Constipation and laxatives

The parameters for constipation vary from person to person.

Generally, if you have difficulty emptying your bowels and have fewer than three bowel movements a week, you likely have constipation.

If these infrequent bowel movements and difficulty passing stools continues for several weeks or longer, you’re considered to have chronic constipation.

A laxative is a medicine that stimulates or facilitates bowel movements. There are different types of laxatives available that don’t require a prescription.

Even though these laxatives are readily available at your drug store or online, you should talk to your doctor or pharmacist about your needs and which type may be the best one for you.

There are five primary types of over-the-counter (OTC) laxatives:

Oral osmotics

Taken orally, osmotics help make the passage of stool easier by drawing water into the colon. Popular brands of osmotics include:

Oral bulk formers

Taken orally, bulk formers prompt normal intestinal muscle contraction by absorbing water to form a soft, bulky stool. Popular brands of bulk formers include:

  • Benefiber
  • Citrucel
  • FiberCon
  • Metamucil

Oral stool softeners

Taken orally, stool softeners work like the name implies — they make hard stools softer and easier to pass with less strain. Popular brands of stool softeners include:

  • Colace
  • Surfak

Oral stimulants

Taken orally, stimulants encourage bowel movements by triggering rhythmic contractions of the intestinal muscles. Popular brands of stimulants include:

  • Dulcolax
  • Senokot

Rectal suppositories

Taken rectally, these suppositories soften stool and trigger rhythmic contractions of the intestinal muscles. Popular brands of suppositories include:

  • Dulcolax
  • Pedia-Lax

Following are the common potential side effects of the five primary types of OTC laxatives.

Oral osmotics

Possible side effects include:

Oral bulk-formers

Possible side effects include:

  • bloating
  • gas
  • cramping
  • increased constipation (if not taken with enough water)

Oral stool softeners

Possible side effects include:

  • loose stools

Oral stimulants

Possible side effects include:

Rectal suppositories

Possible side effects include:

  • cramping
  • diarrhea
  • rectal irritation

As with any OTC medication, read the laxative label carefully and talk with your doctor or pharmacist to see if it’s a viable choice for you and your current state of health.

Just because laxatives are available OTC doesn’t mean that they’re without risks. If you’re considering using laxatives, understand that risks can include:

Interaction with other medications

Among other medications, laxatives can interact with certain heart medications, antibiotics, and bone medications.

This information is often on the label. But to be safe, ask your doctor or pharmacist about the laxative you’re considering and how it might interact with the other medications you’ve been prescribed.

Complications

If your constipation is caused by another condition — such as diverticulosis — frequent or long-term laxative use can worsen constipation by decreasing your colon’s ability to contract.

The exception is bulk-forming laxatives. These are safe to take every day.

Dehydration

If laxative use results in diarrhea, your body can become dehydrated. Diarrhea can also lead to electrolyte imbalance.

Breastfeeding

If you’re breastfeeding, some ingredients can pass to your baby through your breast milk, possibly causing diarrhea or other problems. Talk with your doctor before using any laxative.

Dependency

Overuse of laxatives (other than bulk formers) can result in the intestines losing muscle and nerve response, which can lead to dependency on laxatives to have a bowel movement.

If you find yourself in this situation, your doctor should have suggestions on how to remedy laxative dependency and restore your colon’s ability to contract.

When you have constipation and are using laxatives, make an appointment to see your doctor if you experience unexplained changes in bowel pattern or constipation lasting longer than seven days (even with using a laxative).

Contact your doctor immediately if you experience:

If you don’t get constipated, you won’t need laxatives.

To help treat constipation and avoid it in the future, consider making these dietary and lifestyle changes:

  • Adjust your diet so you’re eating more high-fiber food, such as fresh fruits and vegetables, whole-grain cereals, and bran.
  • Reduce your consumption of low-fiber foods, such as processed foods and dairy products.
  • Drink plenty of fluids.
  • Get regular exercise.
  • Manage stress.
  • When you feel the urge to pass stool, don’t ignore it.
  • Create a regular schedule for bowel movements, such as after meals.

For the treatment of occasional constipation, you have a choice of a number of safe, effective OTC laxatives. If you decide to use one, read the label directions carefully and only use it as directed.

Talk with your doctor or pharmacist to help choose a laxative that won’t interact with other medications you’re taking or otherwise put you at risk.

If you have chronic constipation, see your doctor. They can tailor a plan of medication, diet, and lifestyle changes to help you treat and avoid future problems with bowel movements.