Laxative medication
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Laxative medication

Diet and lifestyle changes are usually recommended as the first treatment for constipation.1
This includes gradually increasing your daily intake of fibre, making sure you drink plenty fluids and trying to get more exercise.1
If these are not effective, your doctor may prescribe an oral laxative medication that can help you empty your bowels.1

Laxatives are a type of medicine that can help you pass stools. There are different types of laxatives and each one has a different effect on your digestive system.1
The goal of constipation therapy is to restore normal bowel function and relieve constipation related symptoms and subsequently improve your quality of life.2

The treatments available for constipation are divided into 4 main groups:2

1) Bulk-Forming Laxatives (Fiber)1,2,3

  • Retains water in the stool through a bulking effect.3
  • Improves the stool consistency.3
  • Maintaining adequate fluid intake is important to avoid excessive bulk which may aggravate constipation2

Examples:

  • Psyllium / Ispaghula
  • Calcium polycarbophil
  • Bran
  • Methylcellulose

2) Osmotic laxatives and saline laxatives1,2,3

  • Retains the water in the stool by osmotic water binding.1,2,3
  • This softens the stool and increases the stool volume which stimulates your body to pass them.1, 3
  • Osmotic Laxatives are the first line treatment for functional constipation along whith fiber. 4

Examples:

  • Lactulose
  • Recommendation Quality of Evidence > Lactulose Strong Low > Macrogol (Polyethylene glycol)
  • Saline laxative: magnesium citrate, magnesium sulfate

3) Stimulant laxatives1,2,3

  • Stimulates the muscles of your digestive tract to increase intestinal motility, helping them to move stools along the bowel1
  • Decreases the bowel’s water absorption2,3

Examples :

  • Bisacodyl
  • Sodium Picosulfate
  • Senne
  • Castor oil
  • Cascara
  • Rhubarb
  • Aloe

4) Stool softeners and emollients2,3

  • Soften the stool with a detergent like action3
  • Increases the stool bulk3

Examples:

  • Mineral oil (paraffin)
  • Docusate

According to your individual requirements, your doctor will prescribe the appropriate treatment.

References:
1: NHS inform. Constipation. [Internet]. 2018. Available from: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/constipation (Accessed 18 October 2018).
2: Sibanda M, Meyer JC, et al. Chronic constipation in adults. S Afr Pharm J. 2018;85(1):34-42.
3: Portalatin M, et al. Clin Colon rectal Surg. 2012 ;25:12-9
4: World Gastroenterology Organisation Guidelines. Constipation, a global perspective