Constipation

Constipation Facts

Constipation, or occasional irregularity, is a fairly common condition that is defined as infrequent bowel movements accompanied by hard, dry stool that is difficult or painful to pass. While normal bowel frequency varies from person to person, you may be suffering from constipation if you have to strain excessively, pass less than three stools in a week, and have a “blocked” feeling in your rectal area. There are many reasons why you may become irregular, including poor diet, dehydration, and lack of exercise. The root cause of constipation is when the muscle contractions in the colon become sluggish or the colon absorbs too much water, which makes the stool become hard and dry and move too slowly through the colon. Laxatives are medicines that are used for the relief of occasional constipation.

Constipation Treatments: Laxatives

Laxatives, like all over-the-counter (OTC) medicines, contain certain active ingredients that make the products work in the human body. The product’s active ingredients, including how much of a substance is in each dose, are listed first on the Drug Facts label.

There are six basic types of OTC laxatives: 1) bulk-forming 2), hyperosmotic 3) lubricant, 4) saline, 5) stimulant, and 6) stool softener. Depending on the product type, laxatives can be taken orally or inserted into the rectum. Some laxatives may contain more than one active ingredient.

Bulk-forming laxatives 
Bulk-forming laxatives increase bulk volume and water content of the stool which promotes a bowel movement. These products are for oral use and must be taken with plenty of fluid. Bulk-forming laxatives generally produce a bowel movement within 12 to 72 hours. Bulk-forming laxative active ingredients include:

  • calcium polycarbophil
  • methylcellulose
  • psyllium

Hyperosmotic laxatives 
Hyperosmotic laxatives attract water into the stool which promotes bowel movement. Hyperosmotic laxatives in suppository form are intended to be inserted into the rectum and generally produce a bowel movement within 15 minutes to one hour. Hyperosmotic laxatives taken orally generally produce a bowel movement in one to three days. Hyperosmotic laxative active ingredients include:

  • glycerin
  • polyethylene glycol 3350

Lubricant laxatives
Lubricant laxatives coat the intestinal tract and soften the stool which helps to lessen straining and promote a bowel movement. Products taken orally generally produce a bowel movement within six to eight hours. Products used rectally generally produce a bowel movement within two to 15 minutes.The active ingredient in lubricant laxatives is:

  • mineral oil

Saline laxatives 
Saline laxatives draw water into the colon which promotes bowel movement. Products taken orally generally produce a bowel movement within six to 12 hours. Products used rectally generally produce a bowel movement within two to 15 minutes. Saline laxative active ingredients include:

    • dibasic sodium phosphate
    • magnesium hydroxide
  • monobasic sodium phosphate

Stimulant laxatives 
Stimulant laxatives cause rhythmic muscle contractions in the intestines which promote bowel movement. Stimulant laxatives taken orally generally produce a bowel movement within six to 12 hours. Products used rectally generally produce a bowel movement within 15 minutes to one hour.Stimulant laxative active ingredients include:

Stool softener laxatives 
Stool softeners penetrate and moisten the stool which prevents dryness and promotes a bowel movement. Stool softeners taken orally generally produce a bowel movement within 12 to 72 hours. Products taken rectally generally produce a bowel movement within two to 15 minutes.The active ingredient in stool softeners is:

  • docusate
  • Taking a bulk-forming laxative without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take a bulk-forming laxative product if you have difficulty swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking a bulk-forming laxative, seek immediate medical attention.
  • Some bulk-forming laxatives may contain calcium. If you are taking any form of tetracycline antibiotic, laxatives containing calcium should be taken at least one hour before or two hours after you have taken the antibiotic.
  • Some products have psyllium-containing ingredients which may cause an allergic reaction in people sensitive to inhaled or ingested psyllium.
  • Talk to a healthcare provider prior to using a lubricant laxative enema to find out how long you should retain the medicine in your rectum.
  • Lubricant laxatives in oral form may be taken alone or mixed with a suitable liquid, such as juice or tea.
  • Be sure to drink a full glass (8 oz.) of liquid with each dose of an oral saline laxative.
  • Talk to a healthcare provider before using an oral saline laxative if you have kidney disease or are on a magnesium-restricted diet.
  • Using more than one saline enema in 24 hours can be harmful.
  • Talk to a healthcare provider before using a saline enema if you have kidney disease or are on a sodium-restricted diet.
  • Oral stimulant laxatives containing bisacodyl should not be used within one hour after taking an antacid or milk.
  • Stimulant laxatives suppositories should be inserted and retained in the rectum for approximately 15 to 20 minutes.
  • Stimulant laxatives may cause stomach discomfort, faintness, or cramps.
  • Talk to a healthcare provider before using a stool softener if you are currently taking mineral oil.
  • All of the tips for the safe use of OTC laxatives in this section also apply to children. But there are some additional considerations when it comes to treating kids with these medicines.
  • Talk to a healthcare provider before using a suppository on a child under the age of two.
  • Discontinue use of a suppository on a child if you encounter resistance. Forcing product insertion may cause injury.
  • OTC laxatives are available in different dosage strengths. Do not give any medicine to a child that is only intended for use in an adult.
  • Click here for more information on giving OTCs to children.

Additional tips by type of laxative―Be sure to read the entire list for medicines that may or may not be labeled for your child.

Bulk-forming:

  • Talk to a healthcare provider before giving a bulk-forming laxative containing psyllium in pill or capsule form to a child under the age of 12. If you are treating a child between the ages of 6 and 11, you should consider using an OTC psyllium laxative in the form of a wafer or powder mixed into liquid.
  • Talk to a healthcare provider before giving a bulk-forming laxative containing calcium polycarbophil or methylcellulose to a child under the age of 6.

Hyperosmotic:

  • Talk to a healthcare provider before using a hyperosmotic laxative containing polyethylene glycol on a child under the age of 16.

Lubricant:

  • Do not use a lubricant laxative enema on a child under the age of 2.
  • Talk to a healthcare provider before using an oral lubricant laxative on a child under the age of 6.

Saline:

  • Talk to a healthcare provider before giving an oral saline laxative to a child under the age of 2.
  • Saline laxative enemas are available in different dosage strengths. Do not use a saline laxative enema on a child that is only intended for use in an adult.
  • Talk to a healthcare provider before using a saline laxative enema on a child under the age of 2.

Stimulant:

  • Talk to a healthcare provider before giving an oral stimulant laxative containing bisacodyl to a child under the age of 6.
  • Talk to a healthcare provider before giving an oral stimulant laxative containing sennosides to a child under the age of 2.
  • Talk to a healthcare provider before using stimulant suppository containing bisacodyl on a child under the age of 6.

Stool Softener:

  • Talk to a healthcare provider before giving a stool softener to a child under the age of 2.