Do you also experience difficulty and pain when you go to the toilet? Do you feel like your stomach is not completely empty even after you pass stool? Are your stools dry and hard like rocks? These are the main symptoms of constipation that we all know. This is actually a very uncomfortable condition.
Often, small changes in our lifestyle can solve the problem of constipation. For example, eating more fiber-rich foods (legumes, vegetables, fruits, brown rice), drinking enough water per day, and exercising can make a big difference. However, if you still have this problem after doing all of this, it is normal to feel like using a laxative as the next step.
What are these laxatives? Who needs them?
Simply put, laxatives are medications that help make it easier to pass stool when you are constipated. They are usually available over the counter at any pharmacy. They may go by different names, such as laxatives , stool softeners, or fiber supplements.
There are generally several situations in which someone may need a laxative:
- Occasional constipation: For occasional constipation that doesn't improve even after making changes to your lifestyle.
- Chronic medical conditions: Some people may experience constipation due to long-term medical conditions, such as Crohn's disease or ulcerative colitis.
- Preparing for medical tests: Sometimes, before tests involving the intestines, such as endoscopy or colonoscopy, laxatives are given to completely cleanse the intestines (bowel cleanse).
But remember, laxatives are not suitable for everyone with constipation. If you are a pregnant mother, never use them without consulting your doctor. Also, do not give laxatives to young children without the recommendation of a pediatrician. If you are taking medication for another condition, be sure to talk to your doctor before using them, as some laxatives can interact with those medications.
Types of laxatives and how they work
Laxatives affect our digestive system in different ways and make it easier to pass stool. Some types absorb water from the stool, softening it. Others stimulate the muscles in the intestines and help push the stool down. Let's take a look at the main types of laxatives.
| Laxative type | How it works | Examples |
|---|---|---|
| Bulk-forming Laxatives (Fiber supplements) (The type that increases the size of the flowers) | These add soluble fiber to the stool, drawing water from the body, making it larger and softer. As the stool becomes larger, the intestines are stimulated and help to pass the stool. These are the softest type. | Psyllium (Metamucil®), Methylcellulose (Citrucel®), Fybogel, Polycarbophil (FiberCon®) |
| Osmotic Laxatives (The type that draws water into the intestines) | Water is drawn from other parts of the body and directed to the colon. This accumulated water softens the stool and makes it easier to pass. | Polyethylene glycol (MiraLAX®), Magnesium hydroxide (Phillips'® Milk of Magnesia), Glycerin |
| Stool Softener Laxatives (Stool softener type) | These increase the amount of water and fat absorbed by the stool, softening it. | Docusate (Colace®) |
| Lubricant Laxatives (Type of lubricant) | These act like a coating on the inside of the large intestine, creating a slippery feeling. As a result, the body absorbs less water in the stool, making the stool softer. | Mineral oil |
| Stimulant Laxatives (The type that stimulates the intestines) | They stimulate the nerves that control the muscles of the colon, causing intestinal movements (peristalsis) and pushing stool down. These are recommended when other types do not work. | Bisacodyl (Dulcolax®), Senna |
Laxatives recommended by a doctor
If over-the-counter laxatives don't help your chronic constipation, your doctor may prescribe a special medication. This is especially important for people with conditions like IBS (Irritable Bowel Syndrome) or those who are constipated due to the use of painkillers (opioids). Medications like Lactulose (Duphalac®), Linaclotide (Linzess®), and Lubiprostone (Amitiza®) fall into this category.
How to use a laxative correctly?
To get the most out of a laxative and minimize side effects, it is essential to read the package insert carefully and use it as directed. Never take more than the recommended dose just because you want to feel better quickly. Doing so can have dangerous consequences.
Laxatives come in different forms:
- Pills: Tablets or capsules that are swallowed by mouth.
- Powders: Powders that are dissolved in water or another liquid and drunk.
- Liquids/Syrups: Liquid medicines that can be measured and drunk.
- Suppositories: Small, soluble capsules of medicine that are inserted into the rectum.
- Enemas: Small tubes that insert liquid into the rectum.
Suppositories and enemas, which are usually inserted into the rectum, provide quick relief within minutes or hours. However, they also carry a higher risk of side effects such as stomach upset and diarrhea. Milder types such as bulk-forming ones may take a few days to work, but have fewer side effects.
Let's also be aware of side effects and risks.
Using laxatives incorrectly or for a long time can cause various problems.
- Dehydration: When using products that draw water from the body, if you do not drink enough water at the same time, your body may become dehydrated.
- Electrolyte imbalance: The body's salt and water balance can be disrupted.
- Chronic constipation: Surprisingly, the continued use of stimulant laxatives can weaken the intestinal muscles, making it impossible to have a bowel movement without medication.
- Avoiding an underlying condition: Laxatives only provide temporary relief from constipation, which is a symptom. They do not treat the underlying cause. Your constipation may be caused by a serious medical condition. Using laxatives can delay the diagnosis of that condition.
Therefore, if you are constantly constipated and the medicine you buy from the pharmacy does not help, you should definitely see a doctor without delay to find out the cause. If you experience severe stomach pain or severe diarrhea, go to the nearest hospital's emergency department (ETU) immediately.
Take-Home Message
- The first step to try for constipation is not to try laxatives, but to make lifestyle changes such as eating a high-fiber diet, drinking plenty of water, and exercising.
- Laxatives are for short-term use. Long-term use can make the problem worse.
- Before using any laxative, read the instructions that come with it carefully and follow them. Do not exceed the recommended dosage.
- Never give laxatives to children without the advice of a pediatrician. Pregnant and nursing mothers should also seek medical advice.
- If your constipation persists or occurs frequently, don't be embarrassed about it, and see a doctor without delay to get the correct cause and treatment.
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