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Laxatives for constipation: What you need to know

Everyone gets stopped up now and again. Here’s the lowdown on products that can help get things moving.

Published: December 6, 2023

Written by: Cheryl Solimini

Illustration of a constipated colon in the shape of a question mark as a man looks questioningly at it.

When you gotta go, you gotta go. But what happens when you can’t? You’re not alone. Constipation is such a common complaint that it leads to at least 2.5 million doctor visits in the U.S. each year, according to the American College of Gastroenterology.1

If your typical bowel movements are off schedule or don’t pass smoothly, you may find relief with laxatives. “Laxatives are medications that help loosen the stool and move it along,” explains Ellen Stein, MD, Associate Professor of Medicine, Division of Gastroenterology and Hepatology at Rutgers Robert Wood Johnson Medical School in New Brunswick, NJ. “Different types of laxatives do their work in separate ways,” she adds.2

So, which to choose? While most laxatives do not need a prescription, your doctor can help you decide the type that might be best for you, especially if your constipation isn’t easily resolved or occurs frequently.

Here is a breakdown of the options available, along with some simple lifestyle changes that may also help restore you to regularity. Remember to use all products following the directions on the package.

In this article:

What causes constipation?

The body passes cellular waste and food we don’t use through the large intestine. When that process goes too slowly, we call it constipation.3,4 But what causes that slowdown?

Constipation is often caused by a change in diet, typically because of either inadequate fluid intake or too many foods that are highly processed and are low in fiber. Lack of regular physical activity may also contribute to a slowdown in bowel function.5 Many other factors, including medications,6 sleep disturbances, stress, travel and various underlying medical conditions can also have an effect.7

Before you reach for a laxative, though, be aware that nobody runs with clock-like precision. “It’s a myth that people need to go once a day,” says Brijen J. Shah, MD, professor of medicine in the Division of Gastroenterology at the Icahn School of Medicine, Mount Sinai Hospital, New York City.8 “In reality, there is a wide range of what is ‘normal.’ Some people go a few times a day and other people go once every three days.”

How do laxatives work?

Four common types of laxatives can help make stool easier or speedier to eliminate.

Oral bulk-forming laxatives. Some fibers, such as psyllium and methylcellulose, absorb fluid and increase stool size.9 When taking these fiber products, be sure to also drink plenty of liquids, advises Dr. Shah. “You want the water and the fiber to combine to become sort of a soft, gelatinous substance that helps to form the stool.”10

Psyllium products, such as CVS Health Daily Fiber and Metamucil 4-in-1 Fiber, often come as a powder to be mixed into water, juice or other liquid. Methylcellulose, which is also a powder, is the active ingredient in Citrucel.

Oral osmotics. These types of laxatives pull water into the intestines from surrounding tissue, softening the stool.11 Their main ingredient is usually magnesium hydroxide, lactulose, polyethylene glycol or sorbitol.12 Dr. Stein warns that osmotics might not be safe for people with kidney disease, so talk to your health care provider or gastroenterologist before using.13

Phillips’ Milk of Magnesia and MiraLax are two options for nonprescription osmotic products.

Oral stimulants. “Stimulant laxatives increase the contractions in the colon,” explains Dr. Shah.14 This squeezing action pushes stools along more quickly, though cramping can be a side effect, he adds.15 The most common of these nonprescription remedies contain bisacodyl or sennosides and are available in several forms.16 The leaves of senna, a flowering plant, is also often found in herbal laxative teas.17

Oral stool softeners. These include docusate sodium and docusate calcium, which allow water and fats to penetrate the stool and make it easier to pass.18 These medications might be less effective for chronic constipation, however.19

Another stool softener, mineral oil, acts as a lubricant, lining the stool and intestines to smooth the way out.20 Mineral oil shouldn’t be used for more than a few days, because it may block the body’s absorption of certain vitamins21 and, if inhaled, can trigger pneumonia.22,23

Colace and CVS Health Mineral Oil USP Lubricant Laxative are two stool softeners in this category. Also consider Dulcolax. CVS Health Senna Laxative Tablets, Ex-Lax and Senokot. For sippable versions, try Senokot Natural Senna Leaf Laxative Tea or Smooth Move.

Liquid laxative vs. laxative pills

Laxatives come in all forms these days, including chewables. Some people like to take pills and others like powders or liquids. So which laxative form you choose may depend on your personal preference, according to Dr. Shah.24

Baby laxatives

Pediatricians should be a first stop with childhood constipation. Constipation can be an issue when infants transition from breast milk or formula to regular milk and other foods, Dr. Stein explains. Parents may note squirming or grunting as their child struggles to pass the firmer stools. “Adding a little fiber — pureed fruits and vegetables — and water to a baby’s diet can sometimes help.”

Some children might need medications or fiber supplements, but, she adds, “any child with tummy issues should have guidance and advice from their pediatrician before engaging in laxative use.”25

There are a number of products to help with children’s digestive health, but make sure to use products only as directed.

Natural laxatives

Look in the kitchen for the first line of defense against constipation. For most people, adding foods naturally high in fiber (fruits, legumes, vegetables and whole-grain breads and cereals) will keep the gut running like clockwork.26

“Like an apple a day, fruits and vegetables do help keep stool flowing,” says Dr. Stein. Prunes or prune juice can also be stimulants to kick-start bowel habits, she notes. A somewhat tastier alternative: kiwifruit. A recent study showed two a day were as effective as psyllium.27

Also, drink up! “Stay hydrated, especially as you increase fiber, because fiber works best when it’s combined with water,” says Dr. Shah. Other liquids like fruit and vegetable juices and clear soups  help too.28 More movement or more exercise — even things as simple as walking — can literally get things moving, he adds.29

If other treatments are not effective, some people might find relief with an at-home enema, injecting warm tap water, a saline solution30 or olive oil31 into the rectum to lubricate stool and stimulate bowel movement. “But if you are considering an enema, you should check in with your physician first,” cautions Dr. Stein.32

If your health care provider gives the okay, you might turn to products such as CVS Health Rectal Syringe or Fleet Laxative Saline Enema.

How long do laxatives take to work?

“Laxatives like fiber gently work overnight,” says Dr. Stein. “Osmotic laxatives may take a few days to slide things along. Stimulants may only take a few hours to produce a result.”33 Some stimulants available as suppositories may work in 15 to 60 minutes.34

Timing is everything: For the gentler laxatives, like stool softeners, the recommended dosage at bedtime will hopefully get you moving by morning.35 Stimulants are stronger, and how quickly they work can be unpredictable, explains Dr. Stein. “You may want to try one on a weekend when you’re going to be at home and can take care of business.” She suggests using any stimulant just once a week. “If you're going to use it more than that, you should be talking to your doctor.”36

How long do laxatives last?

“Laxatives generally work for the day that they are used,” says Dr. Stein. You may not see results for a day or two with slower-acting fiber laxatives or osmotics or because your body has its own idiosyncrasies, so be patient.37

“Mostly people use a laxative one or two times to restore their bowel pattern,” says Dr Shah. If you need to use it for more than one week, seek medical attention.38

He adds that using a remedy even for a limited time is not a cure for people who have chronic constipation. “Some people are born with a lower density of neurons in their colon and so they don’t have the same number of contractions to move stool and water as most other people do,” he explains.39 They should talk with their health care provider, who may advise taking a daily stool softener or perhaps a prescription laxative.40

What is excessive laxative use?

Your body may become dependent on laxative use over time.41 “Ideally, you’d be using these laxatives only to support you while you’re making some diet or lifestyle changes or evaluating why you’re having constipation,” says Dr. Shah. “If you have an underlying condition that is not reversible, then you may need laxatives more permanently.”42

Dr. Shah adds that, as long as you are not having pain between bowel movements, rectal bleeding, unexplained weight loss, anemia or a low blood count, your body may get back on schedule with just a little help from an occasional laxative.43

“Most of my patients say that when they’re physically active, when they’re hydrating and getting their fiber from food, they don’t have trouble with their bowel,” says Dr. Stein, “and they’ll get into a normal pattern.”44

This content is for informational purposes only and is not medical advice. Consult with your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.