing the desired relief or if constipation persists, it is advisable to consult a healthcare provider for further evaluation and guidance.

Rectal laxatives are used as a last resort to treat severe constipation

Laxatives are a common treatment for constipation, but they should be used with caution. While they can be effective in relieving temporary constipation, they can also cause problems if misused or overused. Rectal laxatives, in particular, are often a last resort for treating severe constipation due to their invasive nature and potential side effects.

Rectal laxatives, such as suppositories and enemas, are inserted directly into the rectum. While they can provide faster relief compared to oral laxatives, they are not as convenient or pleasant to use. They also carry a higher risk of side effects, including diarrhoea and stomach cramps.

When constipation occurs, it is essential to first try lifestyle changes, such as increasing fibre intake, staying hydrated, and exercising regularly. If these measures fail to provide relief, over-the-counter laxatives may be considered. Bulk-forming laxatives, which are generally considered the gentlest option, are usually recommended as the first line of treatment.

However, if oral laxatives are ineffective or insufficient, rectal laxatives may be necessary as a last resort. These are typically more potent and work faster than oral laxatives, making them suitable for severe or urgent cases of constipation. For example, enemas and suppositories can provide relief within minutes to an hour, while oral bulk-forming laxatives may take up to several days.

It is important to note that rectal laxatives should be used sparingly and only when necessary. Overuse of laxatives can lead to side effects such as bloating, gas, and dehydration. In the long term, it can even cause chronic constipation and intestinal blockage. Therefore, it is crucial to consult a healthcare professional before using rectal laxatives, especially for those who are pregnant, taking prescription medications, or experiencing persistent constipation.

Frequently asked questions