Emily Tumber
Laxatives are a type of medicine used to treat constipation or empty the bowel before a medical procedure. They come in many forms, including pills, capsules, liquids, suppositories, and enemas. While laxatives are available over the counter, they should be used sparingly and only after lifestyle changes—such as increasing fibre and fluid intake and exercising more—have failed to alleviate constipation. This is because overuse of laxatives can lead to side effects like dehydration, chronic constipation, and intestinal blockage.
| Characteristics | Values |
|---|---|
| Type | Bulk-forming, osmotic, stool softeners, lubricants, stimulants |
| How they work | Soften stools, stimulate bowel movement, or both |
| Forms | Pills, capsules, tablets, powders, liquids, suppositories, enemas |
| Side effects | Bloating, gas, stomach cramps, dehydration, diarrhoea, intestinal blockage, electrolyte imbalance |
| Use | Occasional constipation, preparation for medical procedures, chronic constipation |
| Precautions | Not recommended for children, check with a doctor if pregnant, can interfere with prescription drugs |
| Lifestyle alternatives | High-fibre foods, probiotics, drinking more fluids, exercising |
What You'll Learn
Bulk-forming laxatives
These laxatives are generally safe, but they can cause abdominal cramping, bloating, or gas, especially when increasing or changing your fibre intake abruptly. Fibre can also reduce your body's absorption of some drugs, so it is important to take your medications at least one hour before or two hours after consuming fibre.
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Osmotic laxatives
Common osmotic laxatives include:
- Polyethylene glycol (PEG): An organic compound derived from petroleum that can be safely ingested to manage constipation. PEG-containing laxatives include Miralax and GlycoLax.
- Lactulose: A type of sugar that is not absorbed by the intestine. It sits and ferments in the intestines, producing fatty acids that draw water into the colon. Lactulose-containing laxatives include Cephulac, Duphalac, Kristalose, and others, and they are available by prescription.
- Sorbitol: Another non-absorbable sugar with an action similar to lactulose. Sorbitol is available over the counter and by prescription, including brands such as Arlex and GeriCare.
- Magnesium citrate: Magnesium in salt form combined with citric acid. The salts help draw water into the colon. Over-the-counter versions include Citrate of Magnesia, Citroma, and LiquiPrep.
- Magnesium hydroxide: A milder form of magnesium sold under the brand name Milk of Magnesia. Milk of Magnesia is available over the counter and is also used as an antacid.
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Poo-softener laxatives
Stool softeners are particularly useful for those recovering from surgery, women who have just given birth, or individuals with haemorrhoids. They are also used to empty the bowel of faecal matter before medical procedures or surgery involving the lower bowel.
Stool softeners include docusate (Colace), which is a surfactant that helps to "wet" and soften the stool. It may take a week or longer for emollient laxatives to be effective.
It's important to note that laxatives should be used sparingly and only when needed. They should not be used long-term unless under medical supervision because they can cause side effects such as dehydration, electrolyte disturbances, and a sluggish bowel. Before taking any laxative, it is important to ensure that constipation is not due to an underlying, undiagnosed condition.
If you are experiencing constipation, it is recommended to start with a bulk-forming laxative and then try an osmotic laxative if your stool remains hard. If your stool is soft but still difficult to pass, try taking a stimulant laxative in addition to a bulk-forming laxative.
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Stimulant laxatives
It is important to take laxatives exactly as instructed to prevent side effects. It is also important to drink plenty of fluids when taking stimulant laxatives, as they can cause dehydration.
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Bowel cleansing preparations
- Citric acid/magnesium oxide/sodium picosulfate
- Magnesium sulfate/potassium sulfate/sodium sulfate
- Polyethylene glycol-3350 with or without electrolytes
- Sodium biphosphate/sodium phosphate
There are several types of laxatives, including:
- Bulk-forming laxatives: These increase the bulk or weight of the stool, stimulating the bowel. They include Fybogel (ispaghula husk), psyllium (Metamucil), and polycarbophil (FiberCon).
- Osmotic laxatives: These draw water from the body into the bowel to soften the stool. Examples include lactulose (Duphalac) and macrogol (Movicol).
- Poo-softener laxatives: This type of laxative lets water into the stool to soften it and make it easier to pass.
- Lubricant laxatives: These coat the colon, making it slick and preventing water absorption from the stool. An example is mineral oil.
- Stimulant laxatives: These activate the nerves that control the muscles in the colon, forcing it to move the stool along. Examples include bisacodyl (Dulcolax) and senna (Senokot).
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Frequently asked questions
A laxative pill is a type of medicine that can treat constipation. Laxatives are available to buy from pharmacies and supermarkets, and some are also available on prescription from a doctor. They are usually taken orally and come in different forms, including tablets, capsules, powders, liquids, and syrups.
Laxatives work by softening hard stools or stimulating the bowels to move, making it easier for you to pass stool. They do this by either softening the stool, increasing the frequency of large colon contractions, or stimulating the nerves that control the muscles in your colon.
There are several types of laxatives available, including:
- Bulk-forming laxatives: These increase the weight of the stool, stimulating the bowel to move it along. They include fibre supplements such as psyllium and methylcellulose.
- Osmotic laxatives: These draw water from the body into the colon, softening the stool and making it easier to pass. Examples include lactulose and magnesium hydroxide (Milk of Magnesia).
- Stool softener laxatives: These moisten and lubricate the stool, making it easier to pass. An example is docusate (Colace).
- Lubricant laxatives: These coat the colon, making it slick and preventing water absorption from the stool. An example is mineral oil.
- Stimulant laxatives: These activate the nerves controlling the muscles in the colon, forcing it to move the stool along. Examples include bisacodyl (Dulcolax) and senna (Senokot).
Laxatives can cause side effects such as bloating, gas, stomach cramps, dehydration, and diarrhoea. They can also cause more severe complications with overuse or long-term use, including electrolyte imbalances, chronic constipation, and intestinal blockage. Therefore, it is important to take laxatives as directed and only use them occasionally and for a short period, such as up to a week. 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 fibre to the diet.
