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LaxativesThis factsheet is for people who would like information about taking laxatives. Laxatives are medicines that relieve constipation (difficulty with bowel movements). They are one of the most popular types of over-the-counter remedies. Each year in the UK we spend around £50 million on laxatives in shops and pharmacies.
Why would I take them?Your doctor may advise you to take laxatives if you have constipation, especially if you have another condition that straining to defaecate can make worse, for example:
Laxatives can also be helpful for people with constipation caused by prescription medicines (eg codeine) or by illness, in older people who are constipated because of reduced mobility, and to help get rid of worms. They are also prescribed to clear the bowel before surgery or for colonoscopy, a test for looking inside the bowel. Changes in bowel movements can sometimes indicate more serious conditions. You should talk to your doctor if you are losing weight or if you notice blood in your faeces. What are the main types?Laxatives are medicines that work on the bowel to relieve constipation. There are several types of laxative that you can buy without a prescription. The main ones are:
How do laxatives work?Each type of laxative works in a different way to help relieve or prevent constipation.
Which laxative should I take?Bulk-forming laxatives are good for people who have small, hard faeces and can't increase the amount of natural fibre they eat. This includes people with colostomy or ileostomy bags, piles, or anal fissures. The osmotic laxative lactulose can take 48 hours to work. Make sure you drink a normal amount of fluids while taking these medicines. Stimulant laxatives are helpful if the bowel is full and a bulk-forming laxative is not suitable for you. How to take laxativesYou can buy each of the three basic types of laxatives without a prescription. Bulk-forming laxatives come as powders, granules or tablets. You need to take these with plenty of fluids. The full effect of these medicines can take several days of treatment. Osmotic laxatives come as powders, liquids or enemas. The full effect of these medicines can take several days of treatment. Stimulant laxatives come as tablets, suppositories, capsules, liquids and enemas. Stimulant laxatives such as senna work within eight to 12 hours, so you should take them at night for an effect the next morning. You should start with a low dose and build up gradually until you feel comfortable when you have a bowel movement. You should generally try a bulk-forming laxative (eg bran) first. Then move on to try an osmotic laxative if this doesn't work. It's best to only take the stimulant laxatives if you have already tried changing your diet (eg eating more fibre) and the other types of laxatives, and these have not worked. Generally, laxatives should only be used occasionally. Once your bowel movements are back to normal, you should keep them regular by eating a balanced diet with plenty of fluids and fibre. You shouldn't give laxatives to children unless your doctor has prescribed them. Always read the patient information leaflet that comes with your medicine. Special careCheck with your doctor or pharmacist before taking a laxative if:
Side-effectsCommon side-effects with the bulk-forming laxatives are wind and a swollen abdomen. Rarely, they can also block the intestine. Osmotic laxatives can cause wind, cramps and discomfort in the abdomen. You may also become dehydrated. Stimulant laxatives can cause stomach pains and cramping, and too large a dose can cause diarrhoea. Interactions with other medicinesCheck with your doctor or pharmacist before you take any other medicines or herbal remedies at the same time as a laxative. Names of common laxativesExamples of the main types of laxatives are shown in the table. The generic name is the chemical name of a medicine. If a manufacturer has rights over a medicinal compound, it is given a brand name. Often there is more than one brand name associated with a generic name. Generic names are normally written with a lower-case initial letter and brand names normally start with an upper-case letter. There are many different products marketed for constipation. Some have more than one ingredient, or different ingredients sold under the same brand name. Ask your pharmacist for advice.
Further information
Sources
Published by Bupa's health information team, healthinfo@bupa.com, February 2007.
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