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What medication is used to clear up stool?: A guide to laxative and stool softener options

4 min read

Approximately 16% of adults suffer from symptoms of constipation, a condition that often leads to seeking effective relief. For those wondering what medication is used to clear up stool, the answer depends on the underlying cause, severity, and speed of relief needed. From mild bulk-forming agents to more powerful stimulants, a range of options exist to help restore regular bowel movements.

Quick Summary

An overview of medications used to relieve constipation, including bulk-forming agents, osmotic laxatives, stimulants, and stool softeners. Understanding the different mechanisms, appropriate uses, and onset times helps in choosing the right treatment for constipation.

Key Points

  • Start with mild options: Bulk-forming laxatives, like Metamucil, are often the gentlest starting point for occasional constipation.

  • Consider osmotic laxatives for softening: Products like MiraLAX work by drawing water into the colon to soften stool, typically taking 1 to 3 days to work.

  • Use stimulants for fast, short-term relief: Medications such as Dulcolax and Senokot force intestinal contractions and are best used sparingly due to risk of dependency.

  • Prevent straining with stool softeners: Docusate sodium (Colace) is ideal for softening stools and preventing straining, especially after surgery or childbirth.

  • Consult a doctor for severe or chronic issues: Conditions like fecal impaction or chronic constipation require medical supervision, which might involve stronger medications or specific procedures.

  • Lifestyle changes are the first line of defense: Before medication, try increasing fiber and fluid intake and exercising regularly to encourage natural bowel movements.

  • Prescription options exist for specific conditions: For opioid-induced or chronic constipation, specialized prescription drugs may be necessary.

In This Article

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.

Frequently Asked Questions

For the fastest relief, stimulant laxatives such as bisacodyl (Dulcolax) or senna (Senokot) are often used, especially in suppository form, which can work within minutes to an hour. Rectal enemas also provide quick results.

A stool softener is a type of laxative, but not all laxatives are stool softeners. Stool softeners primarily work by adding moisture and fat to stool to make it softer, while other laxatives, such as stimulants, force the intestines to contract to move stool along.

Bulk-forming laxatives (fiber supplements) like Metamucil are generally considered the safest for long-term use. They work gently and are less likely to cause dependency or electrolyte issues.

Over-the-counter options like polyethylene glycol (MiraLAX) or enemas can be used for disimpaction under medical supervision, but severely impacted stool often requires a doctor's intervention to manually clear the blockage.

Natural remedies include increasing dietary fiber from sources like fruits and vegetables, drinking more water, and engaging in regular exercise. Prunes and prune juice are also known for their natural laxative effects due to their high fiber and sorbitol content.

Choose a stool softener if you need to prevent straining or have mild constipation. Opt for a laxative, particularly an osmotic or stimulant one, if you need to induce a bowel movement more quickly or if your constipation is more severe.

If OTC options are ineffective, it is important to consult a healthcare provider. They can rule out underlying conditions and prescribe stronger medications, such as Linzess or Amitiza, or recommend different treatment strategies.

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.