Laxatives: Which Aisle Are They On?

Laxatives are medicines that help to relieve constipation by loosening stools or inducing a bowel movement. They can be found in the laxative aisle at your local pharmacy or drugstore, and come in many forms, including pills, capsules, liquids, suppositories, and enemas. There are several different types of laxatives, including stool softeners, bulk-forming laxatives, osmotic laxatives, stimulant laxatives, and lubricant laxatives, each with its own mechanism of action and varying timeframes for providing relief. It is important to use laxatives sparingly and follow the instructions provided by healthcare professionals to avoid potential side effects and interactions with other medications.

Laxatives for constipation

Laxatives are medicines that treat constipation by softening hard stools or stimulating your bowels to get moving so you can pass them. They are available over the counter in pharmacies, grocery stores, and online, and can also be prescribed by a doctor.

Before taking a laxative, it is important to ensure that you are actually constipated and that the constipation is not due to an underlying, undiagnosed condition. People's bowel habits vary, and constipation is usually defined as "The passage of hard stools less frequently than the person's normal bowel pattern".

Laxatives should generally not be used long-term unless under medical supervision because they can cause side effects such as electrolyte disturbances (such as low potassium levels), dehydration, and a sluggish bowel. Before using a laxative, it is recommended to first try lifestyle changes such as drinking more fluid, exercising, and increasing the amount of vegetables and fiber in your diet.

There are several different types of laxatives, and each type works in a particular way. Here are some of the most common types:

• Bulk-forming laxatives (such as fiber, psyllium, or polycarbophil) absorb water in the bowel and swell to bulk out the stool, making it softer and easier to pass.
• Emollient stool softeners (such as docusate) moisten and lubricate the stool, making it easier to pass.
• Osmotic laxatives (such as lactulose and magnesium sulfate/hydroxide) draw fluid into the bowel, softening stools.
• Stimulant laxatives (such as senna or bisacodyl) promote contraction of the intestines, helping to move stools through the bowel.
• Lubricant laxatives coat the colon, making it slick. The coating prevents the colon from absorbing water from the stool, so it stays soft.

Laxatives come in different forms, including pills, capsules, liquids, powders, and suppositories that you stick up your butt.

Types of laxatives

Laxatives are a type of medicine used to treat constipation. They are available over the counter without a prescription, as well as from pharmacies and supermarkets. They can also be prescribed by a doctor. It is important to take laxatives exactly as instructed to prevent side effects such as bloating, gas, or stomach cramps.

There are several types of laxatives, including:

Bulk-forming laxatives

Bulk-forming laxatives, also known as fibre supplements, increase the bulk or weight of the stool by adding soluble fibre to it. This draws water from the body into the stool, making it bigger and softer. The increased size stimulates the colon to contract and push out the stool. Bulk-forming laxatives are generally considered the gentlest type and are usually recommended as the first option. They include products such as Fybogel, Metamucil, and Citrucel.

Osmotic laxatives

Osmotic laxatives, including saline laxatives, draw water from other parts of the body into the colon, softening the stool and making it easier to pass. They include products such as Milk of Magnesia, MiraLAX, and Colace.

Stool softener laxatives

Also known as emollient laxatives, stool softeners increase the water and fat content of the stool, making it softer. An example of a stool softener is Colace.

Lubricant laxatives

Lubricant laxatives coat the colon with a slick layer, preventing water absorption from the stool and making it stay soft. Mineral oil is an example of a lubricant laxative.

Stimulant laxatives

Stimulant laxatives activate the nerves controlling the muscles in the colon, forcing it into motion and moving the stool along. They are recommended if other over-the-counter types have not helped. Examples of stimulant laxatives include Dulcolax and Senokot.

Prescription laxatives

In some cases, a doctor may prescribe laxatives for chronic constipation or constipation associated with conditions such as irritable bowel syndrome (IBS) or opioid use. Prescription laxatives include products such as Duphalac, Linzess, and Amitiza.

Laxatives for bowel procedures

Laxatives are medicines that help empty the bowel of faecal matter before procedures or surgery involving the lower bowel. They are also used to treat constipation. However, laxatives should not be used long-term without medical supervision as they can cause dehydration, electrolyte disturbances, and contribute to a sluggish bowel. Before taking a laxative, it is important to ensure that constipation is not due to an underlying, undiagnosed condition.

Types of Laxatives

There are several types of laxatives available, each working in a particular way. Some soften or loosen the stool, while others increase the frequency of large colon contractions, aiding stool movement through the bowel.

Bulk-Forming Laxatives

Bulk-forming laxatives, such as fiber, psyllium, or polycarbophil, absorb water in the bowel, making the stool softer and easier to pass. They are considered a safe option for daily use but may cause side effects like flatulence and bloating.

Emollient Stool Softeners

Emollient laxatives, such as docusate, moisten and lubricate the stool, making it easier to pass. They are often used by those recovering from surgery, women who have given birth, or individuals with hemorrhoids.

Osmotic Laxatives

Osmotic laxatives, such as lactulose and magnesium sulfate/hydroxide, draw fluid into the bowel, softening stools. They are effective but may cause gas and cramps if not taken with enough water.

Stimulant Laxatives

Stimulant laxatives, such as senna or bisacodyl, promote contraction of the intestines, aiding stool movement. They provide fast relief but may cause cramping and diarrhoea. Regular use of stimulant laxatives is not recommended as they may weaken the body's natural ability to defecate.

Bowel Cleansing Preparations

Bowel cleansing preparations are used before bowel surgery, colonoscopy, or radiological examinations to ensure the bowel is free of solid contents. They should be used cautiously in people with fluid and electrolyte imbalances.

Lifestyle Changes

Before resorting to laxatives, it is advisable to try lifestyle changes, such as increasing fluid intake, exercising, and consuming more vegetables and fibre. A healthy diet and active lifestyle can help prevent constipation in most people.

Side effects of laxatives

Laxatives are medicines that help treat constipation or empty the bowel before medical procedures. They work in different ways, depending on the type. Some soften or loosen the stool, while others increase the frequency of the large colon's contractions, aiding stool movement through the bowel.

While laxatives are easily available over the counter, they should be used with caution and only after consulting a doctor or pharmacist. This is because they can have several side effects and risks, especially if overused or misused.

The most common side effect of laxatives is increased constipation if not taken with enough water. This is a concern especially with oral stool softeners, which work by softening stools to make them easier to pass. Without adequate hydration, they may not be effective and can even worsen constipation.

Other potential side effects of laxatives include:

• Diarrhea, which can lead to dehydration and electrolyte imbalance.
• Interaction with other medications, including heart medications, antibiotics, and bone medications.
• Weakened colon function, especially with frequent or long-term use of stimulant laxatives. This can lead to a dependency on laxatives to have a bowel movement.
• Mineral oil in lubricant laxatives can, over time, absorb fat-soluble vitamins and decrease the absorption of certain prescription drugs.
• If breastfeeding, some ingredients can pass into breast milk, potentially causing diarrhea or other issues in the baby.

In rare cases, laxatives may also cause:

• Severe cramps or pain
• Weakness or unusual tiredness
• Skin rash or itching
• Swallowing difficulty (feeling of a lump in the throat)

To avoid these side effects, it is important to use laxatives sparingly and only when necessary. They should not be used long-term unless under medical supervision. Before taking laxatives, it is recommended to try lifestyle changes, such as increasing fluid intake, exercising, and adding more vegetables and fiber to the diet.

Laxatives and interactions

Laxatives are medicines that help treat constipation or empty the bowel before medical procedures. They work in different ways, depending on their type. For instance, bulk-forming laxatives add moisture and weight to stools, making them softer and easier to pass. On the other hand, stimulant laxatives like bisacodyl (Correctol, Dulcolax, and Feen-a-Mint) and sennosides (Ex-Lax and Senokot) stimulate muscle contractions in the intestines, speeding up stool movement through the colon.

There are a variety of interactions to be aware of when taking laxatives. Firstly, laxatives can interact with other medications. For example, bisacodyl may interact with medications that decrease stomach acid, such as H2 blockers or proton pump inhibitors. It is also important to note that laxatives should not be taken within one hour of antacids, milk, or milk products as they can affect the coating on the tablet and increase the risk of stomach upset and nausea.

Additionally, laxatives can interact with certain medical conditions. For instance, bisacodyl has disease interactions with inflammatory bowel disease, intestinal obstruction disorders, and acute surgical abdomen. Furthermore, stimulant laxatives may cause cramping and diarrhoea and should not be used daily as they may limit the body's ability to absorb vitamin D and calcium and can lead to laxative dependency.

Laxatives can also interact with dietary factors. For instance, a high-fibre diet is recommended when taking laxatives, but it is important to increase fibre intake gradually to avoid abdominal cramping, bloating, or gas. Similarly, adequate fluid intake is crucial when taking laxatives to ensure their effectiveness and reduce the possibility of gas and cramps.

Frequently asked questions