Relieving Antibiotic-Induced Constipation: Best Laxatives For Quick Relief

Constipation is a common digestive complaint, with doctors receiving at least 2.5 million visits for constipation each year in the US and other western countries. It is characterised by hard, dry, lumpy stools that are difficult and painful to pass. Constipation can be caused by various factors, including certain medications such as antibiotics, antidepressants, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs). Laxatives are often used to treat constipation and can be effective in providing relief. However, it is important to use them safely and sparingly as they can also have side effects and, in some cases, lead to dependency. Different types of laxatives include stimulant laxatives, osmotic laxatives, emollient laxatives (stool softeners), and bulk-forming laxatives. It is always recommended to consult with a healthcare professional before taking any medication, including laxatives, to ensure proper use and avoid potential side effects.

Stimulant laxatives like senna and bisacodyl

Stimulant laxatives are also available in the form of prunes (dried plums), which are an effective colonic stimulant and taste good too. However, they may cause cramping and diarrhoea. It is important to note that stimulant laxatives should not be used daily or regularly as they may weaken the body's natural ability to defecate and cause laxative dependency.

Before taking stimulant laxatives or any other form of laxatives, it is recommended to make specific lifestyle changes such as eating more fibre-rich foods, exercising regularly, drinking enough water, and limiting the intake of pain relievers and laxatives.

Osmotic laxatives like polyethylene glycol

Polyethylene glycol is available over the counter and can be taken orally as a powder that you mix into a beverage. It typically takes one to three days to work, so it's not the fastest-acting laxative, but it tends to cause fewer side effects than other options. However, it's important to drink plenty of water with this laxative to ensure its effectiveness and reduce the possibility of gas and cramps.

Compared to stimulant laxatives, which are a more common treatment for medication-induced constipation, osmotic laxatives like polyethylene glycol have some advantages. While stimulant laxatives can cause cramping, stomach pain, and diarrhoea, osmotic laxatives generally have milder side effects. They are also a better option than bulk-forming laxatives, which can make the situation worse by adding bulk to the stool without helping it move.

If you're looking for a gentle and effective solution for constipation caused by antibiotics, osmotic laxatives like polyethylene glycol are worth considering. Just be sure to follow the instructions and stay well-hydrated to ensure the best results and minimise any potential side effects.

Emollient laxatives (stool softeners) like docusate sodium

Emollient laxatives, also known as stool softeners, are a type of laxative that can be used to treat constipation caused by antibiotics. One of the most common emollient laxatives is docusate sodium, which is available under various brand names, including Colace, Col-Rite, and Dulcoease.

Docusate sodium is often recommended as a first-line treatment for constipation because it helps to soften the stool, making it easier to pass. It works by increasing the amount of water absorbed by the stool in the gut, which makes the stool softer and less dry. This can be particularly useful for individuals who need to avoid straining during a bowel movement, such as those who have recently had surgery or experienced a heart attack.

The typical dosage for docusate sodium is 100 mg taken twice daily, and it is usually administered orally with a full glass of water or juice. Relief from constipation is usually seen within 1 to 3 days of taking this medication. It is important to follow the directions on the package or the advice of a doctor or pharmacist when taking docusate sodium. It is also recommended to only use this medication when needed and for no more than 1 week unless directed by a doctor.

While docusate sodium is generally well-tolerated, some possible side effects include stomach pain, diarrhea, cramping, and throat irritation (with liquid or syrup forms). In rare cases, an allergic reaction may occur, and individuals may experience symptoms such as a rash, itching, swelling, or trouble breathing. It is important to consult a doctor or pharmacist if any of these side effects occur or if there are any concerns about taking docusate sodium.

In summary, docusate sodium is an effective and commonly used emollient laxative for treating constipation caused by various factors, including antibiotics. It works by softening the stool and is generally safe and well-tolerated, making it a good option for individuals experiencing constipation. However, as with any medication, it is important to follow the recommended dosage and consult a healthcare professional if needed.

Anticholinergic medications

Some common over-the-counter anticholinergic medications include:

• Diphenhydramine (Benadryl, Tylenol PM, Advil PM, Unisom SleepGels)
• Brompheniramine (Dimetapp)
• Dimenhydrinate (Dramamine)
• Doxylamine (Unisom SleepTabs)

Prescription anticholinergics include:

• Belladonna alkaloids
• Benztropine mesylate (Cogentin)
• Cyclopentolate (Cyclogyl)
• Darifenacin (Enablex)
• Fesoterodine (Toviaz)
• Homatropine hydrobromide
• Hyoscyamine (Levsinex)
• Ipratropium (Atrovent)
• Oxybutynin (Ditropan XL)
• Propantheline (Pro-Banthine)
• Solifenacin (Vesicare)
• Tiotropium (Spiriva)
• Tolterodine (Detrol)

Anticholinergics can cause side effects such as decreased urination, digestion, and secretion of mucus and saliva. They can also cause confusion, memory problems, and difficulty peeing, which can be dangerous for older adults. Anticholinergics should be used with caution in elderly patients as they are more vulnerable to their effects due to increased permeability of the blood-brain barrier and decreased acetylcholine-induced transmission within the central nervous system.

In summary, anticholinergic medications are a broad group of drugs that treat various medical conditions by blocking the action of acetylcholine. They are available in different forms, including oral and intravenous, and can cause a range of side effects, especially in older adults.

Lifestyle changes: hydration, fibre, exercise

Lifestyle changes can be an effective way to relieve constipation caused by antibiotics. Here are some tips focused on hydration, fibre, and exercise:

Hydration

Staying hydrated is crucial for easing constipation. Dehydration can cause or worsen constipation by making stools hard and dry. Aim to drink plenty of water throughout the day, and consider keeping a bottle of water with you. If you're not a fan of plain water, ask your doctor about other hydrating liquids you can consume.

Fibre

Increasing your fibre intake can help add bulk to your stools, making it easier to pass them. Adults should aim for 20-35 grams of fibre per day. You can find fibre in whole grains like brown rice and whole wheat bread, as well as in fruits and vegetables. Try to eat whole fruits instead of drinking fruit juices, as juices don't contain fibre. Beans, legumes, nuts, and seeds are also excellent sources of fibre.

Exercise

Lack of physical activity can lead to constipation, especially for older adults. Regular exercise can help regulate your bowel movements. It doesn't have to be strenuous—even light exercises like walking can be beneficial. Try to incorporate a 20-minute walk during your lunch break or after meals.

Remember, these lifestyle changes may not provide immediate relief, but they can have a positive cumulative effect on your digestion over time. If you need more immediate relief, consult a doctor or pharmacist about the possibility of using laxatives or other medications.

Frequently asked questions