Some laxatives work by softening stools, while others work by increasing the bulk of stools with additional fiber. They help people empty their bowels and are common for constipation relief.

Most laxatives are available to buy over the counter and without a prescription. A person can take laxatives by mouth in the form of liquids, tablets, or capsules. An individual can also take them through the rectum — for example, with suppositories or enemas.

Some people need to move their bowels two to three times per day, while others go two to three times per week. There is no “normal” number of times. It is more important to notice changes in bowel habits.

Constipation is when stools become hard, making them difficult or painful to pass.

Fast facts on laxatives:

  • Laxatives are commonly used to relieve constipation.
  • Most are available without the need for a prescription.
  • Some foods are known to have a laxative effect.
  • Improving diet and increasing activity can help reduce constipation, and therefore reduce the need for laxatives.
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Constipation can cause cramps in the abdomen and can make people feel bloated or sick. It can be separated into two different types:

  • Primary constipation: This type is associated with slow intestinal movements caused by an anatomical issue. This is often associated with not consuming enough fiber or not drinking enough fluids.
  • Secondary constipation: This type is associated with:

Some medications can also contribute to constipation. These include:

Different types of laxatives work in different ways. The choice of laxative will depend on a number of different factors.

There are four main types:

  • Bulk-forming laxatives: Also known as fiber supplements, these work in the same way that fiber in the diet normally does. They increase the bulk of stools by getting them to retain liquid, which encourages the bowels to push them out. Adults with constipation should start taking bulk-forming laxatives as a first-line solution unless there is a specific reason not to do so. They usually take 12–24 hours to start working.
  • Osmotic laxatives: These soften the stool by increasing the amount of water secreted into the bowels, making it easier to pass. They may take up to 2–3 days before they start to work.
  • Stimulant laxatives: These stimulate the digestive tract walls, speeding up bowel movements. Usually, they take effect within 6–12 hours.
  • Stool softener laxatives: These decrease the surface tension of stools so that they absorb more water, making them softer. Usually, they work within 12–72 hours.

There are also some less common types of laxatives:

  • Lubricant laxatives: These lubricate the intestines by decreasing the amount of water absorbed by the intestines.
  • Saline laxatives: These are used when there is no blockage in the bowels. Often, they are enemas used to empty the bowel before invasive procedures or surgery.
  • Prokinetic laxatives: These are used for severe constipation in conditions such as irritable bowel syndrome (IBS) and chronic idiopathic constipation.

Like any medication, laxatives can have side effects. Exactly which side effects a person may experience will depend on what type they are taking.

There are some common side effects, which include:

Most side effects will disappear once a person stops taking the medication. People can mostly avoid the side effects by starting on a low dose and increasing the dose gradually.

Serious side effects are rare. However, excessive or prolonged use of laxatives can cause diarrhea or intestinal obstruction, where stools become large and dry. Long-term use can also cause shifts in electrolytes.

Some laxatives react with other medications, so if a person is taking other drugs, it is best to check with a doctor before taking laxatives.

If symptoms get worse after taking laxatives, it is important to speak with a doctor.

Individuals may take laxatives for the wrong reasons, and misuse is relatively common. For instance, some people attempt to lose weight through the frequent and repeated use of laxatives.

Often, this occurs after overeating under the mistaken belief that food and calories will be rushed through the body before they are absorbed. This is not the case, and laxative misuse can lead to a number of health complications.

People with anorexia and bulimia sometimes use large amounts of laxatives as part of a pattern of disordered food behavior.

While those misusing laxatives may notice weight loss, this is usually because of the loss of fluids. They do not reduce body mass, fat, or calories and can contribute to an eating disorder diagnosis.

Health complications associated with laxative misuse include:

  • Imbalance of electrolytes and minerals, particularly potassium: These are necessary for the proper functioning of nerves and muscles, including the colon and heart. Imbalance can affect these organs.
  • Dehydration: This can cause tremors, weakness, blurry vision, and kidney damage. In extreme cases, it can lead to death.
  • Laxative dependency: The colon stops reacting to usual doses, meaning larger and larger doses are required.
  • Internal organ damage: The colon can become stretched and the muscle wall may become thin and flaccid.

Non-fiber-based laxative use has also been associated with an increased risk of colorectal cancer, though more research is needed to fully understand this association.

Laxative misuse often requires medical help for both physical and mental treatment. A doctor will be able to give advice on this.

How someone takes laxatives and how often they take them will vary depending on the type.

Therefore, it is important to carefully read the instructions before taking laxatives. Anyone with concerns should always ask a pharmacist or healthcare professional.

There are also some other important things to consider:

  • Drink plenty of fluids: Laxatives can cause dehydration. It is important to drink at least 2 liters of water per day.
  • Avoid taking too much: Large doses of laxatives can lead to diarrhea and blockages in the bowels.

People should only take laxatives occasionally and for short periods of time. Those with Crohn’s disease or ulcerative colitis should not take laxatives unless their doctor specifically said to do so.

Alternatives

There are some natural alternatives to laxatives and lifestyle changes that can help alleviate constipation:

  • regular activity
  • increasing daily intake of fiber
  • drinking more water
  • adding bulking agents, such as bran, to the diet

There are four main types of laxatives. These can be helpful in reducing constipation, but it is important to use them sparingly and only when necessary. Misuse of laxatives is a concern.

Some foods and lifestyle factors can have a laxative effect, such as increased activity and high fiber foods.

If a person lives with chronic constipation or over-the-counter medications are not working, they should talk with a doctor for advice on treatment. A person should always speak with a doctor before trying a laxative if they live with a gastrointestinal condition or are currently on any medications.