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Laxatives: A Comprehensive Guide to Effective Constipation Relief

Mohommed Essop-Adam
Reviewed by Mohommed Essop-AdamReviewed on 30.10.2023 | 3 minutes read
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Laxatives play a vital role in the treatment of constipation, a common gastrointestinal condition characterised by infrequent bowel movements and difficulty passing stools. As a pharmacist, I present a guide to help you understand the various types of laxatives, their mechanisms of action, recommended usage, precautions, and potential side effects, especially for children and during pregnancy, as these times can be most confusing. By providing reliable information from trusted sources, this guide aims to empower you with knowledge for informed decision-making about laxative use.

Types of Laxatives

Bulk-Forming Laxatives:

  • These laxatives work similarly to dietary fiber, absorbing water and increasing the bulk of stools. This promotes natural contractions of intestinal muscles, facilitating bowel movements.
  • Examples: Ispaghula husk (Fybogel) and methylcellulose.

Osmotic Laxatives:

  • Osmotic laxatives draw water into the large intestine from surrounding tissues, softening the stools and stimulating muscle contractions. They help restore regularity by promoting hydration within the intestines.
  • Examples: Lactulose and macrogols (Movicol).

Stimulant Laxatives:

  • Stimulant laxatives directly activate the nerves in the large intestine, triggering muscular contractions that propel stool forward. These laxatives are often used when a more immediate effect is desired.
  • Examples: Senna, bisacodyl, and sodium picosulfate.

Stool Softeners:

  • Stool softeners facilitate easier passage of stools by allowing more water absorption into the stool mass. They make the stools softer and more manageable, especially for individuals experiencing discomfort during bowel movements.
  • Example: Docusate sodium (also exhibits a stimulant effect).

Duration of action

  • Bulk-forming and osmotic laxatives: These laxatives typically take 2 to 3 days to produce their desired effect due to their gentle nature.
  • Stimulant laxatives: They act relatively faster, usually within 6 to 12 hours, making them suitable for acute constipation relief.
  • Stool softeners: The onset of action ranges from 12 to 72 hours, depending on the individual response.

Should anyone not use laxatives?

  • Allergy and Intestinal Blockage: Prior to using laxatives, it is essential to ensure that you are not allergic to any of the ingredients. Additionally, individuals with diagnosed intestinal blockage should avoid laxative use.
  • Pregnancy, Breastfeeding, and Digestive Disorders: Consultation with a healthcare professional is recommended before using laxatives in these circumstances to ensure the appropriate choice and dosage. Some laxatives, such as Lactulose solution or glyceryn suppositories, are generally considered safest, whereas stimulant laxatives which work quicker, such as senna or bisacodyl, may cause abdominal cramps and may be less suitable.
  • Medication Interactions: Laxatives, especially stimulant laxatives, can interact with certain medications such as digoxin and lithium. It is advisable to consult your doctor or pharmacist to assess potential interactions.
  • Weight Loss: Laxatives should never be used for weight loss purposes, as they are neither effective nor safe. Their use for such purposes can lead to adverse health effects.

Possible Side Effects

Nausea, Wind, Stomach Cramps, Diarrhea, and Bloating are common side effects that may occur, especially during initial usage. Most often, these effects resolve on their own.

Long-term Use: Prolonged use of certain laxatives may lead to electrolyte imbalances and a condition called "lazy bowel," where the intestine becomes reliant on laxatives for regular bowel movements.

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Mohommed Essop-Adam
Reviewed by Mohommed Essop-Adam
Reviewed on 30.10.2023
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