|
What Should I Use for Constipation?
The best way to prevent constipation is through eating fiber, drinking plenty of water and exercising regularly. When it is necessary to use a product for constipation, choices should be made on an individual basis. Laxatives can be grouped into categories by mechanism of action: bulk forming agents, stool softeners, stimulant laxatives and osmotic laxatives.
Bulk forming agents like Metamucil and Benefiber help to increase fiber intake but they take about 3 - 7 days to work and need to be taken with plenty of water. These are often recommended as preventative therapy. They should be taken daily and will not work for immediate relief of constipation.
Stool softeners or docusate (Colace), are used to soften the stool. They do not push anything through the intestines, they only soften what’s there to make the stool easier to pass. These take about 1 to 2 days to work. This is recommended particularly when a patient is straining to pass a stool and producing a very hard stool.
Stimulant laxatives are the most common types of laxatives people use; these include senna (Senokot and Exlax) and bisacodyl (Dulcolax). They work overnight or usually in 6 - 8 hours. These should be used for occasional use because they can cause some dependence. The bowel muscles can start to rely on the medication to have a bowel movement. Additionally, abdominal cramping is a side effect of these medications.
Osmotic laxatives work by drawing water into the intestines. They include medications like lactulose, glycerin suppositories, magnesium citrate and sodium phosphate. Lactulose is a good option for most people to relieve constipation. It is not absorbed into the bloodstream and can be used by children and adults. However, it take about 1 - 2 days to work. If a patient needs immediate relief, glycerin suppositories can be recommended which work in about 15 minutes. Medications like magnesium citrate and sodium phosphate are often used as part of bowel cleaning prior to a colonoscopy. They also work very quickly but they can cause electrolyte imbalances in some patients.
Donna Cranford, R.Ph.
B.S. Pharmacy
Pharm.D.
Fellowship drug metabolism and pharmacokinetics
| 
