Abuse of Laxatives

Laxatives are medicines you buy in a store that will make you have a bowel movement. One common cause of constipation can be the abuse of laxatives.

The common belief that people must have a daily bowel movement has led to self medicating with OTC (over-the-counter) laxative products.

Although people may feel relief when they use laxatives, typically they must increase the dose over time because the body grows reliant on laxatives in order to have a bowel movement. As a result, laxatives may become habit-forming, can lead to dependency and decreased bowel function.

Most people who are mildly constipated do not need laxatives. People who are dependent on laxatives need to slowly stop using them. A doctor can assist in this process. For most people, stopping laxatives restores the colon’s natural ability to contract.

For those people who have made diet and lifestyle changes (eating fiber rich foods, drinking plenty of fluids daily, and exercising regularly) and are still constipated, a doctor may recommend laxatives (taken by mouth) or suppositories or enemas (rectal laxatives) for a limited time. These treatments can help retrain a chronically sluggish bowel. A doctor should determine when a person needs a laxative and which form is best.

Laxatives taken by mouth are available in liquid, tablet, gum powder, and granule forms, and they work in various ways.

Bulk Forming Laxatives (known as fiber supplements)

  • Generally considered the safest, but they can interfere with absorption of some medicines.
  • Must be taken with water or they can cause obstruction.
  • They absorb water in the intestine and make the stool softer.
  • Many people report no relief after taking them, and suffer from a worsening in bloating and abdominal pain.
  • Some brand names: Fiberall, Metamucil, Citrucel, Serutan, Konsyl.

Stimulants

  • Cause rhythmic muscle contractions in the intestines.
  • Phenolphthalein, an ingredient in some stimulant laxatives, might increase a person’s risk for cancer.
  • The Food and Drug Administration has proposed a ban on all over-the-counter products containing phenolphthalein.
  • Most laxative makers have replaced, or plan to replace, phenolphthalein with a safer ingredient.
  • Some brand names: Correctol, Purge, Dulcolax,, Senokot.

Osmotics

  • Cause fluids to flow in a special way through the colon, resulting in bowel distention.
  • Useful for people with idiopathic constipation.
  • People with diabetes should be monitored for electrolyte imbalances.
  • Some brand names: Cephulac, Miralax, Sorbitol.

Stool softeners

  • Moisten the stool and prevent dehydration.
  • Often recommended after childbirth or surgery.
  • Suggested for people who should avoid straining in order to pass a bowel movement.
  • Prolonged use may result in an electrolyte imbalance.
  • Some brand names: Surfak, Colace.

Lubricants

  • Lubricants grease the stool, enabling it to move through the intestine more easily.
  • Typically stimulate a bowel movement within 8 hours.
  • Mineral oil is the most common example.
  • Some brand names: Zymenol, Fleet.

Saline

  • Acts like a sponge to draw water into the colon for easier passage of stool.
  • Used to treat acute constipation if there is no indication of bowel obstruction.
  • Electrolyte imbalances have been reported with extended use, especially in small children and people with renal deficiency.
  • Some brand names: Haley’s M-O, Milk of Magnesia.

Chloride channel activators

  • Increases intestinal fluid and motility to help stool pass, thereby reducing the symptoms of constipation.
  • Amitiza has been shown to be safely used for up to 6 to 12 months, then your doctor should assess the need for continued use.

Some Side Effects of Laxatives
Sometimes laxatives can cause:

  • Nausea
  • Diarrhea
  • Gas
  • Cramps
  • Bloating
  • Increased thirst
  • Choking
  • Increased constipation if not taken with enough water
  • Throat irritation
  • Belching
  • Faintness
  • Urine discoloration
  • Rectal irritation
  • Stomach discomfort

When taking laxatives, always read the directions thoroughly. You should really only use laxatives if a doctor says you should.

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