9/14/22, 1:59 AM Laxatives - Tests & treatments | NHS inform

Laxatives
Introduction
Laxatives are a type of medicine that can help you empty your bowels if
you're having trouble going to the toilet.

They're widely used to treat constipation (/illnesses-and-conditions/stomach-liver-and-

gastrointestinal-tract/constipation/) if lifestyle changes, such as increasing the
amount of fibre in your diet, drinking plenty of fluid and taking regular
exercise, haven't helped.

Laxatives are available over-the-counter, without a prescription, from

pharmacies and supermarkets.
 

Types of laxatives
The main laxatives used in the UK are:
bulk-forming laxatives – such as ispaghula husk and methylcellulose, which
work in the same way as dietary fibre; they increase the bulk of your stools
(faeces) by helping them retain fluid, encouraging your bowels to push the
stools out
osmotic laxatives – such as lactulose and polyethylene glycol, which soften
your stools and make them easier to pass by increasing the amount of water
in your bowels
stimulant laxatives – such as bisacodyl, senna and sodium picosulfate, which
speed up the movement of your bowels by stimulating the nerves that control
the muscles lining your digestive tract
stool softener laxatives – such as arachis oil and docusate sodium, which
increase the fluid content of hard, dry stools, making them easier to pass
There are also a number of alternative laxatives that are less commonly used,
including bowel cleansing solutions, peripheral opioid-receptor antagonists,
linaclotide and prucalopride.

Which laxative should I use?

Although laxatives have been around for a long time, there's a lack of high-
quality evidence about exactly how effective they are and whether certain
laxatives are better than others.

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Unless there's a reason why specific laxatives may be more suitable than
others (see below), most adults should try using a bulk-forming laxative first.
These usually start to work after about 2 or 3 days.
If your stools remain hard, try using an osmotic laxative in addition to – or
instead of – a bulk-forming laxative. If your stools are soft, but are still difficult
to pass, try taking a stimulant laxative in addition to a bulk-forming laxative.

Osmotic laxatives usually start to work after about 2 or 3 days, while stimulant
laxatives usually have an effect within 6 to 12 hours.

Speak to your GP or pharmacist if you're unsure which laxative to use. Also

see your GP if you're still constipated after trying all of the different types of
laxative, or if you think your child might benefit from taking laxatives.

Things to consider
Although laxatives are available over-the-counter, they're not suitable for
everyone.
Laxatives aren't usually recommended for children, unless advised by a
doctor, and some types of laxatives may not be safe to use if you have certain
conditions, such as Crohn's disease (/illnesses-and-conditions/stomach-liver-and-
gastrointestinal-tract/crohns-disease/) or ulcerative colitis (/illnesses-and-
conditions/stomach-liver-and-gastrointestinal-tract/ulcerative-colitis/) .

Before using laxatives, carefully read the patient information leaflet that
comes with the medication to make sure it's safe for you to take.

Read more about the considerations regarding laxatives (/tests-and-

treatments/medicines-and-medical-aids/types-of-medicine/laxatives#considerations) .

How to take laxatives

How you take laxative medication depends on the form it comes in, they are
commonly available as:
tablets or capsules you swallow
sachets of powder you mix with water and then drink
suppositories – a capsule you place inside your back passage (rectum), where
it will dissolve
liquids or gels that you place directly into your back passage
Some laxatives are also designed to be taken at certain times of the day, such
as first thing in the morning or last thing at night.

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Read the patient information leaflet that comes with your medication so you
know how to take it properly. Ask your pharmacist for further advice if you're
still not sure how to take your medication.
While taking bulk-forming or osmotic laxatives it's particularly important to
stay well hydrated by drinking plenty of fluids. This is because these laxatives
can cause dehydration (/illnesses-and-conditions/nutritional/dehydration/) .

Never take more than the recommended dose of laxatives because this can
be harmful and cause troublesome side effects (see below).

How long should laxatives be used for?

Ideally, laxatives should only be used occasionally and for short periods of
time. Stop taking a laxative when your constipation improves.
After taking a laxative, to help stop constipation returning you can make
certain lifestyle changes, such as drinking plenty of water, exercising regularly
(/healthy-living/keeping-active/) and including more fibre in your diet. These types
of measures are a better way of preventing constipation than excessive use of
laxatives.
See your GP for advice if you're often constipated, despite making
appropriate lifestyle changes, or if your constipation hasn't improved after
taking laxatives for more than a week.

Don't get into the habit of taking laxatives every day to ease your
constipation because this can be harmful.

In some cases, you may be prescribed a laxative to use regularly, but this
should always be supervised by your GP or a gastroenterologist (a specialist
in digestive conditions).

Side effects
Like most medications, laxatives can cause side effects. They're usually mild
and should pass once you stop taking the medication.

The side effects you may experience will depend on the specific medication
you're taking, but common side effects of most laxatives include:
bloating
passing wind (/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/flatulence/)
 (flatulence) 
painful tummy (abdominal) cramps
feeling sick

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dehydration – which can make you feel lightheaded, have headaches (/illnesses-
and-conditions/brain-nerves-and-spinal-cord/headaches/) and pass urine that's darker
than normal
Contact your GP for advice if you experience any particularly troublesome or
persistent side effects while taking laxatives.
Excessive or prolonged use of laxatives can also cause diarrhoea (/illnesses-and-
conditions/stomach-liver-and-gastrointestinal-tract/diarrhoea/) , intestinal obstruction
(where the bowel becomes blocked by large, dry stools) and unbalanced
levels of salts and minerals in your body.

Alternatives
It's often possible to improve constipation without having to use laxatives.
Before trying laxatives, it may help to make a number of lifestyle changes,
such as:
increasing your daily intake of fibre – you should eat about 30g of fibre a day;
high-fibre foods include fruit, vegetables and cereals
adding bulking agents, such as wheat bran, to your diet – these will help
make your stools softer and easier to pass, although bran and fibre can
sometimes make bloating worse
drinking plenty of water
exercising regularly
Read more about preventing constipation (/illnesses-and-conditions/stomach-liver-
and-gastrointestinal-tract/constipation#preventing-constipation) .

Considerations
Most people can use laxatives, but not all types are suitable for everyone.
For example, you should check with your GP or pharmacist before using
laxatives if you:
have a bowel condition, such as irritable bowel syndrome (IBS) (/illnesses-and-
conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs/) , Crohn's
disease (/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/crohns-disease/)
or ulcerative colitis (/illnesses-and-conditions/stomach-liver-and-gastrointestinal-
tract/ulcerative-colitis/)

have a colostomy (/tests-and-treatments/surgical-procedures/colostomy/) or ileostomy

(/tests-and-treatments/surgical-procedures/ileostomy/)  (where the small or large
intestine is diverted through an opening in the abdomen)

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have a history of liver or kidney disease

are pregnant or breastfeeding
have an obstruction somewhere in your digestive system
have diabetes (/illnesses-and-conditions/diabetes/diabetes/) , as some laxatives can
cause a rise in blood sugar levels, which could be dangerous if you have
diabetes
have difficulties swallowing (dysphagia) (/illnesses-and-conditions/stomach-liver-and-
gastrointestinal-tract/dysphagia-swallowing-problems/)

have a lactose intolerance (/illnesses-and-conditions/nutritional/lactose-intolerance/) ,

as some laxatives contain lactose
have phenylketonuria (a rare genetic condition where the body is unable to
break down a substance called phenylalanine), as phenylalanine is found in
certain bulk-forming laxatives
are taking opioid painkillers, such as codeine or morphine
These situations don't usually mean you can't use laxatives, but certain types
of laxative may be more suitable for you than others.

Children and laxatives

Laxatives aren't recommended for babies who haven't been weaned. If your
baby is constipated, try giving them extra water in between feeds. Gently
massaging their tummy and moving their legs in a cycling motion may also
help.

Babies who are eating solid foods may be able to use laxatives, but you
should first make sure your baby drinks plenty of water or diluted fruit juice
and increase the amount of fibre in their diet. If they're still constipated, your
GP may prescribe or recommend a laxative.
In older children, osmotic or stimulant laxatives are often recommended
alongside dietary changes as the first treatment for constipation.
Always check with your GP before giving your baby or child a laxative.

Read more about treating constipation in children (/illnesses-and-

conditions/stomach-liver-and-gastrointestinal-tract/constipation#treating-constipation) .

Source:
NHS 24

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Last updated:

23 June 2022

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