
Laxatives are substances that loosen stools and increase bowel movements, treating and preventing constipation. They are also used to empty the bowels before certain medical procedures. There are several types of laxatives, including bulk-forming laxatives, emollient or stool softeners, osmotic laxatives, and stimulant laxatives. While laxatives can be effective in treating constipation, they should be used with caution and only when necessary, as they can cause side effects such as abdominal pain, nausea, and urinary retention. It is important to first try lifestyle changes, such as increasing fluid intake and dietary fiber, before resorting to laxatives.
Characteristics | Values |
---|---|
Name | Plecanatide |
Brand Name | Trulance |
Type | Guanylate cyckase-C agonist laxative |
Site of Action | Colon |
Onset of Action | Not specified |
Use Case | Chronic idiopathic constipation and irritable bowel syndrome with constipation |
Age Restriction | Not recommended for patients younger than six |
Side Effects | Diarrhea, severe dehydration |
Dosage | Not specified |
What You'll Learn
Bulk-forming laxatives
These laxatives contain soluble fibre, which draws water from the body into the stool, making it bigger, softer, and easier to pass. This increase in size stimulates the colon to contract and push out the stool. Common bulk-forming laxatives include psyllium (Metamucil), polycarbophil (FiberCon), and methylcellulose (Citrucel).
- During pregnancy or after giving birth
- During preparation for surgery
- Treating constipation caused by medication, recent surgery, or a sedentary lifestyle
- Preventing strain after surgery
- Restoring normal bowel function after a period of poor eating or physical inactivity
- Helping to reduce cholesterol
- Treating constipation in bedridden people
To prevent constipation in the first place, it is recommended to eat a high-fibre diet consisting of whole grains, fruits, and leafy vegetables, drink plenty of fluids, and avoid constipating foods such as cheese or high-sugar, processed foods.
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Lubricant laxatives
How Lubricant Laxatives Work
The mineral oil within lubricant laxatives adds a slick layer to the walls of the intestine, preventing the stool from drying out. This coating also makes it easier for the stool to pass through the intestines. Lubricant laxatives help keep water in the stool and intestines, softening the stool so it can pass through the body more easily.
Using Lubricant Laxatives
Side Effects and Precautions
While lubricant laxatives are generally well-tolerated, there are some potential side effects and precautions to be aware of. Mineral oil may leak from the rectum, especially at high doses, which can cause irritation or itching. It can also interfere with the absorption of fat-soluble vitamins and decrease the absorption of certain prescription drugs. Therefore, it is important to consult a doctor or pharmacist before taking this type of laxative, especially if there is a medical history of difficulty swallowing, appendicitis, sudden changes in bowel habits, rectal bleeding, or stomach problems.
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Osmotic laxatives
Some common osmotic laxatives include:
- Polyethylene glycol (PEG): An organic compound derived from petroleum, available over the counter in products like Miralax and GlycoLax.
- Lactulose: A type of sugar that is not absorbed by the intestine. It ferments in the intestines, producing fatty acids that draw water into the colon. Lactulose-containing laxatives are available by prescription, including brands like Cephulac, Duphalac, and Kristalose.
- Sorbitol: Another non-absorbable sugar with effects similar to lactulose, available in over-the-counter and prescription versions, such as Arlex and GeriCare.
- Magnesium citrate: Magnesium in salt form combined with citric acid, which helps 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 as a laxative and antacid.
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Stimulant laxatives
Uses
Healthy humans typically have bowel movements between three times a week to three times a day. Doctors consider less than three bowel movements a week as constipation. Other symptoms of constipation include difficulty passing bowel movements and feelings of incomplete bowel movement.
Untreated, chronic constipation might lead to faecal impaction, a condition where the rectum becomes obstructed with a clog of faecal matter.
Side Effects
Some of the side effects of using stimulant laxatives include:
- Diarrhoea
- Cramping
- Dehydration, which can make you feel lightheaded, have headaches, and have darker-coloured urine
- Brownish-red urine, when taking laxatives with senna
Warnings
Do not use stimulant laxatives for more than a week unless advised by your doctor. Understand that stimulant laxatives can be habit-forming and harmful to your bowels if used for an extended period.
Do not give stimulant laxatives to children under the age of six unless instructed to do so by a pediatrician.
Brands
- Senexon
- Fletcher's Laxative
- Senokot
- Black Draught
- Feen-A-Mint
- Correctol
- Dulcolax
- Carter's Little Pills
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Bowel cleansing preparations
Bowel cleansing is a critical component of effective colorectal cancer screening, and various preparations are available to achieve this. The ideal bowel preparation is safe, highly effective, reliable, convenient, and tolerable enough that patients are willing to repeat the procedure.
One commonly used preparation is polyethylene glycol-electrolyte lavage solution (PEG-ELS), which is considered the gold standard for bowel cleansing. It is safe and effective, but some precautions are necessary, especially with sodium phosphate, which can cause significant electrolyte disturbances and even acute renal failure in certain populations.
Another option is sodium phosphate, an osmotic laxative initially prescribed as a more tolerable alternative to whole gut lavage with PEG preparations. However, concerns about safety and mucosal changes have limited its use.
Other bowel cleansing preparations include:
- Oral sulfate solution (OSS)
- Sodium picosulfate (PMC)
- Phosphate enema
- Citric acid with magnesium carbonate
- Fleet Phospho-soda®
- Gastroenteral oral solution
The choice of bowel cleansing preparation depends on the individual patient's needs and circumstances, but low-volume PEG preparations are generally well-tolerated, effective, and relatively inexpensive.
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Frequently asked questions
Metamucil, Citrucel, FiberCon, psyllium, and methylcellulose.
Stool softeners.
Colace, Diocto, and Gibs-Eze.
Substances that coat the stool with slippery lipids, decreasing water absorption in the colon and making it easier for stool to pass through.
Fleet Phospho-Soda, lactulose (Duphalac, Kristalose), magnesium hydroxide (Milk of Magnesia), lactitol (Pizensy), and polyethylene glycol (MiraLAX, Gavilax).