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Different Types of Laxatives: How They Work, Onset Times & Which to Choose

MiraLAX Gentle Constipation Relief Laxative

Laxatives are a type of medication widely used to alleviate constipation, a common gastrointestinal issue that many people experience at some point in their lives. They work by facilitating bowel movements, making it easier to pass stools. Laxatives are beneficial for individuals who struggle with irregular bowel movements or those who experience discomfort due to hard stools.

The top 9 Laxatives

Product name	Pros	Cons	More information
TOP PICK MiraLAX Gentle Constipation Relief Laxative	Gentle on the stomach Mixes easily with liquids without altering the taste Effective for occasional constipation	May not work immediately Can be expensive Not suitable for frequent use	Coming Soon!
BUDGET PICK Colace 2-In-1 Stool Softener & Stimulant Laxative	Gentle stool softener, good for preventing straining Often recommended for post-surgery or postpartum use Less likely to cause cramping Reports of decades long customers of this product are common	Slower acting Not effective for immediate relief May require increased fluid intake	Coming Soon!
AMAZONS PICK Senokot Extra Strength Natural Vegetable Laxative	Natural ingredient (senna) Effective for gentle overnight relief Can be used for occasional constipation	May cause stomach cramps Not suitable for chronic use Can interact with certain medications	Coming Soon!
Dulcolax Stimulant Laxative	Fast-acting, usually works overnight Comes in various forms (tablets, suppositories) Helpful for severe constipation	Can cause stomach cramps Not recommended for long-term use May cause dependency if overused	Coming Soon!
ex-lax Maximum Strength Stimulant Laxative	Effective for relieving constipation Available in different strengths Can be used for children (in appropriate doses)	May cause diarrhea if overdosed Can lead to stomach discomfort Not for long-term use	Coming Soon!
Phillips’ Milk of Magnesia Liquid Laxative	Effective for quick relief Also works as an antacid Gentle on the stomach	Can cause diarrhea Not recommended for kidney patients Can interfere with the absorption of other medications	Coming Soon!
Fleet Laxative Saline Extra	Rapid action, usually works within minutes Effective for severe constipation Easy to use	Can be uncomfortable to administer Not for frequent use May cause electrolyte imbalance	Coming Soon!
Metamucil, Daily Psyllium Husk	Natural fiber supplement Good for long-term use Benefits overall digestive health	Slow acting, more of a long term solution Requires sufficient water intake Can cause gas or bloating	Coming Soon!
Prunelax Ciruelax Natural Laxative	Natural ingredients Effective for gentle overnight relief Also provides the nutritional benefits of prunes	May cause cramping Not for long-term use	Coming Soon!

How the Top Laxative Supplements Compare

Product	Type	Key Ingredients	Serving Size	Action Time	Additional Benefits	Gluten-Free	Non-GMO
TOP PICK MiraLAX Gentle Constipation Relief Laxative	Powder	Polyethylene Glycol 3350	1 Capful	12-72 Hours	Gentle, No Cramping	Yes	Yes
BUDGET PICK Colace 2-In-1 Stool Softener & Stimulant Laxative	Capsules	Docusate Sodium, Senna	1-2 Capsules	6-12 Hours	Softens Stool & Stimulates	Yes	Yes
AMAZONS PICK Senokot Extra Strength Natural Vegetable Laxative	Tablets	Senna Extract	2 Tablets	6-12 Hours	Derived from Natural Vegetables	Yes	Yes
Dulcolax Stimulant Laxative	Tablets	Bisacodyl	1-3 Tablets	6-12 Hours	Overnight Relief	Yes	Yes
ex-lax Maximum Strength Stimulant Laxative	Tablets	Senna	2 Tablets	6-12 Hours	Maximum Strength Relief	Yes	Yes
Phillips’ Milk of Magnesia Liquid Laxative	Liquid	Magnesium Hydroxide	30 mL	6-12 Hours	Soothing, Gentle	Yes	Yes
Fleet Laxative Saline Extra	Liquid	Sodium Phosphates	118 mL	5-15 Minutes	Fast Relief	Yes	Yes
Metamucil, Daily Psyllium Husk	Powder	Psyllium Husk	1 Scoop	12-72 Hours	Supports Digestive Health	Yes	Yes
Prunelax Ciruelax Natural Laxative	Tablets	Senna, Prune Extract	2 Tablets	6-12 Hours	Natural Herbal Formula	Yes	Yes

What is the purpose of Laxatives?

The primary function of laxatives is to soften the stool, increase stool volume, or stimulate intestinal muscle contractions, which assists in promoting bowel movements. They come in various forms, including oral tablets, capsules, liquids, powders, and suppositories, offering a range of options depending on the user's preference and specific needs.

There are several types of laxatives, each working in a unique way. Bulk-forming laxatives, such as psyllium, are high in fiber and work by increasing the water content and size of the stool, making it softer and easier to pass. Stimulant laxatives, like bisacodyl and senna, trigger rhythmic contractions in the intestines, helping to move the stool along. Stool softeners, such as docusate, add moisture to the stool, making it softer and less painful to pass. Osmotic laxatives, including polyethylene glycol, draw water into the bowels from surrounding tissues, softening the stool and stimulating bowel movements. Lubricant laxatives, like mineral oil, coat the stool's surface, helping it retain moisture and pass through the intestine more smoothly.

Laxatives are not only used for treating constipation but are also often recommended in preparation for certain medical procedures, such as colonoscopies, to ensure that the bowel is empty. They can be particularly useful for individuals recovering from surgery, women post-pregnancy, or those taking certain medications that can cause constipation as a side effect.

The History of Laxatives

The use of substances to alleviate constipation dates back to ancient civilizations. In these early times, various natural remedies were employed, ranging from herbal concoctions to dietary modifications.

Fast forward to the 19th century, a notable development in the world of laxatives was the creation of Beecham's Pills. Invented around 1842 in Wigan, Lancashire by Thomas Beecham, these pills contained a blend of aloe, ginger, and soap. Initially marketed as a general cure-all, they gained recognition for their effectiveness in aiding digestion. Beecham's Pills were just the beginning of what would become a global pharmaceutical empire.

Another significant advancement came in the early 20th century with the invention of Ex-Lax in 1906. Created by Max Kiss, a Hungarian immigrant in the United States, Ex-Lax was a chocolate-flavored laxative containing phenolphthalein as its active ingredient. This product marked a shift towards more palatable and consumer-friendly laxative options, leading to the widespread popularity of Ex-Lax.

The concept of laxatives evolved further in the 20th century with an increased understanding of the body's digestive processes and the development of more sophisticated pharmaceutical compounds. This period saw the introduction of various types of laxatives, such as bulk-forming agents, stool softeners, osmotic agents, and stimulant laxatives, each working through different mechanisms to alleviate constipation.

Today, laxatives continue to be an important part of medical treatments, providing relief for those suffering from temporary or chronic constipation. Their history reflects not only the growth of medical science but also the changing perceptions of health, wellness, and the importance of digestive health.

Ingredients of Laxatives

Laxatives, used to relieve constipation, come in various types and formulations. The active ingredients in laxatives depend on their specific type and mechanism of action:

Bulk-forming Laxatives: These contain soluble fibers that absorb water in the intestine, increasing stool bulk and promoting bowel movements. Common ingredients include psyllium (found in products like Metamucil), methylcellulose (found in Citrucel), and polycarbophil (found in FiberCon and Equalactin).
Stool Softeners (Emollient Laxatives): These laxatives soften the stool by increasing water content. Docusate sodium (found in Colace and Diocto) and docusate calcium (found in Surfak) are typical ingredients.
Lubricant Laxatives: These laxatives help the stool retain moisture and pass more easily through the intestine. Mineral oil is a common ingredient.
Stimulant Laxatives: These substances stimulate bowel movements by acting on the intestinal lining. Common ingredients include bisacodyl (in Dulcolax and Correctol) and senna compounds (in Senokot and Ex-Lax).
Osmotic and Hyperosmotic Laxatives: These draw water into the intestines to soften the stool. Ingredients include polyethylene glycol (in MiraLAX), lactulose, and magnesium-based compounds like magnesium citrate and magnesium hydroxide (milk of magnesia).
Saline Laxatives: Similar to osmotic laxatives, saline laxatives also attract and retain water in the intestines. Ingredients may include magnesium sulfate (Epsom salts), magnesium citrate, and sodium phosphate.
Chloride Channel Activators: These increase intestinal fluid and motility. An example is lubiprostone (Amitiza).
Serotonin Agonists: These enhance intestinal movement through activation of 5-HT4 receptors. An example is prucalopride (Resolor, Motegrity).

Who should take Laxatives

Laxatives are typically used by various groups of individuals under specific circumstances:

People with Occasional Constipation: Individuals experiencing temporary constipation due to changes in diet, lifestyle, medication, or travel may benefit from laxatives to alleviate symptoms.
Patients with Chronic Constipation: Those suffering from chronic constipation, possibly due to medical conditions, aging, or certain medications, might use laxatives as part of their management plan.
Preparation for Medical Procedures: Laxatives are often prescribed to patients preparing for medical procedures such as colonoscopies, to ensure the bowel is empty and clear.
Individuals with Certain Digestive Disorders: People with specific digestive issues that cause constipation may be advised to use laxatives under medical supervision.

However, laxatives should be used cautiously and are generally not recommended for certain individuals without a doctor's approval. This includes people with certain gastrointestinal conditions like inflammatory bowel disease, bowel obstruction, or those experiencing abdominal pain of unknown cause. Pregnant or breastfeeding women should also consult their healthcare provider before using laxatives.

What Laxatives are NOT intended for

Certain individuals should avoid or use laxatives with caution, as their use might be inappropriate or potentially harmful in some conditions:

People with Gastrointestinal Disorders: Individuals with certain gastrointestinal conditions like Crohn's disease, ulcerative colitis, or irritable bowel syndrome should use laxatives only under medical supervision, as they can worsen these conditions.
Those with Bowel Obstruction: Laxatives should not be used by people with suspected bowel obstruction, as they can exacerbate the problem and lead to complications.
Individuals with Severe Dehydration: Those who are severely dehydrated should avoid laxatives, especially osmotic and saline types, as they can increase dehydration.
Patients with Abdominal Pain or Nausea: If the cause of abdominal pain, nausea, or vomiting is unknown, laxatives should be avoided until a healthcare provider has made a diagnosis.
Children: The use of laxatives in children should be under strict medical guidance, as their bodies can react differently to these medications compared to adults.
Pregnant or Breastfeeding Women: Laxatives should be used with caution during pregnancy or while breastfeeding, as some types may pose risks to the baby.
People with Certain Medical Conditions: Those with heart conditions or kidney disease should consult with a healthcare provider before using certain types of laxatives, as they can affect electrolyte and fluid balance.
After Surgery: Patients who have recently undergone abdominal or bowel surgery should not use laxatives unless prescribed by a healthcare provider.

Pros and Cons of Laxatives

Pros

Relief from Constipation: Laxatives effectively alleviate symptoms of constipation, promoting regular bowel movements.
Variety of Types: Different types are available to suit various needs, from bulk-forming to stool softeners to stimulants.
Quick Relief: Some types provide quick relief, which is beneficial for acute constipation.
Ease of Access: Available over-the-counter, making them easy to obtain without a prescription.
Preparation for Medical Procedures: Essential for bowel preparation before certain medical procedures, like colonoscopies.
Can Aid Digestive Process: In some cases, they help restore the natural movement of the intestines.
Beneficial for Certain Medical Conditions: Helpful for people with specific medical conditions that cause constipation.
Variety of Formulations: Available in various forms, from pills and liquids to suppositories, catering to different preferences.
Nutrient Absorption in Some Types: Bulk-forming types can aid in nutrient absorption and improve gut health.
Psychological Relief: Can provide psychological comfort to those suffering from constipation and its discomfort.

Cons

Risk of Dependency: Overuse can lead to dependency, making it difficult to have bowel movements without them.
Potential for Side Effects: Can cause side effects like bloating, gas, cramping, dehydration, and electrolyte imbalance.
Not a Long-Term Solution: Generally not intended for long-term use except under medical supervision.
Not Suitable for Everyone: May not be appropriate for individuals with certain health conditions like bowel obstruction.
Alteration of Bowel Flora: Overuse might disrupt the natural balance of intestinal flora.
Interaction with Other Medications: Can interact with other drugs, altering their effectiveness.
Risk of Overuse: Easy access can lead to misuse or overuse, leading to further health problems.
Incorrect Use Risks: Misunderstanding the correct type and dosage can lead to complications.
Delayed Effectiveness: Some types, like bulk-forming laxatives, may take several days to work.
Masking Underlying Health Issues: Frequent use may mask underlying health problems that cause constipation.

Studies regarding the benefits of Laxatives

Laxatives for the management of constipation in people receiving palliative care (Cochrane): This study aimed to determine the effectiveness of different laxatives in palliative care. It reviewed various laxatives, including lactulose and senna, but found no clear evidence on whether individual laxatives were more effective or had fewer side effects.

Interventions for treating constipation in pregnancy (Cochrane): This study focused on constipation in pregnancy, comparing stimulant laxatives to bulk-forming laxatives. It found that stimulant laxatives were more effective in improving constipation but also caused more abdominal discomfort and a borderline increase in diarrhea.

Chronic Constipation in Adults (AAFP): This article discusses various interventions for chronic constipation, providing insight into the effectiveness and risks associated with long-term laxative use.

About Senna (NHS): This study examined senna, a natural laxative, noting its effectiveness in treating constipation by stimulating gut muscles. It recommends trying other laxatives first, such as bulk-forming or osmotic types, before using senna.

Frequently Asked Questions about Laxatives

What are laxatives and how do they work?

Laxatives are substances that help stimulate bowel movements or loosen stool to relieve constipation. There are several types of laxatives, each working in different ways:

Bulk-forming laxatives: These absorb water into the stool, making it bulkier and easier to pass.
Stimulant laxatives: These stimulate the muscles of the intestines to move stool through more quickly.
Osmotic laxatives: These draw water into the bowel from surrounding tissues, softening the stool and making it easier to pass.
Stool softeners: These increase the amount of water absorbed by the stool to make it softer and easier to pass.
Lubricant laxatives: These coat the stool and the intestine to make it easier to pass.

When should I use a laxative?

Laxatives should be used when you are experiencing constipation and have not found relief from dietary changes (such as increased fiber intake), hydration, and exercise. They can be particularly useful for short-term relief. However, it is important to use them under the guidance of a healthcare provider, especially if constipation persists for more than a few days, to avoid underlying conditions.

Are there any side effects of using laxatives?

Yes, laxatives can have side effects, especially if used incorrectly or for extended periods. Common side effects include:

Cramping and abdominal pain
Diarrhea
Dehydration
Electrolyte imbalance (particularly with stimulant and osmotic laxatives)
Dependence (with prolonged use of stimulant laxatives, the bowel can become dependent on them to produce movements)

Can I become dependent on laxatives?

Yes, overuse of stimulant laxatives can lead to dependency. This means your bowels might become reliant on laxatives to produce movements, and natural bowel function can be impaired. To avoid this, laxatives should only be used occasionally and as directed by a healthcare provider.

How long does it take for laxatives to work?

The time it takes for laxatives to work depends on the type:

Bulk-forming laxatives: 12 to 72 hours
Stimulant laxatives: 6 to 12 hours
Osmotic laxatives: 30 minutes to 6 hours (some may take 1 to 3 days)
Stool softeners: 12 to 72 hours
Lubricant laxatives: 6 to 8 hours

Can laxatives be used for weight loss?

Laxatives should not be used for weight loss. They primarily affect the large intestine, whereas calorie and nutrient absorption occurs in the small intestine. Therefore, using laxatives for weight loss can lead to dehydration, electrolyte imbalances, and serious health issues without effectively reducing body fat.

Are natural or herbal laxatives safer than synthetic ones?

Natural or herbal laxatives are not necessarily safer than synthetic ones. Both can cause side effects and potential complications. Some natural laxatives, like senna and cascara, are stimulant laxatives and can cause dependency and bowel issues if used long-term. It’s important to consult with a healthcare provider before using any laxative, natural or synthetic.

What are some non-laxative ways to relieve constipation?

Non-laxative methods to relieve constipation include:

Increasing fiber intake: Eat more fruits, vegetables, whole grains, and legumes.
Staying hydrated: Drink plenty of water throughout the day.
Regular exercise: Physical activity helps stimulate intestinal activity.
Establishing a routine: Try to have a bowel movement at the same time each day.
Avoiding constipating foods: Reduce intake of dairy, red meat, and processed foods.

Who should avoid using laxatives?

Certain individuals should avoid using laxatives or use them with caution, including:

Pregnant or breastfeeding women: Some laxatives can be harmful to the baby.
People with certain medical conditions: Conditions like inflammatory bowel disease (IBD), intestinal blockages, or certain heart and kidney conditions.
Individuals with a history of eating disorders: As laxatives can be misused in attempts to control weight.

How should I properly use laxatives?

Using laxatives properly is crucial to ensure safety and effectiveness while minimizing potential side effects. Here are detailed guidelines on how to properly use laxatives:

1. Consult a Healthcare Provider

Before starting any laxative, it’s essential to consult with a healthcare provider, especially if you have underlying health conditions, are pregnant, breastfeeding, or taking other medications.

2. Choose the Right Type of Laxative

Select the type of laxative that best suits your needs:

Bulk-forming laxatives (e.g., psyllium, methylcellulose): Suitable for maintaining regular bowel movements.
Stimulant laxatives (e.g., senna, bisacodyl): For short-term use to relieve occasional constipation.
Osmotic laxatives (e.g., polyethylene glycol, lactulose): For drawing water into the intestines to soften stool.
Stool softeners (e.g., docusate sodium): For making stool easier to pass.
Lubricant laxatives (e.g., mineral oil): For coating the stool and intestines.

3. Follow the Instructions

Dosage: Adhere to the recommended dosage on the product label or as prescribed by your healthcare provider.
Timing: Take the laxative at the time suggested. Some work best at bedtime (e.g., stimulant laxatives) as they can work overnight.
Duration: Use for the shortest period necessary. Prolonged use, especially of stimulant laxatives, can lead to dependency and decreased bowel function.

4. Stay Hydrated

Drink plenty of water when using laxatives, particularly bulk-forming and osmotic types, to help them work effectively and to prevent dehydration.

5. Dietary Considerations

Fiber Intake: Increase dietary fiber gradually through fruits, vegetables, whole grains, and legumes to help maintain regular bowel movements.
Avoid Certain Foods: Limit intake of constipating foods such as dairy, red meat, and processed foods.

6. Monitor for Side Effects

Be aware of potential side effects:

Cramping and Abdominal Pain: Common with stimulant laxatives.
Diarrhea: Can occur if the dosage is too high.
Dehydration: Risk with osmotic laxatives, especially if not enough fluids are consumed.
Electrolyte Imbalances: Monitor especially in the elderly or those with underlying health issues.

7. Gradual Increase in Fiber (for Bulk-Forming Laxatives)

When using bulk-forming laxatives, increase fiber intake gradually to prevent bloating and gas. Ensure adequate fluid intake to help the fiber work effectively.

8. Use the Correct Form

Laxatives come in various forms (pills, powders, liquids, suppositories). Choose the form that is most convenient and comfortable for you to use.

9. Store Properly

Store laxatives as directed, usually in a cool, dry place away from direct sunlight and out of reach of children.

10. Avoid Overuse and Dependency

Short-Term Use: Laxatives should generally be used for short-term relief unless otherwise directed by a healthcare provider.
Alternative Methods: Incorporate lifestyle changes such as regular exercise, adequate hydration, and a high-fiber diet to help maintain regular bowel movements without relying on laxatives.

11. Special Considerations

Pregnancy and Breastfeeding: Some laxatives may not be safe; always consult a healthcare provider.
Chronic Conditions: Individuals with conditions like IBD, heart or kidney issues should use laxatives under medical supervision.

12. Monitor Results and Adjust Accordingly

Effectiveness: If the laxative does not work within the expected time frame, do not take an extra dose. Consult a healthcare provider.
Side Effects: If you experience severe side effects, discontinue use and seek medical advice.

The Different Types of Laxatives, Explained