When dealing with constipation, a number of over-the-counter (OTC) and prescription medications can provide relief. These medicines, collectively known as laxatives, work in various ways to soften stool, stimulate bowel contractions, or both, depending on the specific type. Before turning to medication, it is often recommended to first try lifestyle changes such as increasing fiber and fluid intake and getting regular exercise. If those changes are insufficient, a variety of pharmacological options are available.
Types of Over-the-Counter Laxatives
Bulk-Forming Laxatives (Fiber Supplements)
Often the first and gentlest line of treatment, bulk-forming laxatives work by absorbing water in the gut to form a soft, bulky stool. This added mass stimulates the intestines to contract and move the stool along. They are suitable for long-term use and are less likely to cause side effects than stronger options.
- How they work: Absorb water in the intestine to add bulk and moisture to the stool.
- Examples: Psyllium (Metamucil, Konsyl), methylcellulose (Citrucel), and calcium polycarbophil (FiberCon).
- Onset: Typically take 12 to 72 hours to produce a bowel movement.
Osmotic Laxatives
These laxatives draw water from surrounding body tissues into the colon, which softens the stool and promotes more frequent bowel movements. Osmotics can be effective for both occasional and chronic constipation.
- How they work: Pull water into the intestinal tract to soften stool.
- Examples: Polyethylene glycol (MiraLAX), magnesium hydroxide (Phillips' Milk of Magnesia), and magnesium citrate.
- Onset: Can range from 30 minutes to three days, depending on the specific product and dosage.
Stimulant Laxatives
Designed for quicker, short-term relief, stimulant laxatives trigger rhythmic contractions of the intestinal muscles. They are not recommended for long-term use, as dependency can develop over time.
- How they work: Cause the walls of the large intestine to contract, forcing stool through the colon.
- Examples: Bisacodyl (Dulcolax) and sennosides (Senokot).
- Onset: Oral forms work within 6 to 12 hours, while rectal suppositories are much faster, working within 15 to 60 minutes.
Stool Softeners
Stool softeners, or emollient laxatives, increase the amount of water and fat the stool absorbs, making it softer and easier to pass. They are often used to prevent straining, such as after surgery or childbirth.
- How they work: Add moisture to stool to soften it.
- Example: Docusate sodium (Colace).
- Onset: Usually take 1 to 3 days to become effective.
Advanced and Prescription Treatments
For chronic or more severe cases of constipation, including fecal impaction, healthcare providers may recommend prescription medications or specific interventions.
Fecal Impaction
If stool becomes so hard and compacted that it cannot be passed, a healthcare provider may need to use more aggressive methods. Oral solutions of polyethylene glycol or enemas can be used to break up the mass. In severe cases, manual disimpaction by a medical professional may be necessary.
Prescription Options
For chronic idiopathic constipation or irritable bowel syndrome with constipation (IBS-C), there are specific prescription drugs available. These include:
- Lubiprostone (Amitiza): Increases fluid secretion in the small intestine.
- Linaclotide (Linzess): Regulates fluid in the intestines and speeds up stool movement.
- Plecanatide (Trulance): Also increases fluid secretion to aid in stool passage.
- Motegrity (Prucalopride): Used for chronic idiopathic constipation in adults.
Opioid-Induced Constipation
For individuals experiencing constipation due to opioid pain medication, there are specialized prescription drugs that block the effect of opioids in the gut without affecting pain relief. Examples include methylnaltrexone (Relistor) and naloxegol (Movantik).
A Comparison of Laxative Types
Type of Laxative | How It Works | Time to Work | Best For | Potential Side Effects |
---|---|---|---|---|
Bulk-Forming | Adds bulk and moisture to stool | 12-72 hours | Gentle, long-term use; preventing constipation | Bloating, gas, cramping (if not enough water is consumed) |
Osmotic | Draws water into the colon | 30 mins to 3 days | Occasional or chronic constipation | Bloating, gas, nausea, cramping |
Stimulant | Causes intestinal contractions | 6-12 hours (oral); 15-60 mins (rectal) | Quick, short-term relief for severe cases | Cramping, belching, diarrhea |
Stool Softener | Increases water/fat content of stool | 1-3 days | Preventing straining (post-surgery, post-childbirth) | Mild stomach discomfort, electrolyte imbalance with long-term use |
Lubricant | Coats the stool for easier passage | 6-8 hours | Short-term relief | Vitamin absorption issues with long-term use |
Conclusion
When seeking medication to clear up stool, the most suitable option depends on individual symptoms and circumstances. For general, occasional constipation, bulk-forming agents or osmotic laxatives are often the safest and gentlest starting point. More severe or chronic conditions may require faster-acting stimulant laxatives or prescription-strength options under a doctor's supervision. Crucially, laxatives are not a cure for the underlying cause of constipation. Addressing dietary fiber and hydration is always the recommended first step. Long-term or frequent reliance on laxatives should be discussed with a healthcare provider to avoid dependency and other health issues. Always read directions carefully and consult a professional for personalized medical advice. For more detailed information on types of laxatives and their use, refer to resources from reputable health organizations like the Mayo Clinic.
How to Prevent Future Constipation
Beyond medication, several lifestyle adjustments can help prevent constipation from recurring:
- Increase fiber intake: Aim for 25-38 grams of fiber daily from fruits, vegetables, beans, and whole grains.
- Stay hydrated: Drink plenty of water and other caffeine-free fluids to keep stools soft.
- Exercise regularly: Physical activity helps stimulate normal muscle contractions in the bowels.
- Maintain a routine: Attempt to use the bathroom at a consistent time each day to train your digestive system.
Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult with a healthcare provider before starting any new medication or treatment, especially if you have chronic health conditions or are pregnant or breastfeeding.