Laxatives Vs. Stool Softeners: What's The Difference?

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Constipation is a common problem, affecting around 16% of all adults and up to 33% of adults over 60. While occasional constipation is normal, it can be extremely uncomfortable. Laxatives and stool softeners are two types of over-the-counter remedies that can provide relief. But what's the difference between them?

Laxatives are substances that help people empty their bowels. There are many types of laxatives, including bulk-forming, osmotic, stimulant, saline, and lubricant laxatives. Each type works differently, but they all aim to relieve constipation. Stool softeners, also known as emollient laxatives, are a specific type of laxative. They work by adding moisture to the stool, making it softer and easier to pass.

While all stool softeners are laxatives, not all laxatives are stool softeners. Stool softeners are generally considered milder and have fewer side effects compared to other types of laxatives. They are suitable for those with temporary or mild, chronic constipation. However, they are the least effective option for treating constipation and may take longer to work.

If you are experiencing constipation, it is recommended to first try lifestyle changes such as increasing fibre and water intake, and physical activity. If these changes do not help, a healthcare professional can advise on the most suitable type of laxative or stool softener to use.

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Stool softeners are a type of laxative

Stool softeners work by adding moisture to stools to make them softer and easier to pass. They are considered the most mild among the choices to treat constipation and have the fewest side effects. They are available in capsule, tablet, liquid, and syrup form and are usually taken at bedtime.

Stool softeners are a good option for occasional constipation and are particularly helpful if you have hemorrhoids or have recently had surgery and need to avoid straining during a bowel movement. They are also safe to use daily. However, they are the least effective option for treating constipation. They are best for people with temporary constipation or mild, chronic constipation.

The active ingredients in stool softeners are docusate sodium and docusate calcium.

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Laxatives are used to treat constipation

There are different types of laxatives, including:

  • Emollient laxatives (stool softeners): These help to "wet" and soften the stool, making it easier to pass. They are often used by people recovering from surgery, women who have recently given birth, or individuals with hemorrhoids.
  • Bulk-forming laxatives: These draw water into the stool, making it softer and easier to pass. They are considered safe to use daily and can be found in fiber supplements.
  • Lubricant laxatives: These coat the intestines with a layer of mineral oil, preventing water loss and lubricating the stool for easier passage. They are not recommended for regular use as they can interfere with the absorption of fat-soluble vitamins.
  • Osmotic laxatives: These draw water into the intestines, softening the stool and stimulating movement. An example is polyethylene glycol (Miralax).
  • Saline laxatives: These are magnesium-based laxatives that pull water into the intestines, softening the stool and increasing bowel movements. Examples include milk of magnesia and magnesium citrate.
  • Stimulant laxatives: These stimulate the intestines to have a bowel movement. They are fast-acting but should not be used regularly as they can cause the body to become dependent on them. Examples include bisacodyl and sennosides.

It is important to note that laxatives should be used sparingly and with caution. They are typically recommended for short-term relief from occasional constipation. If constipation persists or becomes chronic, it is advisable to consult a healthcare professional for guidance and alternative treatment options.

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Stool softeners are the mildest option with fewest side effects

Stool softeners are a type of laxative called an emollient laxative. This means that all stool softeners are laxatives, but not all laxatives are stool softeners. Stool softeners are the mildest option with the fewest side effects. They are gentle enough to prevent constipation with regular use. However, they are the least effective option for treating constipation.

Stool softeners are best for people with temporary constipation or mild, chronic constipation. They are also suitable for those who should avoid straining during bowel movements, such as those with heart conditions or hemorrhoids. Stool softeners work by increasing the amount of water and fat that the stool absorbs, making it softer and easier to pass. The active ingredients in stool softeners are typically docusate sodium and docusate calcium.

Stool softeners are available in various forms, including oral softgel capsules, tablets, and liquid or syrup. They usually take 12 to 72 hours to work and are not recommended for long-term use, typically no more than a week at a time. Side effects of stool softeners are minimal and may include throat irritation, stomach cramps, or a rash.

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Bulk-forming laxatives are safe to use daily

Bulk-forming laxatives are considered safe for daily use. They are often recommended as the first port of call for adults experiencing constipation. These laxatives are usually derived from plants and work by forming a watery gel in the intestines, adding lubrication and bulk to stools. This stimulates the intestines to pass the stool more quickly.

Bulk-forming laxatives are available over the counter and include products such as Fybogel (ispaghula husk), Metamucil (psyllium), FiberCon (polycarbophil), and Citrucel (methylcellulose). They are also available in the form of unprocessed wheat bran, unrefined breakfast cereals, whole wheat and rye flours, and grainy breads.

While generally safe, it is important to note that bulk-forming laxatives can cause some side effects such as gastrointestinal issues like bloating, diarrhoea, and nausea. They should not be used continuously for longer than one week without consulting a doctor. Additionally, it is important to drink plenty of water while taking these laxatives, as a lack of water can lead to complications such as intestinal blockage.

It is also worth noting that laxatives, in general, are not meant for long-term use and should only be used occasionally and for short periods. They are also not recommended for children unless advised by a doctor.

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Stimulant laxatives are the strongest and fastest-acting laxatives

Stimulant laxatives are the fastest-acting and strongest type of laxative. They are used to treat constipation and work by stimulating the intestinal muscles to contract and push out the stool. They are available in various forms, including liquids, powders, chewables, tablets, and suppositories. Some common brand names of stimulant laxatives include Senexon, Fletcher's Castoria, Senokot, Black Draught, Feen-A-Mint, Correctol, Dulcolax, and Carter's Little Pills.

Stimulant laxatives are typically recommended when osmotic laxatives do not work. They usually take 6 to 12 hours to produce a bowel movement if taken orally and 15 minutes to an hour if given rectally. However, it is important to note that stimulant laxatives should not be used regularly as they can cause dehydration, electrolyte imbalances, and dependency. They can also be habit-forming and harmful to the bowels if used for extended periods. Therefore, it is advised not to use them for more than a week without consulting a doctor.

In addition to their effectiveness in treating constipation, stimulant laxatives also come with certain side effects. Some common side effects include abdominal cramps, diarrhoea, and nausea. More serious side effects that require immediate medical attention include rectal bleeding, severe stomach pain, and vomiting. People with intestinal blockages, undiagnosed rectal bleeding, or signs of appendicitis should avoid using stimulant laxatives. It is always recommended to consult a healthcare professional before taking any type of laxative to ensure its safety and suitability for your specific needs.

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Frequently asked questions

A laxative is a broad term for any medicine or supplement that facilitates having a bowel movement. There are many types of laxatives, including stool softeners, osmotic laxatives, stimulant laxatives, and lubricant laxatives.

A stool softener is a type of laxative called an emollient laxative. It helps to hydrate and soften the stool, making it easier to pass. Stool softeners are considered the mildest option for treating constipation and have the fewest side effects.

Stool softeners work by adding moisture to the stool, making it softer and easier to pass. They can be taken in capsule, tablet, liquid, or syrup form, usually at bedtime. Common examples include docusate sodium (Colace) and docusate calcium (Surfak).

A stool softener is a specific type of laxative. Laxatives can work in different ways, depending on the type, but the common goal is to help relieve constipation. Stool softeners specifically work by hydrating and softening the stool.

For occasional constipation, stool softeners are a good option, especially if you have hemorrhoids or are recovering from surgery and need to avoid straining during bowel movements. Bulk-forming laxatives, such as Metamucil or Citrucel, are recommended as a first-line treatment. If that doesn't work, osmotic laxatives like MiraLAX are a good next step. Stimulant laxatives are stronger and work quickly but may cause cramping, so they are recommended for more severe constipation.

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