Laxatives can help relieve and prevent constipation. But not all of them are safe for long-term use. Overuse of certain laxatives can lead to dependency and decreased bowel function.
Laxatives are substances taken orally or rectally to relieve and prevent constipation. Oral laxatives come in many different forms: liquids, tablets, wafers, gums, or powders that you dissolve in water. Rectal laxatives include suppositories and enemas.
Because bowel movements are a natural process, with "normal" frequency ranging from as many as three a day to as few as three a week, your body ordinarily needs no help to have them. But a poor diet, physical inactivity, pregnancy, illness or stress can disrupt normal bowel function. Before turning to laxatives, you may want to try the following lifestyle changes to help manage occasional irregularity:
- Eat fiber-rich foods.
- Drink plenty of fluids daily.
- Get regular exercise.
- Use medications cautiously.
How they work
Laxatives work in different ways, and the effectiveness of each laxative type varies from person to person. In general, bulk-forming laxatives, such as Metamucil, Citrucel and FiberCon are the gentlest on the system, while stimulant laxatives, such as Ex-Lax and Senokot, are the harshest. If you stay constipated despite changing your diet and exercise routine, your first choice should usually be a mild laxative.
Combination laxatives: Check labels carefully
Some products combine different types of laxatives. Combinations may include:
- A bulk former and a stimulant
- A bulk former, stimulant and stool softener
- A hyperosmotic and lubricant
- A stimulant and stool softener
Combination products may not be any more effective than single-ingredient products. But they may be more likely to cause side effects because of their multiple ingredients. Carefully inspect labels to see how many types of laxatives a product contains.
What are the risks?
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 diabetes and anti-seizure 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.
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 the large intestine.
Children under age 6 shouldn't be given laxatives without a doctor's recommendation. If you're pregnant, seek your doctor's advice before using laxatives. Bulk-forming laxatives and stool softeners may be safe to use during pregnancy, but stronger laxatives can harm you or your baby. The stimulant laxative castor oil, for example, can cause early labor. 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 infants.
Don't be lax about laxatives
See your doctor if you have unexplained changes in bowel patterns or habits, if constipation lasts longer than seven days despite laxative use, or if constipation is accompanied by rectal bleeding. If you're dependent on laxatives, ask your doctor for advice on how to gradually withdraw from them and restore your colon's natural ability to contract.
Last Updated: 04/29/2005
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