Laxatives Vs Anti-Laxatives: Which Is The Better Option?

Laxatives are a type of medicine used to treat constipation and empty the bowels of fecal matter. They are available over the counter and by prescription. Laxatives work by softening hard stools or stimulating the bowels to get moving. However, they are not recommended for long-term use and can cause side effects such as bloating, gas, and stomach cramps. On the other hand, anti-laxatives are medications that help to slow down bowel movements and are typically used to treat diarrhea. They can be helpful for people who have frequent loose stools or diarrhea. It's important to note that anti-laxatives should also be used sparingly and under medical supervision.

Laxatives for constipation relief

Laxatives are a type of medicine that can treat constipation. They are available over the counter in pharmacies, grocery stores, and online, as well as on prescription from a doctor. They are usually recommended if lifestyle changes, such as increasing fibre intake, drinking more fluids, and exercising, have not helped with constipation.

There are four main types of laxatives: bulk-forming, osmotic, stool softener, and stimulant. Bulk-forming laxatives increase the "bulk" or weight of the stool, which stimulates the bowel. Osmotic laxatives draw water from the body into the bowel to soften the stool and make it easier to pass. Stool softener laxatives increase the water and fat the stool absorbs, softening it. Stimulant laxatives activate the nerves that control the muscles in the colon, forcing the colon into motion to move the stool along.

Bulk-forming laxatives are generally considered the gentlest and are the best to try first. They include psyllium (Metamucil), polycarbophil (FiberCon), and methylcellulose (Citrucel). Osmotic laxatives include polyethylene glycol (MiraLAX) and magnesium hydroxide solution (Milk of Magnesia). Stool softeners include docusate (Colace). Stimulant laxatives include bisacodyl (Dulcolax) and senna (Fletcher's Laxative).

Laxatives should be taken as directed to prevent side effects such as bloating, gas, and stomach cramps. It is important to drink plenty of fluids when taking laxatives, as they can cause dehydration. They should only be taken occasionally and for up to a week at a time. If constipation continues after taking laxatives for a week, it is recommended to speak to a doctor.

The different types of laxatives

Laxatives are a type of medicine that can treat constipation. They are often used if lifestyle changes, such as eating high-fibre foods, taking probiotics, drinking more fluids, and exercising, have not helped. Laxatives are available over the counter in pharmacies, grocery stores, and online. They may be labelled as laxatives, stool softeners, or fibre supplements.

There are four main types of laxatives: bulk-forming laxatives, osmotic laxatives, stool softener laxatives, and lubricant laxatives. Most laxatives are available without a prescription, but you may need a prescription if over-the-counter options are ineffective or if you have a chronic condition causing constipation.

Bulk-forming laxatives

Bulk-forming laxatives, also known as fibre supplements, increase the weight of the stool by adding soluble fibre, which draws water from the body into the stool, making it bigger and softer. This stimulates the colon to contract and push out the stool. They are considered the gentlest type of laxative and are the best option to try first. They include psyllium (Metamucil®), polycarbophil (FiberCon®), and methylcellulose (Citrucel®). They usually take two to three days to work.

Osmotic laxatives

Osmotic laxatives pull water from the body into the colon, softening the stool and making it easier to pass. They include polyethylene glycol (Gavilax®, MiraLAX®), magnesium hydroxide solution (Dulcolax®, Ex-Lax®, Phillips'® Milk of Magnesia), and glycerin (Colace Glycerin®, Fleet Pedia-Lax®). They also take two to three days to work, but saline laxatives, a subtype of osmotic laxatives, act quicker, from 30 minutes to six hours.

Stool softener laxatives

Also called emollient laxatives, stool softeners increase the water and fat absorbed by the stool, making it softer. They include docusate (Colace®).

Lubricant laxatives

Lubricant laxatives coat the colon, making it slippery. This prevents the colon from absorbing water from the stool, keeping it soft. It also makes passing the stool easier. Lubricant laxatives include mineral oil. They are best used as a short-term cure for constipation.

Stimulant laxatives

Stimulant laxatives activate the nerves controlling the muscles in the colon, forcing it to move the stool along. They include bisacodyl (Dulcolax®) and senna (Fletcher's® Laxative).

Laxatives come in different forms, including pills, powders, liquids or syrups, suppositories, and enemas. It is important to take laxatives exactly as instructed to prevent side effects such as bloating, gas, and dehydration.

The risks of taking laxatives

Laxatives are a type of medicine that can treat constipation. They are available over the counter and on prescription. While they can be effective in treating constipation, they also come with certain risks and side effects.

Dehydration and Electrolyte Imbalance

Laxatives that draw water into the intestines, such as osmotic and hyperosmolar laxatives, can cause dehydration if not taken with enough water. Dehydration can lead to symptoms such as feeling lightheaded, having headaches, and darker-than-normal urine. Diarrhea, which can be a side effect of some laxatives, can also contribute to dehydration and electrolyte imbalance.

Intestinal Blockage

Overuse of laxatives can lead to intestinal blockage or obstruction due to large, dry stools. This can occur especially if laxatives are not taken with enough water.

Dependency and Loss of Muscle Tone

Overuse of laxatives, especially stimulant laxatives, can lead to a loss of muscle tone in the colon, resulting in a dependency on laxatives to have a bowel movement. The body may lose its natural ability to defecate, and chronic constipation may develop.

Interaction with Other Medications

Laxatives can interact with certain medications, including heart medications, antibiotics, and bone medications. This can affect the absorption or effectiveness of these medications. It is important to consult a doctor or pharmacist to ensure that laxatives will not interfere with any other medications being taken.

Side Effects

Laxatives can cause various side effects, including abdominal cramping, bloating, gas, and diarrhoea. These side effects can be unpleasant and may require medical attention.

Masking Underlying Conditions

Laxatives treat the symptoms of constipation but do not address the underlying cause. If constipation is due to a more serious condition, such as colon cancer, diabetes, or hypothyroidism, laxatives can delay diagnosis and proper treatment.

Lifestyle changes to prevent constipation

Constipation is a common problem, affecting as many as one in five people. It can be uncomfortable and distressing, and may even lead to waste products being reabsorbed into the body. However, it can often be resolved with simple dietary and lifestyle changes.

Increase your fibre intake

Fibre-rich foods include fruits, vegetables, whole grains, nuts and legumes. Aim for 20-35 grams of fibre per day, and be sure to increase your fibre intake gradually so as to avoid side effects such as cramps and gas.

Good sources of fibre include:

• Whole grains such as brown rice and whole wheat bread
• High-fibre fruits such as dried figs, prunes, Asian pears, raspberries and apples
• Vegetables such as broccoli, carrots, baked potatoes with skin, peas and sun-dried tomatoes
• Nuts such as almonds
• Legumes such as beans and lentils

Drink plenty of fluids

Water and other fluids such as fruit and vegetable juices and clear soups help the fibre in your diet to work better. Aim for at least 1.5 litres of water per day, and avoid caffeine as it can be dehydrating.

Get more exercise

Regular exercise can help to keep things moving through your colon. Try to get at least 150 minutes of moderate activity every week, and consider taking a short walk after meals to aid digestion.

Go to the toilet when you feel the urge

Don't hold it in! When you ignore the urge to go to the toilet, those signals can weaken over time, contributing to constipation.

Try to establish a regular bowel routine

Research has shown that people with a regular bowel pattern tend to empty their bowels at approximately the same time every day. Try to go to the toilet at the same time every day, and allow yourself plenty of time and privacy.

Try a fibre supplement

If you're unable to get enough fibre through your diet, a fibre supplement may help. These are available in capsule, powder, gummy and chewable tablet form. Be sure to drink plenty of water when taking a fibre supplement.

When to see a doctor about constipation

Constipation is a common problem, but that doesn't mean it's normal. While it usually resolves on its own within a few days, it can sometimes be a sign of something more serious. Here are some guidelines on when to see a doctor about constipation:

Consult a Doctor if You Experience Any of the Following:

• Severe abdominal pain: While constipation can cause discomfort, if the pain becomes debilitating, seek medical help. In rare cases, chronic constipation can cause bowel perforation, or holes in the lining of the colon, which requires immediate medical attention.
• Blood in your stool: This could be a sign of various conditions, including colorectal cancer or inflammatory bowel disease (IBD). Consult a healthcare provider to receive the necessary treatment.
• Fever: Constipation itself does not cause a fever. If you are constipated and develop a fever, it may be a sign of diverticulitis, a condition where small pouches form in the colon, which can become inflamed or infected.
• Inability to pass gas: This may indicate a bowel obstruction in the small or large intestine, preventing the body from moving digested food through the gastrointestinal tract.
• No bowel movements for more than a week: While not always an emergency, a healthcare provider can prevent the situation from becoming more serious. Prolonged constipation can lead to fecal impaction, where stool hardens and remains in the rectum.
• Vomiting: Vomiting along with constipation may indicate that impacted stool has seriously blocked your colon.

Constipation in Children:

Constipation can look different in babies and young children, including changes in bowel movements and behavioural changes. If you are concerned about your child's bowel habits or notice any of the following symptoms, seek medical advice:

• Infants younger than four months: Excessive crying, fewer than three bowel movements per week, hard stools, and vomiting.
• Older infants: Lack of appetite, blood in the diaper, distended abdomen, vomiting, and weight loss.
• Children: Lack of appetite, blood in bowel movements, pain during bowel movements, repeated constipation episodes, and toilet training difficulties.

Preventing and Treating Constipation:

To relieve constipation, you can try dietary and lifestyle changes, such as:

• Increasing fibre intake by consuming more fresh produce, whole grains, and dried fruits.
• Staying hydrated by drinking enough water to soften the stool and make it easier to pass.
• Engaging in regular physical activity to stimulate the digestive tract.
• Practising bowel training by going to the restroom at the same time every day.
• Responding to the urge to go to the restroom instead of holding it in.

If constipation persists or interferes with your daily life, consult a healthcare provider to rule out any serious problems and explore treatment options, including prescription laxatives.

Frequently asked questions