Crystell Harty
Constipation is a common issue that can cause discomfort and pain. It is characterised by hard stools that are difficult or painful to pass, and a feeling that the bowels are not empty even after a bowel movement. While lifestyle changes such as increasing fibre intake, drinking more fluids, and exercising can often relieve constipation, laxatives can be used as a plan B when these changes are ineffective. Laxatives are a type of medicine that can help treat constipation by softening stools or stimulating the bowels. They are available over the counter in pharmacies, supermarkets, and online, as well as on prescription from a doctor. It is important to use laxatives sparingly and only when necessary, as they can cause side effects such as bloating, gas, and stomach cramps, and prolonged use can lead to more serious complications.
| Characteristics | Values |
|---|---|
| When to take a laxative | When experiencing constipation that hasn't improved with lifestyle changes such as increasing fibre intake, drinking more fluids, and exercising |
| Type of constipation | Occasional or short-term constipation |
| Who should take laxatives | Adults experiencing constipation. Not usually recommended for children unless advised by a doctor. |
| When to see a doctor | If constipation continues after taking a laxative for a week, or if you think your child might need a laxative |
| When to take laxatives | Laxatives should be taken occasionally and for up to a week at a time. Stop taking them when your constipation improves. |
| How often to take laxatives | Laxatives should only be taken occasionally and for short periods of time. |
| When to take laxatives with other medications | Laxatives can interact with other medications, so check with a doctor before taking them if you are on prescription medication. |
| When to take different types of laxatives | The timing depends on the type of laxative and how you take it. For example, suppositories and enemas act faster (within minutes or hours) but have a greater risk of side effects. Bulk-forming laxatives are gentler but may take a few days to work. |
What You'll Learn
Bulk-forming laxatives
Common bulk-forming laxatives include psyllium (Metamucil), polycarbophil (FiberCon), and methylcellulose (Citrucel). They are available over the counter in pharmacies, grocery stores, and online. They may be labeled as laxatives, stool softeners, or fiber supplements.
It is important to take bulk-forming laxatives with at least 8 ounces of water or fruit juice to prevent bowel obstruction. Staying well-hydrated throughout the day is also important. You should begin to feel relief within 12 hours to 3 days of taking a bulk-forming laxative.
Laxatives should only be used in the short term, unless instructed otherwise by a doctor. It is recommended to make lifestyle changes, such as eating a high-fiber diet, drinking plenty of fluids, and exercising regularly, to prevent constipation.
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Osmotic laxatives
Common osmotic laxatives include:
- Polyethylene glycol (PEG): An organic compound derived from petroleum that can be safely ingested to manage constipation. PEG-containing laxatives are available over the counter, including brands like 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. Lactulose-containing laxatives are available by prescription, including brands like Cephulac, Duphalac, and Kristalose.
- Sorbitol: Another non-absorbable sugar with an action similar to lactulose. Sorbitol is available over the counter and by prescription, including brands like Arlex and GeriCare.
- Magnesium citrate: Magnesium in salt form combined with citric acid. The salts help 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. It is available over the counter and is also used as an antacid.
It is important to follow the dosing instructions carefully when using osmotic laxatives. They should only be used when needed, and it is recommended to eat plenty of fibre-rich foods to optimise digestive health. If you experience chronic constipation, it is advisable to consult a healthcare provider to identify the underlying cause.
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Stimulant laxatives
However, it's important to note that stimulant laxatives should not be used daily or regularly. Overuse may weaken the body's natural ability to defecate and cause laxative dependency. They may also cause cramping and diarrhoea.
If you constantly need to take laxatives, it's recommended that you see your doctor. Constipation may be a warning sign of a more serious problem such as colon cancer, diabetes, or hypothyroidism. Your doctor can evaluate your medical history, perform a physical exam and lab tests, and determine the exact cause and solution for your constipation.
To prevent constipation, it's recommended to eat a healthy diet rich in fresh fruits, vegetables, and whole grains, stay hydrated, and exercise regularly.
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Stool softener laxatives
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 available in oral softgel capsules, while other laxatives come in oral granules (powder) form.
Stool softeners work by softening stools to make them easier to pass. They can be in capsule, tablet, liquid, and syrup form and are usually taken at bedtime. It is important to take stool softeners exactly as directed by your doctor.
Stool softeners contain active ingredients such as docusate sodium and docusate calcium, which help to wet and soften the stool. They are gentle enough to be used regularly to prevent constipation, but they are the least effective option for treating it. Stool softeners are best for people with temporary constipation or mild, chronic constipation. They typically take 12 to 72 hours to work.
Mineral oil is a lubricant that can also be used as a stool softener. It coats the stool and intestines to prevent water loss and lubricates the stool to help it move more easily. However, mineral oil should not be used regularly as it can interfere with the absorption of fat-soluble vitamins such as vitamins A, D, E, and K. It can also cause pneumonia if inhaled, so it is recommended to wear a protective pad to absorb any leakage.
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Lubricant laxatives
Mineral oil is the most common lubricant laxative. It is generally considered safe and effective and has been used for many years to treat constipation. It is available over the counter and can be purchased in liquid or oral form, or as an enema. The oral dose for adults ranges from 15 to 45 millilitres (ml), and for children under 6, it is typically between 15 and 30 ml, although some doctors advise against giving mineral oil to children under 6. It is important to follow the instructions carefully and consult a doctor or paediatrician for the appropriate dose.
Mineral oil should be taken at least 2 hours before or after taking other medications or supplements as it can interfere with their effectiveness and absorption. It should also not be taken with meals as it can affect the absorption of important nutrients. It is recommended to take mineral oil at bedtime to avoid disrupting sleep due to the need to use the bathroom.
While lubricant laxatives are effective in providing short-term relief, they should not be used for an extended period. Prolonged use of mineral oil can result in the absorption of fat-soluble vitamins from the intestine and interfere with the absorption of certain prescription medications. Additionally, mineral oil may leak out of the rectum, causing irritation and messiness. Therefore, it is important to use lubricant laxatives sparingly and only as needed for occasional constipation.
If constipation persists or becomes a regular issue, it is advisable to consult a doctor to identify the underlying cause and determine a suitable treatment plan, which may include dietary and lifestyle changes or alternative types of laxatives.
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Frequently asked questions
You may need to take a laxative if you are experiencing occasional constipation that has not improved with lifestyle changes such as increasing your fibre intake, drinking more fluids, and exercising more.
There are four main types of laxatives: bulk-forming, osmotic, stool softener, and stimulant. Lubricant and prokinetic laxatives are less common.
How you take a laxative depends on the form it comes in. Laxatives are commonly available as tablets or capsules you swallow, sachets of powder you mix with water and then drink, liquids or gels that you place directly into your bottom, or a capsule you place inside your bottom (rectum), where it will dissolve (suppositories).
This depends on the type of laxative and how you take it. Enemas and suppositories will help you pass stools the fastest (within minutes or hours) but carry a greater risk of side effects. Gentler types of laxatives, like bulk-forming laxatives, are less likely to cause side effects but may take a few days to work.
Laxatives can cause abdominal cramps, dehydration, bloating, and gas. Excessive or prolonged use can lead to diarrhoea, intestinal obstruction, and electrolyte imbalance.
