Laxatives are medicines that will make you pass a stool. Use laxatives only if a doctor says you should. Most people with mild constipation do not need laxatives.
For those who have made diet and lifestyle changes and are still constipated, a doctor may recommend laxatives or enemas for a limited time. These treatments can help retrain a chronically sluggish bowel. For children, short-term treatment with laxatives, along with retraining to establish regular bowel habits, helps prevent constipation. A doctor should determine when a patient needs a laxative and which form is best. Laxatives can be dangerous to children and should be given only with a doctor’s approval.
Abuse of Laxatives
Myths about constipation have led to a serious abuse of laxatives. This is common among people who are preoccupied with having a daily bowel movement. Laxatives usually are not necessary and can be habit forming.
The colon begins to rely on laxatives to bring on bowel movements. Over time, laxatives can damage nerve cells in the colon and interfere with the colon’s natural ability to contract. For the same reason, regular use of enemas can also lead to a loss of normal bowel function.
Laxatives taken by mouth come in many forms: liquid, chewing gum, pills, and powder that you mix with water. They work in various ways:
Bulk-forming laxatives, also known as fiber supplements, generally are considered the safest, but they can interfere with absorption of some medicines. These laxatives are taken with water. They absorb water in the intestine and make the stool softer. These agents must be taken with water or they can cause obstruction. Many people also report no relief after taking bulking agents and suffer from a worsening in bloating and abdominal pain. You can buy fiber products in a pharmacy or grocery store without a prescription. Brand names include:
Stimulants cause rhythmic muscle contractions in the intestines. Studies suggest that phenolphthalein, an ingredient in some stimulant laxatives, might increase a person’s risk for cancer. The Food and Drug Administration has proposed a ban on all over-the-counter products containing phenolphthalein. Most laxative makers have replaced, or plan to replace, phenolphthalein with a safer ingredient. Stimulant laxatives should be avoided or used infrequently because of concern that they may cause permanent damage to the colon. Most herbal laxatives contain stimulant type laxatives. Always consult with your doctor. Brand names include:
Osmotics cause fluids to flow in a special way through the colon, resulting in bowel distention. This class of drugs is useful for people with idiopathic constipation. Idiopathic is of unknown origin, constipation does not respond to standard treatment. People with diabetes should be monitored for electrolyte imbalances. Brand names include:
Stool softeners moisten the stool and prevent dehydration. These laxatives are often recommended after childbirth or surgery. These products are suggested for people who should avoid straining in order to pass a bowel movement. The prolonged use of this class of drugs may result in an electrolyte imbalance. Brand names include:
Lubricants grease the stool, enabling it to move through the intestine more easily. Mineral oil is the most common example. Lubricants typically stimulate a bowel movement within 8 hours. Brand names include:
Saline laxatives act like a sponge to draw water into the colon for easier passage of stool. Saline laxatives are used to treat acute constipation if there is no indication of bowel obstruction. Electrolyte imbalances have been reported with extended use, especially in small children and people with renal deficiency. Brand names include:
- Milk of Magnesia
- Haley’s M-O
Chloride Channel Activators
Chloride channel activators increase intestinal fluid and motility to help stool pass, thereby reducing the symptoms of constipation. One such agent is Amitiza, which has been shown to be safely used for up to 6 to 12 months. Thereafter a doctor should assess the need for continued use.
People who are dependent on laxatives need to slowly stop using them. A doctor can assist in this process. For most people, stopping laxatives restores the colon’s natural ability to contract.
Source: digestive.niddk.nih.gov – July 2007