Marc Holland
Laxatives are a type of medicine used to treat constipation and help people empty their bowels. They are available over the counter from pharmacies and supermarkets, or on prescription from a doctor. There are four main types of laxatives: bulk-forming laxatives, osmotic laxatives, poo-softener laxatives, and stimulant laxatives. Bulk-forming laxatives are often recommended as a first choice for constipation, as they are considered gentle and safe. They work by drawing water into the stool to make it softer and easier to pass. Osmotic laxatives also draw water into the intestines, softening the stool and stimulating movement. Poo-softener laxatives, also known as emollient laxatives, work by adding moisture to the stool. Stimulant laxatives are fast-acting and can be used for quick relief from painful constipation. They stimulate the intestines to have a bowel movement and increase the liquid in the stool.
| Characteristics | Values |
|---|---|
| Type | Bulk-forming laxatives, osmotic laxatives, poo-softener laxatives, stimulant laxatives, saline laxatives, lubricant laxatives, guanylate cyclase-C agonist laxatives |
| How it works | Bulk-forming laxatives increase the "bulk" or weight of the stool, stimulating the bowel. Osmotic laxatives draw water from the body into the bowel to soften the stool. Poo-softener laxatives let water into the stool to soften it. Stimulant laxatives stimulate the lining of the intestine, accelerating the stool's journey through the colon. Saline laxatives pull water into the intestines. Lubricant laxatives coat the intestines to help move the stool through quicker. Guanylate cyclase-C agonist laxatives increase water in the gastrointestinal tract and increase gastrointestinal movement. |
| Active ingredients | Bulk-forming laxatives: ispaghula husk, psyllium, methylcellulose, and calcium polycarbophil. Osmotic laxatives: lactulose, macrogol, bisacodyl, senna. Poo-softener laxatives: docusate sodium and docusate calcium. Saline laxatives: magnesium citrate, magnesium hydroxide, magnesium. Lubricant laxatives: mineral oil. Guanylate cyclase-C agonist laxatives: plecanatide, linaclotide, lubiprostone. |
| Forms | Oral capsule or tablet, softgel capsules, liquids or gels, suppositories |
| How to use | Laxatives should be used occasionally and for up to a week at a time. Stop taking a laxative when your constipation improves. Drink plenty of fluids when taking laxatives. |
| Side effects | Dehydration, diarrhoea, intestinal obstruction, unbalanced salts and minerals in the body, allergic reaction, throat irritation, rash. |
What You'll Learn
Bulk-forming laxatives
It is important to take bulk-forming laxatives with at least 8 ounces of water or fruit juice to prevent bowel obstruction and stay well-hydrated throughout the day. They should only be used occasionally and for a short period, and you should stop taking them once your constipation improves. While they are generally safe, side effects may include mild stomach pain, bloating, gas, and allergic reactions.
Before taking bulk-forming laxatives, consult your doctor if you have kidney disease or diabetes, as there is a risk of electrolyte imbalances. Additionally, laxatives may impact how your body absorbs medications, so it is important to leave at least two hours between taking a laxative and any other medication.
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Osmotic laxatives
- Polyethylene glycol (PEG): An organic compound derived from petroleum that can be safely ingested to manage constipation. Available over the counter, PEG-containing laxatives include Miralax and GlycoLax.
- Lactulose: A type of sugar that is not absorbed by the intestine. Instead, it sits and ferments in the intestines, producing fatty acids that draw water into the colon. Available by prescription, lactulose-containing laxatives include Cephulac, Duphalac, and Kristalose.
- Sorbitol: Another non-absorbable sugar with an action similar to lactulose. Available over the counter and by prescription, including 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. Available over the counter, Milk of Magnesia is also used as an antacid.
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Poo-softener laxatives
These laxatives are safe for regular use and are often prescribed after major surgeries, such as heart surgery or hernia repair, to prevent straining during recovery. They are also commonly used by individuals recovering from childbirth or surgery, as well as those with haemorrhoids.
It's important to note that poo-softener laxatives may take a week or longer to be effective, so they are not suitable if you need immediate relief. They are also the least effective option for treating constipation. If you have severe constipation, a doctor may suggest a stronger laxative.
As with all laxatives, it is important to follow the instructions provided with the medication and not to exceed the recommended dosage.
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Stimulant laxatives
Some common stimulant laxatives include Bisacodyl (Correctol, Dulcolax, Feen-a-Mint) and Senna (Ex-Lax, Senokot). Prunes, or dried plums, are also considered a natural stimulant laxative.
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 can cause laxative dependency. Additionally, they may cause side effects such as cramping and diarrhoea. As with all laxatives, it is important to follow the instructions on the medication to prevent side effects and potential overdose.
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Saline laxatives
The salts in saline laxatives retain water in the intestine through osmosis, increasing the bulk of the stool. The larger stool stimulates the intestinal muscles to contract naturally, causing the faeces to move along. This type of laxative is also known as an osmotic laxative.
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Frequently asked questions
A laxative is a substance that helps you have a bowel movement. They are a type of medicine that can treat constipation.
There are four main types of laxatives: bulk-forming, osmotic, stimulant, and stool softeners.
The best laxative for you will depend on your symptoms, health history, and how long you need to use it. Bulk-forming laxatives are a good first choice as they are safe to use daily and can be used for longer periods with little risk of side effects. If this doesn't work, try an osmotic laxative in addition to or instead of a bulk-forming laxative. If your stool is soft but still difficult to pass, try a stimulant laxative.
Yes, you can try making lifestyle changes such as increasing your daily intake of fibre, drinking plenty of water, and exercising regularly.
