What are the primary uses of Colace stool softener. How long does it take for Colace to work. What are the potential side effects of using Colace. Is Colace safe for pregnant women and children. How should Colace be taken for optimal results. What precautions should be considered when using Colace. Can Colace be used long-term for chronic constipation.

Understanding Colace: A Powerful Stool Softener for Constipation Relief

Colace, also known by its generic name docusate, is a widely used stool softener designed to alleviate occasional constipation and reduce discomfort associated with hard stools. This medication works by increasing the amount of water the stool absorbs, making bowel movements softer and easier to pass. But how exactly does Colace function, and what should users know before incorporating it into their health regimen?

How Does Colace Work?

Colace functions by allowing more water to penetrate the stool, softening it and facilitating easier passage through the intestines. This mechanism of action differs from stimulant laxatives, which work by increasing intestinal contractions. The gentler approach of Colace makes it a preferred option for many individuals seeking constipation relief without the potential urgency or cramping associated with stronger laxatives.

The Versatility of Colace: Uses Beyond Constipation

While primarily known for its constipation-relieving properties, Colace has several other applications in medical settings. Healthcare providers may recommend Colace for various purposes, showcasing its versatility in addressing digestive health concerns.

Secondary Uses of Colace

• Preparation for medical procedures: Colace may be used to empty the bowels before X-rays of the stomach or other diagnostic imaging tests.
• Post-surgical care: Patients recovering from surgery, especially those on pain medications that can cause constipation, may be prescribed Colace.
• Hemorrhoid management: By softening stools, Colace can reduce strain during bowel movements, benefiting those with hemorrhoids.
• Anal fissure prevention: Softer stools can help prevent the development or exacerbation of anal fissures.

Administering Colace: Dosage Guidelines and Best Practices

Proper administration of Colace is crucial for achieving optimal results while minimizing the risk of side effects. Understanding the correct dosage, timing, and method of taking Colace can significantly impact its effectiveness.

How Should Colace Be Taken?

To ensure the best results when using Colace:

1. Follow the prescribed dosage or the instructions on the product label carefully.
2. Take Colace with a full glass of water to enhance its effectiveness.
3. Maintain adequate hydration throughout the day by drinking plenty of fluids.
4. Be consistent with the timing of your doses if taking Colace regularly.
5. Do not exceed the recommended duration of use without consulting a healthcare professional.

Are there specific times of day when Colace should be taken? While Colace can be taken at any time, some users find it most effective when taken before bedtime. This allows the medication to work overnight, potentially resulting in a bowel movement in the morning.

Colace Efficacy: Understanding the Timeline for Relief

One of the most common questions among Colace users is how quickly they can expect to see results. The timeline for Colace’s effectiveness can vary depending on several factors, including individual physiology and the severity of constipation.

How Long Does It Take for Colace to Work?

The onset of action for Colace can differ based on the formulation:

• Oral capsules and liquid forms typically take 1-3 days to produce a bowel movement.
• Rectal suppositories or enemas may work more quickly, often within 20 minutes to an hour.

It’s important to note that while some users may experience relief within 24 hours, others might need to wait up to 72 hours to see the full effects of Colace. Patience is key when using stool softeners, as their gentle action may require more time compared to stimulant laxatives.

Navigating Potential Side Effects of Colace

While Colace is generally well-tolerated, like all medications, it can cause side effects in some individuals. Being aware of these potential reactions can help users make informed decisions about their treatment and know when to seek medical advice.

What Are the Common Side Effects of Colace?

The most frequently reported side effects of Colace include:

• Mild stomach cramps
• Nausea
• Diarrhea
• Throat irritation (from liquid formulations)

These side effects are typically mild and often resolve on their own as the body adjusts to the medication. However, if these symptoms persist or worsen, it’s advisable to consult a healthcare provider.

When to Seek Medical Attention

While rare, some side effects of Colace warrant immediate medical attention. Users should stop taking Colace and contact their doctor if they experience:

• Rectal bleeding
• Severe abdominal pain
• Signs of an allergic reaction (hives, difficulty breathing, swelling of face, lips, tongue, or throat)
• No bowel movement after using the medication for several days

Special Considerations: Colace Use in Pregnancy, Breastfeeding, and Children

The safety of medications during pregnancy, while breastfeeding, and for pediatric use is a critical concern for many. Understanding the appropriate use of Colace in these special populations can help ensure safe and effective treatment.

Is Colace Safe During Pregnancy and Breastfeeding?

Pregnant and breastfeeding individuals should always consult their healthcare provider before using any medication, including Colace. While stool softeners are generally considered low-risk during pregnancy and breastfeeding, individual circumstances may vary. Some key points to consider:

• Pregnancy: Colace is often recommended as a first-line treatment for constipation during pregnancy due to its gentle action and low risk of systemic absorption.
• Breastfeeding: Limited data suggest that Colace is unlikely to harm a nursing infant when used as directed. However, monitoring the infant for potential side effects is advisable.

Can Children Use Colace?

Colace can be used in children, but it’s crucial to follow age-appropriate dosing guidelines and consult a pediatrician before administration. Factors to consider include:

• Age and weight of the child
• Severity of constipation
• Presence of any underlying medical conditions

Parents should not give Colace to children without medical advice, as other interventions (such as dietary changes or increased fluid intake) may be more appropriate initial steps for managing childhood constipation.

Long-Term Use of Colace: Benefits and Risks

While Colace is effective for short-term relief of occasional constipation, questions often arise about its suitability for long-term use. Understanding the potential benefits and risks associated with prolonged Colace use is crucial for making informed decisions about ongoing constipation management.

Can Colace Be Used for Chronic Constipation?

Colace is generally recommended for short-term use, typically no longer than one week without medical supervision. However, some individuals with chronic constipation may be advised to use Colace for extended periods under the guidance of a healthcare provider. Considerations for long-term use include:

• Potential dependency: While Colace does not cause physical dependence, relying on it long-term may mask underlying causes of chronic constipation.
• Electrolyte imbalances: Prolonged use of stool softeners can potentially lead to electrolyte disturbances, particularly in elderly or debilitated patients.
• Reduced natural bowel function: Over time, the body may adapt to the presence of the stool softener, potentially impacting natural bowel function.

For individuals considering long-term use of Colace, it’s essential to work closely with a healthcare provider to monitor efficacy, adjust dosages as needed, and explore alternative or complementary treatments for managing chronic constipation.

Interactions and Precautions: Maximizing Colace Safety and Effectiveness

To ensure the safe and effective use of Colace, it’s important to be aware of potential interactions with other substances and to understand the precautions that should be taken when using this medication.

What Substances Should Be Avoided While Taking Colace?

Certain substances can interact with Colace, potentially affecting its efficacy or increasing the risk of side effects. Key interactions to be aware of include:

• Mineral oil: Using mineral oil concurrently with Colace is generally not recommended unless specifically advised by a healthcare provider. The combination can lead to increased absorption of mineral oil, potentially causing adverse effects.
• Other laxatives: Combining Colace with stimulant laxatives may increase the risk of electrolyte imbalances and dehydration. Always consult a healthcare provider before using multiple laxative products simultaneously.
• Certain medications: Some drugs may interact with Colace, affecting its absorption or efficacy. Always inform your healthcare provider about all medications, supplements, and herbal products you are taking.

Important Precautions When Using Colace

To maximize the safety and effectiveness of Colace treatment, consider the following precautions:

1. Medical conditions: Inform your healthcare provider if you have stomach pain, nausea, vomiting, or a sudden change in bowel habits lasting more than two weeks before starting Colace.
2. Allergies: Do not use Colace if you are allergic to docusate or any of the product’s ingredients.
3. Hydration: Ensure adequate fluid intake while using Colace to support its stool-softening effects and prevent dehydration.
4. Duration of use: Limit use to one week unless otherwise directed by a healthcare provider. Prolonged use may indicate an underlying condition requiring medical evaluation.
5. Rectal bleeding: Stop using Colace and seek immediate medical attention if you experience rectal bleeding.

By adhering to these precautions and being mindful of potential interactions, users can help ensure a safe and effective experience with Colace.

Beyond Medication: Lifestyle Modifications to Complement Colace Treatment

While Colace can be an effective tool for managing constipation, combining its use with lifestyle modifications can enhance its effectiveness and promote overall digestive health. Implementing dietary changes, increasing physical activity, and adopting healthy bowel habits can significantly improve constipation symptoms and reduce reliance on medication.

Dietary Adjustments for Improved Bowel Function

Incorporating the following dietary changes can complement Colace treatment and support regular bowel movements:

• Increase fiber intake: Aim for 25-30 grams of fiber daily through fruits, vegetables, whole grains, and legumes.
• Stay hydrated: Drink at least 8 glasses of water per day to soften stools and promote regularity.
• Limit constipating foods: Reduce consumption of processed foods, dairy products, and foods high in fat and sugar.
• Consider probiotic-rich foods: Yogurt, kefir, and fermented vegetables can support gut health and improve digestion.

Physical Activity and Its Impact on Digestive Health

Regular exercise can stimulate bowel function and complement the effects of Colace. Consider incorporating the following activities into your routine:

• Daily walks: Even short walks can help stimulate bowel movements.
• Yoga: Certain poses can massage the digestive organs and promote regularity.
• Abdominal exercises: Strengthening core muscles can support healthy bowel function.

How does physical activity improve digestive health? Exercise increases blood flow to the digestive tract, stimulates intestinal contractions, and can help reduce stress, all of which contribute to improved bowel function.

Developing Healthy Bowel Habits

Establishing a regular routine for bowel movements can complement the use of Colace and promote long-term digestive health:

1. Set aside time for bowel movements: Try to use the bathroom at the same time each day, preferably after meals when the gastrocolic reflex is strongest.
2. Don’t ignore the urge: Respond promptly to the body’s signals for a bowel movement.
3. Use proper posture: Elevating feet on a small stool while on the toilet can help align the colon for easier elimination.
4. Avoid straining: Use gentle breathing techniques instead of forceful pushing to prevent hemorrhoids and other complications.

By incorporating these lifestyle modifications alongside Colace treatment, individuals can develop a comprehensive approach to managing constipation and promoting overall digestive wellness.

Colace (Docusate Oral/Rectal) – Side Effects, Interactions, Uses, Dosage, Warnings

uses

What is Colace (Docusate Oral/Rectal) used for?

• Constipation

warnings

What is the most important information I should know about Colace (Docusate Oral/Rectal)?

You should not use docusate if you are allergic to it.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

• stomach pain;
• nausea;
• vomiting; or
• a sudden change in bowel habits that lasts over 2 weeks.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

Side Effects

What are the side effects of Colace (Docusate Oral/Rectal)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using docusate and call your doctor at once if:

• you have rectal bleeding;
• no bowel movement occurs after using a laxative;
• you need to use a stool softener for more than 1 week; or
• rash occurs.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Colace (Docusate Oral/Rectal) if I’m pregnant or breastfeeding?

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Interactions

What drugs and food should I avoid while taking Colace (Docusate Oral/Rectal)?

Avoid using mineral oil, unless told to do so by a doctor.

Dosage Guidelines & Tips

How to take Colace (Docusate Oral/Rectal)?

Use Colace (Docusate Oral/Rectal) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Colace (Docusate Oral/Rectal)?

Since docusate is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

Overdose Signs

What happens if I overdose on Colace (Docusate Oral/Rectal)?

If you think you or someone else may have overdosed on: Colace (Docusate Oral/Rectal),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Colace (Docusate Oral/Rectal), call 911

911

What to Expect

The liquid and capsule forms of docusate typically take about one to two days to work. Docusate enemas usually take effect within 20 minutes.

It’s best to use this medicine only for short periods of time. Let your doctor know if you’re still constipated after one week.

Secondary Uses

Your doctor may recommend docusate for other uses. For example, it’s sometimes given to empty the bowels before an X-ray of the stomach.

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Colace: Side Effects, Uses, & Dosage

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Generic name: docusate [ DOK-ue-sate ]
Drug class: Laxatives

Medically reviewed by Philip Thornton, DipPharm. Last updated on Mar 3, 2022.

What is Colace?

Colace is a stool softener. It makes bowel movements softer and easier to pass.

Colace is used to treat or prevent occasional constipation, and to reduce pain or rectal damage caused by hard stools or by straining during bowel movements.

Colace may also be used for purposes not listed in this medication guide.

Warnings

You should not use Colace if you have a blockage in your intestines.

Do not use Colace while you are sick with nausea, vomiting, or severe stomach pain.

You should not use docusate if you also use mineral oil, unless your doctor tells you to.

Before taking this medicine

You should not use Colace if you are allergic to docusate.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

How should I use Colace?

Use Colace exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Take this medicine with a full glass of water. Drink plenty of liquids while you are taking this medicine.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Colace generally produces bowel movement in 12 to 72 hours. Call your doctor if your symptoms do not improve after 72 hours.

You should not use this medicine for longer than 1 week, unless your doctor tells you to. Call your doctor if your symptoms do not improve, or if you have not had a bowel movement within 1 to 3 days. Overuse of a stool softener can lead to serious medical problems.

Store at room temperature away from moisture, light, and heat. Do not freeze liquid medicine.

Dosing information

Usual Adult Dose for Constipation:

50 to 300 mg daily divided in 1 to 4 doses each day.

Usual Pediatric Dose for Constipation:

Less than 2 years: Check with your doctor.

2 to 12 years: 50 to 150 mg daily divided in 1 to 4 doses each day.

What happens if I miss a dose?

Since Colace is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Colace?

Avoid using mineral oil, unless told to do so by a doctor.

Colace side effects

Get emergency medical help if you have signs of an allergic reaction to Colace : hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if:

• you have rectal bleeding;

• no bowel movement occurs after using a laxative;

• you need to use a stool softener for more than 1 week; or

• if a rash occurs.

Less serious Colace side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Colace?

Other drugs may interact with docusate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Popular FAQ

Any drug that is classified as an “opioid” can cause constipation. Examples of commonly prescribed opioids that may cause this side effect include morphine, tramadol, fentanyl, methadone, hydrocodone, codeine and oxycodone. Continue reading

More FAQ

• What is the maximum dosage for Colace stool softener at one time?

References

1. Colace Product Label

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Professional resources

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Related treatment guides

• Constipation

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Colace only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Copyright 1996-2023 Cerner Multum, Inc. Version: 5.01.

top 12 rating according to KP

Constipation (which is what doctors officially call constipation) indicates problems in the gastrointestinal tract. If the process becomes chronic, then this is already a serious cause for concern. Obviously: it’s time to see a doctor, because the problem cannot be solved by auxiliary drugs alone.

Treatment of chronic constipation should be complex. It is necessary to change the lifestyle – increase physical activity, reconsider the nature of nutrition, accustom yourself to the optimal water regime, and, of course, choose medications together with the doctor.

To combat constipation, a number of drugs are used that help soften the intestinal contents and increase its volume, increase peristalsis and facilitate the process of defecation. Our top 12 best laxatives for colon cleansing combines remedies with different mechanisms of action. The rating includes syrups, tablets, capsules and powders for oral solution preparation. The drugs in the rating are divided into groups according to the active substance.

Top 12 ranking according to KP

Important! Any drugs and dietary supplements have side effects and contraindications. Our list is an overview and does not serve as a guide to action. Before using any drug, consult your doctor.

Lactulose products

Lactulose is a synthetic disaccharide that is not absorbed in the intestines, but serves as food for beneficial bacteria living there. These bacteria break down lactulose into lactic, formic and acetic acids, as a result, the contents of the intestine “acidify” and begin to attract water. This increases the osmotic pressure, the stool becomes softer, and the peristalsis of the colon increases ¹ . All this contributes to the gentle cleansing of the intestines.

But it is important to know that lactulose has a very low level of evidence.

Duphalac

Lactulose syrup at a dosage of 667 mg/ml is packaged in individual sachets. Each sachet contains 15 ml of the drug, in total there are 10 sachets in the package. But the manufacturer also offers other forms of release: bottles containing 200, 500 and 1000 ml of syrup. These packages come with a measuring cup.

The preparation is a viscous liquid which may be colorless, yellowish or yellow-brown. It has no smell, and the taste is slightly sweet due to the presence of sugars in the composition. “Duphalac” is indicated for use in constipation, hepatic encephalopathy and for softening stools for medical purposes. It is allowed to use during pregnancy and lactation, as well as in childhood.

Contraindications : galactosemia, galactose and fructose intolerance, individual hypersensitivity to the components, obstruction of the gastrointestinal tract, perforation of the digestive tract or the threat of its occurrence. A complete list of contraindications is in the instructions.

Pros and cons

is suitable for children, pregnant and lactating women.

high price in the segment.

Portalak

Lactulose clear viscous syrup is supplied in 500 ml vials. The syrup has a neutral smell and a sweetish taste. The active ingredient lactulose is an osmotic laxative that increases the volume of fluid in the intestines, helps soften the stool and improve peristalsis. The drug is used in the treatment of chronic constipation, for the treatment and prevention of hepatic encephalopathy, and for diseases that require relief from defecation.

Contraindications : intestinal obstruction, hypersensitivity to lactulose, suspected appendicitis, acute inflammation in the abdominal cavity, rectal bleeding not associated with hemorrhoids, glucose-galactose malabsorption and others. Use during pregnancy and lactation is possible only with the permission of a doctor.

Pros and cons

reasonable price; large bottle.

extensive list of contraindications; in the reviews there are complaints about too sweet taste.

Lactulose

Lactulose syrup appears as a viscous, clear liquid that varies in color from colorless to yellowish brown. Sometimes crystals are visible in the liquid, which dissolve when heated. Release form – individual sachets, which contain 15 ml of syrup. The drug can be used for the prevention and treatment of hepatic encephalopathy, chronic constipation and other diseases and conditions in which defecation is difficult.

Among contraindications indicated intestinal obstruction, individual intolerance to lactulose, suspicion of appendicitis, acute inflammatory diseases of the abdominal cavity, intolerance to galactose and fructose, lactase deficiency and others. Use in pregnant and lactating women is allowed only after consulting a doctor.

Pros and cons

convenient packaging; you can take with you, reasonable price.

many contraindications; may not be available for sale.

Macrogol Laxatives

Macrogol 4000 is an osmotic laxative that increases the water content of the intestinal lumen and thereby increases the volume and softens its contents. Macrogol is not absorbed into the blood and is excreted from the body unchanged. Due to this, preparations with macrogol practically do not have side effects ² .

Like lactulose, macrogol has a very low level of evidence.

Forlax

Macrogol laxative is intended for use in adults and children over 8 years of age and appears as a white powder with a slight citrus scent. The characteristic aroma of the preparation is given by orange and grapefruit oil and concentrated orange juice. A solution for oral administration is prepared from the powder. “Forlax” is used for the symptomatic treatment of constipation, and it is allowed for pregnant and lactating women.

The list of contraindications for includes: individual intolerance to components, total or partial intestinal obstruction or suspected of it, abdominal pain of unknown origin, toxic megacolon, Crohn’s disease and other serious inflammatory bowel diseases, perforation or risk of perforation of the gastrointestinal tract.

Pros and cons

pleasant smell; convenient packaging; availability in pharmacies.

tastes too sweet according to some users.

Lavacol

This drug is a white or off-white powder for oral solution. The composition includes macrogol and electrolytes, including sodium and potassium. Macrogol increases the volume of fluid in the intestines and facilitates defecation, while electrolytes maintain the composition of the blood plasma. The drug can be used for the symptomatic treatment of constipation and bowel cleansing before surgery and endoscopy.

Contraindications : general serious condition of the patient, individual sensitivity to the components, obstruction and obstruction of the gastrointestinal tract, malignant tumors of the colon, perforation of the gastrointestinal tract or the risk of its occurrence, toxic colitis or toxic megacolon and others. Pregnant and lactating women can use the drug after consulting a doctor.

Pros and cons

reasonable price; retail availability.

many contraindications.

Macrogol Lekas ​​

Macrogol laxative is a white powder that is used as an oral solution. The finished solution has a neutral smell and a sweetish taste. Indications for the use of the drug: symptomatic treatment of constipation and bowel cleansing before surgical and diagnostic interventions on the colon.

The contraindication list for includes idiosyncrasy, gastrointestinal obstruction, severe heart failure, dehydration, gastric ulcers, tumors or other conditions involving the colon mucosa, inflammatory bowel disease, and toxic megacolon associated with spastic stenosis. The entire list of contraindications is indicated in the instructions. Use during pregnancy and lactation – only with the permission of a doctor.

Pros and cons

inexpensive drug; convenient packaging.

many contraindications.

Laxatives with hay and sodium picosulfate

These drugs have a stimulating effect on the colonic mucosa, increasing the amount of water and electrolytes in the intestinal lumen. This activates peristalsis and accelerates the passage of feces from the lower gastrointestinal tract ³ . Please note that these drugs are not suitable for long-term use.

Picosulfate has moderate evidence and senna has low evidence.

Guttalax

Sodium picosulfate is available as oral drops. A 30 ml vial contains a clear, colorless or slightly yellowish viscous liquid. The drug is dosed in drops that can be mixed with water or taken in pure form.

“Guttalax” is intended for the treatment of constipation of various origins, including against the background of intestinal atony and hypotension, dysbacteriosis, after taking medications. It can be used for diseases of the gallbladder and irritable bowel syndrome, which are accompanied by constipation.

Contraindications : obstructive bowel disease, intestinal obstruction, intolerance to drug components, severe dehydration, abdominal pain with nausea and vomiting, acute inflammatory bowel disease and others.

Pros and cons

handy dispenser; economical consumption.

a large list of contraindications and possible side effects.

Senade

Herbal laxative contains dry extract of senna leaves. The active substance is able to irritate the receptors of the large intestine and thereby enhance its peristalsis. Tablets are recommended for constipation associated with atony and weak intestinal motility, as well as for regulating stool in certain diseases: hemorrhoids, proctitis, anal fissures.

Suitable for adults and children over 6 years of age, use with caution during pregnancy and lactation.

Contraindications : spastic constipation, abdominal pain of unknown origin, intestinal obstruction, peritonitis, strangulated hernia, cystitis, gastrointestinal and uterine bleeding, hypersensitivity to components, water and electrolyte imbalance.

Pros and cons

inexpensive drug; herbal ingredients.

long-term use may cause flatulence and abdominal pain.

Regulax Picosulfate

As the name implies, the drops contain sodium picosulfate, a laxative that has a stimulating effect on the colonic mucosa and causes the accumulation of water and electrolytes in it.

The drug facilitates defecation and is used to treat constipation associated with medication, intestinal atony and hypotension, and some diseases: diseases of the gallbladder and biliary tract, irritable bowel syndrome.

Contraindications : acute inflammatory bowel disease, severe dehydration, acute abdominal disease or severe abdominal pain, intestinal obstruction, intolerance to components and fructose.

Pros and cons

neutral odor and taste; convenient dosing.

waste packaging.

Laxatives with psyllium

Psyllium is the seed coat of psyllium ovata or Plantago ovata. This shell consists of almost 80% soluble fiber, which, when it enters the intestines, attracts moisture, swells and acquires the consistency of a gel. Due to this, the volume of intestinal contents increases, and it freely leaves the body in a natural way. In addition, psyllium serves as food for beneficial intestinal microflora and helps to avoid dysbacteriosis ⁴ .

Drink plenty of water while taking psyllium medications. It is worth noting that psyllium has a low level of evidence.

Phytomucil Norm

This dietary supplement contains 2 active ingredients – psyllium husk and plum fruit pulp. Soluble psyllium fiber helps form soft stools and aids in bowel cleansing. Homemade plum fruits contain insoluble dietary fiber – they stimulate the mucous membrane of the colon and improve its peristalsis.

BAA is produced in the form of granules, which are packaged in individual sachets of 5 g. The bioadditive is indicated for use as an additional source of fiber and flavonoids for constipation, irritable bowel syndrome with a predominance of constipation, hemorrhoids, rectal fissures.

Among the contraindications for are individual intolerance, acute inflammatory diseases and obstruction of the gastrointestinal tract, children under 3 years of age. The dietary supplement is approved for use in pregnant and lactating women.

Pros and cons

2 active ingredients; can be for children from 3 years old, women during pregnancy and lactation.

high price in the segment; small package size.

Psyllium

Dietary supplement in the form of capsules contains psyllium husks in the amount of 750 mg. The dietary supplement serves as a source of soluble and insoluble dietary fiber, which increases stool volume and stimulates intestinal contractility. Also, Psyllium can be an additional source of dietary fiber for people who suffer from constipation and follow a diet low in fiber.

Contraindications : individual intolerance, pregnancy and lactation, age under 18 years.

Pros and cons

high content of psyllium in 1 capsule.

small package.

Psyllium Husks Fiber

A dietary supplement from a popular brand is available in the form of capsules, each containing 500 mg of psyllium. The dietary supplement is intended to improve intestinal motility, as it helps to increase the volume of intestinal contents and make it softer. After entering the digestive tract, the dietary fibers of psyllium “swell” – the manufacturer reports that this allows you to create a feeling of satiety and reduce the number of absorbed calories.

BAA is not recommended to be taken during pregnancy and lactation, as well as in case of individual intolerance and under the age of 18 years.

Pros and cons

well-known manufacturer; big package.

is sometimes out of stock.

How to choose a laxative for colon cleansing

– Of course, anyone can choose a laxative for themselves – after all, prescriptions are not required for them. But it is better to entrust this to a specialist, – emphasizes gastroenterologist Liliya Sagdutdinova . – Only a doctor, taking into account his education and experience, can choose the most effective medicine for a particular patient from a number of good drugs.

If you dare to solve the problem yourself, it is very important to first study the list of contraindications indicated in the instructions. Ignoring this is fraught with serious consequences.

What if the laxative doesn’t help?

– For patients who do not respond well to laxatives, a prokinetic 5-HT4 agonist is recommended. In general, to avoid problems with constipation, you need to move more (at least walk – at least 60 minutes a day), drink more water (30 ml per 1 kg of body weight), and add foods consisting of insoluble dietary fiber to the diet – for example, wheat bran, our expert adds.

Photo: market.yandex.ru, KP

Sources:

1. Clinical aspects of the use of lactulose in the practice of a gastroenterologist. I. G. Fedorov, L. Yu. Ilchenko, S. D. Kosyura, M. A. Chichkina.
   https://cyberleninka.ru/article/n/klinicheskie-aspekty-primeneniya-laktulozy-v-praktike-gastroenterologa/viewer
2. Evaluation of the efficacy of macrogol in chronic functional constipation. S. D. Kosyura, Z. R. Shcherbova. Medical business. 2018 year. https://cyberleninka.ru/article/n/otsenka-effektivnosti-makrogola-pri-chronicheskom-funktsionalnom-zapore/viewer
3. Possibilities of using sodium picosulfate in the pharmacotherapy of constipation in functional bowel disorders. 2019 year. V. N. Drozdov, K. I. Karnoukh, S. Yu. Serebrova, I. A. Komissarenko, A. K. Starodubtsev v-farmakoterapii-zaporov-pri-funktsionalnyh-rasstroystvah-kishechnika
4. Impaired bowel function in patients with metabolic syndrome. I. A. Komissarenko, S. V. Levchenko. 2022 https://cyberleninka.ru/article/n/narushenie-funktsii-kishechnika-u-patsientov-s-metabolicheskim-sindromom/viewer
5. Chang L et al. American Gastroenterological Association-American College of Gastroenterology clinical practice guideline: Pharmacological management of chronic idiopathic constipation. Gastroenterology 2023 Jun; 164:1086

Laxatives for constipation | Microlax

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Laxatives for constipation

Contents

• Stimulant laxatives
• Bulking agents
• Emollients
• Microclysters

Stool retention is common in both sexes and in all age groups ² . According to various sources, from 2 to 27% of the population ¹ suffer from it, and there is a trend towards an increase in the prevalence of constipation among young people ² . There are no exact statistics in Russia, because not everyone reports such a delicate problem to the doctor ¹ .

Constipation can be a symptom of a specific medical condition. If, after examination, no changes in the intestines or other organs can be found, constipation is considered a primary violation ¹⁶ .

To restore the regularity of the stool, you need to change the diet, drink enough fluids and increase physical activity ⁴ .

If these methods fail, laxatives are used as symptomatic treatment ² .

They are prescribed to cleanse the intestines, removing from it dense stools that are difficult to pass.

Also, laxatives help restore regular and painless stools, make them soft and prevent the occurrence of “fecal blockage” ^1,3,11 .

Laxatives with different mechanisms of action are presented on the pharmaceutical market today. But for convenience they are divided into 3 large groups ^{1, 3} :

• Stimulating;
• Increasing the volume of intestinal contents;
• Stool softeners.

Each group is suitable for a specific problem that has led to constipation ³ . We will deal with all this diversity in the article.

Stimulant laxatives

Peristalsis stimulants (intestinal contractions) – irritants that act on the nerve endings in the intestinal mucosa ^3,4,5,6,7 .

Drugs with an irritating effect may affect different parts of the digestive tract ^3,4,5 :

• small intestine – area of ​​action of castor oil and laxative resins;
• Colon activity is increased by senna, buckthorn, rhubarb, sulfur, sodium picosulfate and diphenylmethane derivatives.

They also produce drugs that are converted to their active form by intestinal enzymes, so they “work” in both the small and large intestines ^3,4,5,6 .

It is important to remember that the abuse of stimulant laxatives can cause side effects:

Diarrhea with cramping pain in the abdomen. Due to diarrhea, the body loses the potassium, sodium and chloride ions it needs.

With their deficiency, general weakness worries, and due to an imbalance of ions, there is a possibility of arrhythmias and a decrease in blood pressure ^5.16

The “lazy bowel” phenomenon “Lazy” refers to the large intestine, which has turned into an enlarged tube that has lost its tone. Without taking large doses of laxatives, it is not able to contract and move feces. This often happens if the drug accumulates in the colon mucosa and its nerve plexuses, and then destroys the smooth muscles that push the feces ^1,5,16

The “lazy bowel” syndrome is manifested by the progression of constipation, which is difficult to correct ^2.5 . Due to rapid tolerance ⁷ peristalsis stimulants are not recommended for more than 14 days ^5.16 .

Bulking agents

Bulk laxatives retain water, swell and stretch the intestinal walls with increased volume. Excessive stretching triggers peristalsis and bowel movement is accelerated ¹⁷ .

This group of drugs includes ^3.16 :

• dietary fiber;
• osmotic laxatives – macrogol, lactulose, salts.

The listed drugs are difficult to digest, and some are not digested at all, so they are practically not absorbed through the mucous into the blood ¹⁷ .

Dietary fiber

Dietary fiber (fiber) is found in bran, seaweed, psyllium and flax husks ¹⁴ . They are also found in vegetables and fruits. Fiber is able to swell in the intestinal lumen, increasing the mass of feces, which mechanically irritates the intestinal wall ^3.7 . But the effect is manifested immediately, and after 10 days, sometimes the result has to wait up to 3 weeks ⁶ .

To get a laxative effect when using dietary fiber, do not forget to drink enough water ³ – 1.5-2 liters per day ¹⁷ , because to increase the volume of feces, fiber must absorb a lot of liquid ^{3. 7} .

When choosing between wheat bran and psyllium, be aware that wheat bran can cause flatulence ^7.16 . Therefore, the elderly are advised to use psyllium seeds, which are better tolerated ¹⁶ .

Macrogol

Products based on polyethylene glycol (macrogol) are poorly absorbed substances ^6.9 . Due to this property, they are able to retain fluid in the intestinal lumen ^7.9 .

Macrogol does not cause dehydration, but only slows down the absorption of water ¹⁴ . After taking a laxative, the stool becomes thinner, its consistency improves, and the frequency of bowel movements increases ⁷ .

The disadvantage of macrogol is a rather slowly developing effect and intestinal hypotension ¹ , and the main side effect is potentiation of fecal incontinence ⁷ . According to the instructions, the recommended duration of macrogol intake is up to 14 days ⁸ .

Saline laxatives

Concentrated salts – magnesium sulfate, sodium sulfate, Karlovy Vary salt ^{8, 9} – act at the level of the small intestine and increase the osmotic pressure in it ¹⁷ . On the one hand, this attracts liquid into the intestinal lumen ^1,4,5,6,7 , and on the other hand, it retains water in it ^7.8 .

Under the influence of salts, the feces become liquid, as in diarrhea, and are easily excreted ^,8,17 .

But it is precisely because of severe diarrhea that saline laxatives are not suitable for long-term use. With the constant release of loose stools, water and ion imbalances may occur ¹⁷ . Also, these drugs are not recommended for people with kidney and heart diseases, because salts can be absorbed into the bloodstream in a minimal amount and retain water in the body ¹⁴ . When using Karlovy Vary salt, its unpleasant taste can become a problem for patients ⁸ .

Lactulose

Lactulose does not have a direct laxative effect, but with the help of beneficial bacteria. Using it as food ^{10, 13} , bifidobacteria and lactobacilli living in the intestines secrete substances that act like osmotic laxatives ^7,10,13,17 . But at the same time, severe diarrhea does not occur, because lactulose “works” exclusively in the large intestine ^15.17 .

The laxative effect of lactulose develops gradually:

with a single dose after 24-48 hours;

systemically – after 2-4 hours ¹⁵

Since lactulose is not digested, it is practically not absorbed and has no systemic side effects ¹⁵ . Sometimes, with an incorrectly selected dose against the background of the use of the drug, bloating may disturb ^15.17 .

Emollients

These constipation medicines include glycerin, almond oil, liquid paraffin, sodium docusate ^2,7,8 . They contribute to the impregnation of stool with water, increasing the volume of intestinal contents and softening its consistency. In addition, stool softeners lubricate the intestinal mucosa. Currently, drugs in this group have a limited set of indications due to side effects (loss of fat-soluble vitamins) ^6.7 .

Watch in our video which laxative to choose for constipation: tablets, syrup or microclysters

Microclysters

For emergency bowel relief from hard stools, laxatives in the form of microclysters can be used ¹² . This form includes drugs with a combined mechanism of action, that is, working “together”. They calpeptize (break down dense masses), increase its volume and make it soft ^2.11 .

Microenemas are also used to correct constipation associated with lazy bowel syndrome ² .

Micro enema MICROLAX ^® acts locally and has a mild laxative effect due to the presence in its composition ¹¹ :

• sodium citrate , which displaces bound water from the fecal lump;
• sodium lauryl sulfoacetate which loosens stools;
• sorbitol , which increases the flow of water into the intestinal lumen.

Using MICROLAX ^® is easy, no special knowledge or training is required ¹¹ . The tube with a tip contains the necessary single dose of the drug, and the micro enema format facilitates the use of a laxative drug, including in the “fecal plug” or preparation for the study of the rectum ¹¹ .

MICROLAX ^® is approved for use in adults and children from birth ¹¹ . It acts only on the feces, softens them and facilitates bowel movements ¹¹ . At the same time, the drug is not addictive and does not affect the function of other parts of the gastrointestinal tract.

Remember that laxatives do not eliminate the cause of constipation, they only reduce unpleasant symptoms. Their independent, prolonged or uncontrolled intake may aggravate the course of the causative disease, if stool retention is one of its manifestations ² .

All laxatives should be taken only after consulting a doctor. To get rid of constipation comfortably and effectively, be sure to be examined by a general practitioner or gastroenterologist. Only a specialist will be able to take into account all contraindications, the risk of side effects and prescribe medications so that they are not addictive.

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Dealing with constipation requires patience and a holistic approach. Lifestyle changes, dietary modifications, and physical activity can help restore stool regularity ² . It is important to follow the recommendations of a specialist, and if necessary, use laxatives prescribed by a doctor.

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

Literature

1. Minushkin O.N. Functional constipation: dynamics of representations, diagnostics, some therapeutic approaches. Medical advice. 2017; 20:92-95
2. Turchina M.S. The use of a complex laxative in the treatment of chronic constipation. Medical advice. 2017; 5:77-79
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4. Plotnikova E.Yu., Krasnov K.A. Constipation needs to be treated. Medical advice. 2018; 14:61-66
5. Stepanov Yu. M., Vlasova O.N. et al. Negative effects of abuse of laxatives in medical practice. gastroenterology. 2018; 52(3): 168-173
6. Luzina E.V. Safety of the use of laxatives. Russian medical journal. 2014; 5:41-44
7. Parfenov A.I. Three variants of pathogenesis and therapy of chronic constipation. Gastroenterology. 2012; 3:7-19
8. Plotnikova E.Yu. Modern concepts of constipation. Attending doctor. 08/2015
9. Pharmacology of drugs that affect the function of the digestive system: textbook A.N. Leventa, L.B. Kuklina, S.G. Alexandrov, N.V. Verlan, L.O. Hutsol, I.Zh. Seminsky, O.V. Shabaturova; GBOU VPO IGMU of the Ministry of Health of Russia – Irkutsk, 2013. -112 p.102-103
10. World Gastroenterological Organization Global Practice Guidelines. Probiotics and prebiotics. 2017 – 37s.
11. Instructions for use MICROLAX ^® microclysters. // Reg. number P N011146/01 // GRLS RF. – URL: https : //grls . rosminzdrav . ru/Grls_View_v2.aspx?routingGuid=f052fb31-5426-4bc1-958f-9fce793aa43f&t= (accessed 05.05.2010).
12. Erdes S.I., Matsukatova B.O. and others. Episodic and chronic constipation in children: a stepwise approach to therapy within the Rome IV criteria. Pediatrics. Consilium Medicum. 2019; 1: 71-76
13. Constipation in young children: causes and features of dietary correction O.N. Komarova, A.I. Khavkin (Issues of modern pediatrics. 2014; 13 (1): 114–118
14. Clinical guidelines. Constipation in adults (as a manifestation of systemic diseases). Scientific Society of Gastroenterologists of Russia (NOGR), Russian Scientific Medical Society of Therapists (RNMOT) — 2019
15. Lactulose: arguments and facts. Yu.O. Shulpekov. EFFECTIVE PHARMACOTHERAPY. Gastroenterology. 5/2011 – S. 28-71.
16. Clinical guidelines: Constipation / Russian Gastroenterological Association. Association of Coloproctologists of Russia – 2020.
17. Minushkin O.N. 1, Elizavetina G.