Laxatives for Constipation: What You Should Know

Everyone has stomach troubles from time to time. If you’ve ever experienced constipation, you’ve likely used a laxative at some point in your life and may need one again.

Strolling down the aisles at your local pharmacy, you’ll see a number of different options for laxatives. You might think they’re all the same, but how much do you actually know about these drugs?

Here, we break down the different types of laxatives, when it’s appropriate to take these drugs, and their potential risks and side effects.

According to Harvard Health, laxatives are drugs that relieve constipation by loosening stools or inducing a bowel movement. Some laxatives are also used before bowel procedures or examinations.

Laxatives can take many forms and come as pills, capsules, liquids, foods, gums, suppositories, and enemas.

Most laxatives are intended for short-term use.

Per the Cleveland Clinic, common types of laxatives include:

Bulking agents: These fiber-based laxatives increase the water content and bulk of the stool, making it move more easily through the intestinal tract.

They typically take 12 to 72 hours to work.

Examples include psyllium (Metamucil); methylcellulose (Citrucel); and high-fiber foods, such as fruits, vegetables, and whole grains.

Stool softeners: Also called emollient laxatives, stool softeners cause fats and water to penetrate to the stool, making it move more easily through the digestive system.

They typically take 12 to 72 hours to work. Examples include Colace (Docusate, Diocto).

Stimulant laxatives: These stimulate the lining of the intestine to propel the stool along.

They provide very quick relief but should only be used occasionally. Examples include Senokot, Correctol, and Bisacodyl (Dulcolax, Feen-a-Mint)

Osmotic and hyperosmolar laxatives: These draw fluids into the intestine from the surrounding tissues, making stool softer and easier to pass.

They may take 30 minutes to six hours to work, depending on the type. Examples include Milk of Magnesia, lactulose, and Miralax.

Lubricant laxatives: These make stool slippery, so it moves through the intestine more easily and quickly.

They typically take six to eight hours to work. Examples of these include mineral oil and glycerin suppositories.

Prescription-only laxatives: Most laxatives can be bought over the counter and are meant for short-term use, but if you have chronic constipation or a digestive condition like irritable bowel syndrome (IBS), you may need to use prescription laxatives under the supervision of your doctor. These laxatives aren’t intended for rapid relief but rather help keep you regular if constipation is an ongoing issue.

Prescription laxatives include: Enulose (Duphalac), Linzess (Linaclotide), Amitiza (Lubiprodtone) and Trulance (Pleclanatide).

Laxatives are meant to treat constipation in adults. Individuals who may benefit from taking laxatives include:

• Adults who experience occasional constipation that hasn’t improved with diet and lifestyle changes like increasing fiber intake, drinking more fluids, and regular physical activity
• People with digestive conditions and diseases who have chronic constipation, including IBS and inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis
• Individuals preparing for bowel surgery who need to flush stool out of their intestines

Precautions for Pregnant Women and Children

Pregnant women and those who are breastfeeding should speak to their doctor before using a laxative. While bulk-forming laxatives and stool softeners are typically considered safe for pregnant women, other forms, including stimulants, may be harmful. It may also be possible for laxatives to get into breast milk, and there’s been some reports of babies having diarrhea following exposure to laxatives from breast milk. Mineral oil, in particular, can pass through breast milk in large quantities so it should be used sparingly.

Some children and babies with constipation may require a laxative, but this should only be done in consultation with your pediatrician. In 2023, prescription stool softener Linzess (linaclotide) became the first treatment for functional constipation approved by the U.S. Food and Drug Administration for children aged 6 to 17.

While laxatives are considered generally safe, there are potential risks and side effects you should know about. According to StatPearls, the most common side effects of laxatives are:

• Bloating
• Gassiness
• Abdominal pain
• Nausea and vomiting
• Diarrhea
• Dehydration

You should always drink plenty of fluids and stay hydrated when taking a laxative. It’s recommended to drink at least six to eight glasses of liquids each day (preferably water) when using laxatives, according to the Canadian Society of Intestinal Research.

Risks associated with using laxatives include medication interactions, delayed diagnosis of certain conditions, and overuse or abuse.

Medication Interactions

Laxatives may interact with some medications, including certain antibiotics, as well as some heart and bone medicines, per Mayo Clinic. Make sure to read labels carefully and speak to your doctor or pharmacist about which laxatives may be safe for you to take if you have any concerns.

Delayed Diagnosis of Digestive Conditions

Another potential risk of laxative use is that reliance on them may mask a medical condition, leading to delayed diagnosis. Conditions causing chronic constipation include IBS, IBD, appendicitis, and colon cancer.

If you use a laxative and it doesn’t work, or if you continue to use laxatives regularly for constipation, tell your doctor who can help get to the root of the problem.

Laxative Overuse and Abuse

Laxative abuse happens when a person takes higher or more frequent doses of laxatives than are recommended.

Abusing these medicines is dangerous and can result in serious or life-threatening complications, such as:

• Electrolyte and mineral imbalances
• Severe dehydration
• Laxative dependence
• Chronic constipation
• Blockage in the intestine
• Severe diarrhea
• Increased colon cancer risk

Some people take laxatives to lose weight.

However, research has shown the medicines are not effective at promoting weight loss, and they can be dangerous when used for this purpose, leading to the same complications listed above. Other studies have found that using laxatives for weight loss may be a sign of an eating disorder.

Any weight loss that's achieved by a laxative-induced bowel movement contains little food, fat, or calories. This so-called water weight returns when you drink fluids, according to the National Eating Disorders Association.

To prevent contamination, make sure laxatives are stored in a closed container and kept at room temperature. Keep out of direct sunlight and away from heat and moisture.

Additional reporting by Julie Lynn Marks.