Medicine-Induced Poop: Why It Happens

Constipation is a common condition that makes it difficult to have a bowel movement. It can be caused by too little physical activity, a diet lacking in fibre, or not drinking enough fluids. In most cases, constipation can be treated with lifestyle changes, such as increasing fibre intake, taking probiotics, drinking more fluids, and exercising. However, if these changes do not help, over-the-counter (OTC) medicines called laxatives can be used to treat constipation. Laxatives work by softening hard stools or stimulating the bowels to get moving. Common types include bulk-forming laxatives, osmotics, stool softeners, lubricants, and stimulants. Most laxatives are available without a prescription, but it is important to follow the instructions and not exceed the recommended dosage to avoid side effects such as bloating, gas, or stomach cramps. If OTC laxatives are ineffective, prescription medications may be recommended, especially for chronic constipation or constipation associated with conditions like irritable bowel syndrome (IBS) or the use of opioids.

Bulk-forming laxatives

These laxatives are generally considered safe for healthy individuals and are often recommended as the first line of treatment for constipation before trying other types of laxatives. They are also suitable for use during pregnancy or after giving birth. However, it is important to note that they should be taken with at least 8 ounces of water or fruit juice to prevent bowel obstruction, and users should stay well-hydrated throughout the day. Additionally, people with kidney disease or diabetes should consult a doctor before using bulk-forming laxatives due to the risk of electrolyte imbalances.

Osmotics

Osmotic laxatives are medications used to treat or prevent constipation by drawing water into the stool, making it softer and easier to pass. Osmotic laxatives are available over the counter and by prescription. They are commonly used to alleviate constipation and are available in various forms, including oral solutions, powders, and tablets.

Constipation occurs when stools are infrequent and hard to pass. Osmotic laxatives can help relieve constipation by increasing the amount of fluid in the intestines, softening stools, and making them easier to pass. The term "osmotic" refers to the movement of a fluid through a membrane so that the concentration is equal on both sides. In people with constipation, the concentration of water in the wall of the colon and the inside of the colon (lumen) is balanced but too low to compensate for hard, dry stools. Osmotic laxatives use substances such as salts, sugars, and other organic compounds to encourage the movement of water into the lumen.

Common osmotic laxatives

There are several common osmotic laxatives available with different active ingredients:

• 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 lumen. Available by prescription, lactulose-containing laxatives include Cephulac, Duphalac, and Kristalose.
• Sorbitol: Another non-absorbable sugar with an action similar to lactulose. Over-the-counter (OTC) and prescription versions are available, including Arlex and GeriCare.
• Magnesium citrate: Magnesium in salt form combined with citric acid, which helps draw water into the lumen. OTC 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.

Possible side effects

Osmotic laxatives can cause side effects, typically mild and resolving within a few days. Common side effects include nausea, bloating, cramping, flatulence, and diarrhea. Overuse of osmotic laxatives can lead to dehydration and electrolyte imbalances, affecting the body's ability to regulate heartbeats and muscle contractions.

Stool softeners

Natural stool softeners are also an option and involve making lifestyle changes such as drinking more water, getting regular exercise, and increasing daily fibre intake. This can include consuming more fruits and vegetables, as well as fibre-rich foods like prunes, apples, and pulses, which can help with constipation.

Lubricants

Lubricant laxatives are used to treat constipation by making stools slippery and easier to pass. Lubricants work by coating the intestinal wall and stool mass with a waterproof film layer, preventing the faeces from drying out. Lubricants also decrease water absorption by the intestine, helping the stool to retain moisture and remain soft. Lubricant laxatives include mineral oil, which can be taken orally or used as an enema.

Lubricant laxatives are available over the counter without a prescription and can be taken orally or as an enema. However, they can cause side effects such as anal seepage, pruritus ani, perianal discomfort, and intestinal malabsorption. It is important to follow the instructions on the medication and not to take more than the recommended dose. Lubricant laxatives should also not be used for more than a few days as they can interfere with the absorption of vitamins and can cause pneumonia if inhaled.

Lubricant laxatives are generally considered a gentle and safe option for treating constipation and are often recommended as a first-line treatment. They are particularly useful for treating fecal impaction, a large, hard mass of stools that gets stuck in the colon or rectum. Some lubricant laxatives may also have additional uses, such as antacids.

Stimulants

Adderall is a stimulant medication that is primarily used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It combines dextroamphetamine and amphetamine, which are central nervous system stimulants. Amphetamine is one of the chemical components that give Adderall its stimulating effects.

Adderall boosts the production of the neurotransmitters dopamine and norepinephrine in the brain. This may help reduce ADHD symptoms by kickstarting the body's central nervous system. However, the stimulating effects of Adderall are also why taking the drug may cause digestive issues and make you poop.

Adderall can induce a case of the jitters or anxiety, activating the "fight-or-flight" response in the body. This response diverts blood away from the gastrointestinal tract to other organs like the heart and head. As a result, intestinal transit times slow down, and constipation can occur.

On the other hand, once the stimulating effects of Adderall wear off, the body returns to its resting state, which enhances gastrointestinal functioning. This can lead to faster digestive times and the urge to poop.

Additionally, Adderall can irritate the stomach, causing nausea and stomach pain. In some cases, it may also lead to serious side effects such as bowel ischemia, where the intestines don't receive enough blood flow.

It is important to note that the timing of medication intake and meals can also influence bowel movements. Taking Adderall with breakfast or drinking coffee, a bowel stimulant, at the same time may contribute to the feeling of having to poop more frequently.

If you experience gastrointestinal issues that you suspect are related to your medication, it is recommended to consult your physician for advice.

Frequently asked questions