Poop Potions: Laxatives Explained

Constipation is a common issue that can be treated with over-the-counter or prescription medications. Laxatives are a type of medicine that can help treat constipation by softening stools or stimulating the bowels. They are widely available without a prescription from pharmacies and supermarkets. However, it is important to note that laxatives are not suitable for everyone, and one should always consult a doctor or pharmacist before taking any medication. Some common types of laxatives include bulk-forming laxatives, osmotics, stool softeners, lubricants, and stimulants. These treatments work by increasing water content in the stool, making it softer and easier to pass.

Bulk-forming laxatives

These laxatives are considered the gentlest type and are usually the first line of defence against constipation. They are often preferred as they offer a more gradual improvement of constipation symptoms, and there is less risk of side effects such as cramping or explosive diarrhoea. Bulk-forming laxatives can be beneficial during pregnancy or after surgery, for treating constipation caused by medication or poor diet, and for helping to reduce cholesterol.

It is important to take bulk-forming laxatives with plenty of water to prevent bowel obstruction. They usually take 12 hours to three days to work, and side effects are rare but may include mild stomach pain, bloating, gas, and allergic reactions. People with kidney disease or diabetes should consult a doctor before using them.

Osmotics

Osmotic laxatives are medications used to treat or prevent constipation. They work by drawing water into the stool, making it softer and easier to pass. The term "osmotic" refers to the movement of fluid through a membrane so that the concentration is equal on both sides. In the context of constipation, osmotic laxatives increase the amount of fluid in the intestines, which softens the stools and facilitates their passage.

Osmotic laxatives are available over the counter and by prescription. Some common osmotic laxatives include:

• Polyethylene glycol (PEG): An organic compound derived from petroleum that can be safely ingested to manage constipation. Over-the-counter options 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. Prescription options include Cephulac, Duphalac, and Kristalose.
• Sorbitol: Another non-absorbable sugar with an action similar to lactulose. It is available in over-the-counter and prescription versions, such as Arlex and GeriCare.
• Magnesium citrate: Magnesium in salt form combined with citric acid. The salts help draw water into the lumen. 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. It is available over the counter and is also used as an antacid.

Osmotic laxatives can cause side effects like nausea, bloating, cramping, flatulence, and diarrhea. Overuse of osmotic laxatives can lead to dehydration and the loss of electrolytes like sodium, calcium, and potassium. Therefore, it is important to follow the dosing instructions carefully and only use them when needed. Eating plenty of fibre-rich foods and optimising digestive health is also recommended.

Stimulants

Stimulant laxatives are a type of medicine that can help treat constipation. They are widely available over the counter without a prescription from pharmacies and supermarkets. They are usually recommended for severe constipation when other drugs have not worked. They work by activating the nerves that control the muscles in your colon, forcing your colon into motion and stimulating your intestines to contract, which moves stool through your colon and intestines.

Stimulant laxatives include bisacodyl (Dulcolax) and senna/sennoside (Senokot). These are available in the form of oral liquids or capsules, suppositories, and enemas. Oral stimulant laxatives typically work within 6 to 12 hours. However, suppositories and enemas are faster-acting, usually taking effect within 15 minutes to an hour.

It is important to note that stimulant laxatives are not recommended for long-term use. Overuse can lead to dependence, and your body may become tolerant, worsening constipation when you stop taking the laxative. Common side effects include abdominal pain and cramping, and in some cases, diarrhoea.

Stool softeners

In addition to medication, natural stool softeners can also be achieved through lifestyle changes such as drinking more water, exercising regularly, and increasing daily fibre intake.

Lubricant laxatives

It is important to follow the instructions provided by a healthcare professional or the product manufacturer when taking lubricant laxatives. They should not be used for longer than a week, as prolonged use may cause vitamin deficiencies and interfere with the absorption of certain medications. Pregnant women and individuals with difficulty swallowing should avoid using lubricant laxatives.

Frequently asked questions