Best Otc Constipation Remedies

Constipation is a common condition that can usually be treated with over-the-counter (OTC) medicines called laxatives. These can be bought without a prescription and include stool softeners and fibre supplements. There are several different kinds of laxatives, each working in a different way. Bulk-forming laxatives, for example, add soluble fibre to the stool, creating larger, softer stools that help trigger the bowel to contract. Lubricant laxatives, on the other hand, coat the stool and colon with a waterproof film, allowing it to stay soft and move through the intestine without losing moisture. An example of a lubricant laxative is mineral oil. Osmotic laxatives, such as polyethylene glycol (MiraLAX) and magnesium hydroxide (Milk of Magnesia), help keep water within the intestines, softening stool and increasing the number of bowel movements. Stimulant laxatives, such as bisacodyl (Dulcolax) and senna (Senokot), increase muscle contractions in the digestive tract, speeding up transit time.

Bulk-forming laxatives

One of the benefits of bulk-forming laxatives is that they usually result in a more gradual improvement of constipation symptoms. They are also associated with a lower risk of side effects such as cramping or explosive diarrhoea, which can occur with stimulant laxatives. Additionally, bulk-forming laxatives can be beneficial during pregnancy or after surgery, and they can help treat constipation caused by medication or a lack of physical activity.

However, it is important to note that bulk-forming laxatives should be taken with at least 8 ounces of water or fruit juice to prevent bowel obstruction. Staying well-hydrated throughout the day is crucial when taking these laxatives. While they are generally safe, some side effects or drug interactions may occur, such as difficulty swallowing, feeling a lump in the throat, or difficulty breathing. People with kidney disease or diabetes are at a higher risk of electrolyte imbalances when taking laxatives, so it is recommended to consult a doctor before use.

To prevent constipation, it is advisable to maintain a high-fibre diet that includes whole grains, fruits, and leafy vegetables. Drinking plenty of fluids and avoiding constipating foods such as cheese or high-sugar, processed foods can also help.

Osmotics

Osmotic laxatives are medications used to treat or prevent constipation. They work by drawing extra water into the stool, making it softer and easier to pass. Osmotic laxatives are available over the counter and by prescription. They are particularly useful for treating chronic constipation.

The term "osmotic" refers to the movement of fluid through a membrane so that the concentration is equal on both sides. Osmotic laxatives alter the balance of water in the colon, making it easier for stools to pass through. They do this by using substances such as salts, sugars, and other organic compounds to encourage the movement of water.

Some common osmotic laxatives include:

• 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. 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.

Osmotic laxatives are generally safe and well-tolerated, but they can cause side effects such as nausea, bloating, cramping, flatulence, and diarrhoea. Overuse of osmotic laxatives can lead to dehydration and the loss of electrolytes like sodium, calcium, and potassium. It is important to follow the dosing instructions carefully and only use laxatives when needed. Eating plenty of fibre-rich foods can also help optimise digestive health.

Stimulants

Stimulant laxatives include bisacodyl (Correctol, Ducodyl, Dulcolax) and sennosides/senna (Senexon, Senokot). They take 6 to 12 hours to work and should not be used for more than a few days. Long-term use may cause damage to the intestinal muscles and the bowel may lose its muscle tone. This can lead to long-term constipation.

Stimulant laxatives can cause abdominal pain and, in some cases, severe diarrhea, dehydration, and electrolyte disturbances. They should be avoided by patients with intestinal obstruction.

Stool softeners

It is important to follow the directions on the label when taking stool softeners or any over-the-counter medication. Do not take more or less than the recommended amount, and consult a healthcare professional if you have any questions or concerns.

Suppositories

While suppositories are generally safe, there are some potential side effects to be aware of. Rectal irritation, burning, abdominal discomfort, and small amounts of mucus in the stool may occur. If these effects persist or worsen, it is important to consult a doctor or pharmacist. Additionally, overuse of suppositories can lead to laxative dependence, and they should not be used for more than seven days without consulting a doctor.

Frequently asked questions