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Over-the-counter laxatives for constipation: Use with caution
Laxatives can help relieve and prevent constipation. But not all laxatives are safe for long-term use. Overuse of certain laxatives can lead to dependency and decreased bowel function.
By Mayo Clinic staff If you've ever experienced the discomfort of constipation — perhaps while traveling or after a change in diet — you may have considered over-the-counter laxatives. Laxatives are substances taken by mouth (oral laxatives) or in your rectum (rectal laxatives) that relieve and prevent constipation. You can take oral laxatives in many different forms — liquids, tablets, wafers, gums, or powders that you dissolve in water. You take rectal laxatives in the form of suppositories or enemas.
How often you have a bowel movement varies, but a "normal" frequency ranges from as many as three a day to as few as two or three a week. Your body ordinarily needs no help to have them. But a poor diet, physical inactivity, pregnancy, illness or some medications can disrupt normal bowel function and cause constipation.
Before trying laxatives
Before turning to laxatives for relief, you may want to try the following lifestyle changes to help manage occasional irregularity:
How laxatives relieve constipation
Laxatives work in different ways, and the effectiveness of each laxative type varies from person to person. In general, bulk-forming laxatives, which are also referred to as fiber supplements, are the gentlest on your body and safe to use long term. Metamucil and Citrucel fall into this category. Stimulant laxatives, such as Ex-lax and Senokot, are the harshest and shouldn't be used long term.
Following are some examples of common types of laxatives. Other types of laxatives also exist. Even though many laxatives are available over-the-counter, it's best to talk to your doctor about which laxative may be best for you.
Type of laxative
(brand examples)How they workSide effects Oral hyperosmotics (Epsom salts, Phillips' Milk of Magnesia) Draw water into colon from surrounding body tissues to allow easier passage of stool Bloating, cramping, diarrhea, nausea, gas, increased thirst Oral bulk formers (Citrucel, Metamucil) Absorb water to form soft, bulky stool, prompting normal contraction of intestinal muscles Bloating, gas, cramping, choking or increased constipation if not taken with enough water Oral stool softeners (Colace, Kaopectate) Add moisture to stool to allow strain-free bowel movements Throat irritation, stomach or intestinal cramping Oral stimulants (Ex-lax, Senokot) Trigger rhythmic contractions of intestinal muscles to eliminate stool Belching, cramping, diarrhea, nausea, faintness, urine discoloration Rectal stimulants (Fleet Bisacodyl, Dulcolax) Trigger rhythmic contractions of intestinal muscles to eliminate stool Rectal irritation, stomach discomfort, faintness, cramping
In addition, oral laxatives may interfere with your body's absorption of some medications and food nutrients. Rectal laxatives do not have this effect. Also, some oral and rectal laxatives can lead to an electrolyte imbalance, especially after prolonged use. Electrolytes, which include calcium, chloride, potassium, magnesium and sodium, regulate muscle contraction, heart rhythm, nerve function, fluid balance and other body functions. An electrolyte imbalance can cause abnormal heart rhythms, weakness, confusion and seizures.
Over-the-counter laxatives for constipation: Use with caution
Combination laxatives: Check labels carefully
Some products combine different types of laxatives, such as a stimulant and a stool softener. Combination products may not be any more effective than are single-ingredient products. But they may be more likely to cause side effects because of their multiple ingredients. Carefully read labels to see how many types of laxatives a product contains.
Risks of laxative use
Interaction with medications
Your medical history and other medications you're taking may limit your laxative options. Laxatives can interact with blood thinners such as warfarin (Coumadin), antibiotics such as tetracycline and ciprofloxacin (Cipro), and certain heart and bone medications. Before using any laxative, read the label carefully. If you're not sure whether a particular laxative is right for you, ask your pharmacist or doctor. Don't exceed recommended dosages unless your doctor tells you otherwise.
Complicating conditions
Just because laxatives are available without a prescription doesn't mean that they're without risk. Laxative use can be dangerous if constipation is caused by a serious condition, such as appendicitis or a bowel obstruction. If you frequently use certain laxatives over a period of weeks or months, they can decrease your colon's natural ability to contract and actually worsen constipation. In severe cases, overuse of laxatives can damage nerves, muscles and tissues of your large intestine.
Unsafe if you're pregnant or under age 6
Don't give children under age 6 laxatives without a doctor's recommendation. If you're pregnant, get your doctor's advice before using laxatives. Bulk-forming laxatives and stool softeners are generally safe to use during pregnancy, but stronger laxatives can harm you or your baby. The stimulant laxative castor oil, for example, can cause womb contractions. If you've recently given birth, consult your doctor before using laxatives. Although laxatives are usually safe to use during breast-feeding, some ingredients may pass into breast milk and cause diarrhea in nursing infants.
Don't be lax about laxatives
Talk to your doctor before using laxatives if you have the following:
Over-the-counter laxatives for constipation: Use with caution - MayoClinic.com
Laxatives can help relieve and prevent constipation. But not all laxatives are safe for long-term use. Overuse of certain laxatives can lead to dependency and decreased bowel function.
By Mayo Clinic staff If you've ever experienced the discomfort of constipation — perhaps while traveling or after a change in diet — you may have considered over-the-counter laxatives. Laxatives are substances taken by mouth (oral laxatives) or in your rectum (rectal laxatives) that relieve and prevent constipation. You can take oral laxatives in many different forms — liquids, tablets, wafers, gums, or powders that you dissolve in water. You take rectal laxatives in the form of suppositories or enemas.
How often you have a bowel movement varies, but a "normal" frequency ranges from as many as three a day to as few as two or three a week. Your body ordinarily needs no help to have them. But a poor diet, physical inactivity, pregnancy, illness or some medications can disrupt normal bowel function and cause constipation.
Before trying laxatives
Before turning to laxatives for relief, you may want to try the following lifestyle changes to help manage occasional irregularity:
- Eat fiber-rich foods.
- Drink plenty of fluids daily.
- Exercise regularly.
How laxatives relieve constipation
Laxatives work in different ways, and the effectiveness of each laxative type varies from person to person. In general, bulk-forming laxatives, which are also referred to as fiber supplements, are the gentlest on your body and safe to use long term. Metamucil and Citrucel fall into this category. Stimulant laxatives, such as Ex-lax and Senokot, are the harshest and shouldn't be used long term.
Following are some examples of common types of laxatives. Other types of laxatives also exist. Even though many laxatives are available over-the-counter, it's best to talk to your doctor about which laxative may be best for you.
Type of laxative
(brand examples)How they workSide effects Oral hyperosmotics (Epsom salts, Phillips' Milk of Magnesia) Draw water into colon from surrounding body tissues to allow easier passage of stool Bloating, cramping, diarrhea, nausea, gas, increased thirst Oral bulk formers (Citrucel, Metamucil) Absorb water to form soft, bulky stool, prompting normal contraction of intestinal muscles Bloating, gas, cramping, choking or increased constipation if not taken with enough water Oral stool softeners (Colace, Kaopectate) Add moisture to stool to allow strain-free bowel movements Throat irritation, stomach or intestinal cramping Oral stimulants (Ex-lax, Senokot) Trigger rhythmic contractions of intestinal muscles to eliminate stool Belching, cramping, diarrhea, nausea, faintness, urine discoloration Rectal stimulants (Fleet Bisacodyl, Dulcolax) Trigger rhythmic contractions of intestinal muscles to eliminate stool Rectal irritation, stomach discomfort, faintness, cramping
In addition, oral laxatives may interfere with your body's absorption of some medications and food nutrients. Rectal laxatives do not have this effect. Also, some oral and rectal laxatives can lead to an electrolyte imbalance, especially after prolonged use. Electrolytes, which include calcium, chloride, potassium, magnesium and sodium, regulate muscle contraction, heart rhythm, nerve function, fluid balance and other body functions. An electrolyte imbalance can cause abnormal heart rhythms, weakness, confusion and seizures.
Over-the-counter laxatives for constipation: Use with caution
Combination laxatives: Check labels carefully
Some products combine different types of laxatives, such as a stimulant and a stool softener. Combination products may not be any more effective than are single-ingredient products. But they may be more likely to cause side effects because of their multiple ingredients. Carefully read labels to see how many types of laxatives a product contains.
Risks of laxative use
Interaction with medications
Your medical history and other medications you're taking may limit your laxative options. Laxatives can interact with blood thinners such as warfarin (Coumadin), antibiotics such as tetracycline and ciprofloxacin (Cipro), and certain heart and bone medications. Before using any laxative, read the label carefully. If you're not sure whether a particular laxative is right for you, ask your pharmacist or doctor. Don't exceed recommended dosages unless your doctor tells you otherwise.
Complicating conditions
Just because laxatives are available without a prescription doesn't mean that they're without risk. Laxative use can be dangerous if constipation is caused by a serious condition, such as appendicitis or a bowel obstruction. If you frequently use certain laxatives over a period of weeks or months, they can decrease your colon's natural ability to contract and actually worsen constipation. In severe cases, overuse of laxatives can damage nerves, muscles and tissues of your large intestine.
Unsafe if you're pregnant or under age 6
Don't give children under age 6 laxatives without a doctor's recommendation. If you're pregnant, get your doctor's advice before using laxatives. Bulk-forming laxatives and stool softeners are generally safe to use during pregnancy, but stronger laxatives can harm you or your baby. The stimulant laxative castor oil, for example, can cause womb contractions. If you've recently given birth, consult your doctor before using laxatives. Although laxatives are usually safe to use during breast-feeding, some ingredients may pass into breast milk and cause diarrhea in nursing infants.
Don't be lax about laxatives
Talk to your doctor before using laxatives if you have the following:
- Kidney disease
- Heart disease or high blood pressure
- Stomach pain, nausea, vomiting or rectal bleeding
- Bloody stools
- Constipation doesn't improve after a week of laxative use
Over-the-counter laxatives for constipation: Use with caution - MayoClinic.com
