What are the different types of laxatives. How do laxatives work to relieve constipation. What are the potential side effects of using laxatives. When should you consider using laxatives for constipation relief. How can laxative misuse impact your health.

Understanding Constipation and Its Causes

Constipation is a common digestive issue characterized by infrequent bowel movements and difficulty passing stools. While the “normal” frequency of bowel movements varies from person to person, constipation is generally defined as having fewer than three bowel movements per week or experiencing hard, dry stools that are painful to pass.

There are two main types of constipation:

• Primary constipation: Associated with slow intestinal movements, often due to insufficient fiber intake or dehydration.
• Secondary constipation: Linked to underlying medical conditions or medications.

Several factors can contribute to constipation, including:

• Inadequate fiber intake
• Dehydration
• Lack of physical activity
• Certain medications (e.g., antidepressants, iron supplements, opioids)
• Medical conditions (e.g., diabetes, Parkinson’s disease, multiple sclerosis)
• Eating disorders

The Role of Laxatives in Treating Constipation

Laxatives are medications designed to help relieve constipation by promoting bowel movements. They are available in various forms, including oral liquids, tablets, capsules, and rectal suppositories or enemas. Most laxatives can be purchased over the counter without a prescription, making them a popular choice for managing occasional constipation.

When considering laxative use, it’s important to understand their mechanism of action and potential benefits. Do laxatives provide immediate relief for constipation? While some types of laxatives can work relatively quickly, others may take several days to produce an effect. The speed of relief depends on the specific type of laxative used and individual factors.

Types of Laxatives and Their Mechanisms of Action

There are several types of laxatives, each working in a unique way to alleviate constipation. Understanding these differences can help you choose the most appropriate option for your needs.

1. Bulk-Forming Laxatives

Also known as fiber supplements, bulk-forming laxatives work by increasing the volume and water content of stools. This makes them easier to pass through the intestines. Examples include psyllium, methylcellulose, and polycarbophil.

How long do bulk-forming laxatives take to work? Typically, these laxatives begin to take effect within 12-24 hours after ingestion.

2. Osmotic Laxatives

Osmotic laxatives draw water into the intestines, softening stools and making them easier to pass. Common examples include polyethylene glycol, lactulose, and magnesium citrate.

These laxatives may take 2-3 days to produce noticeable effects.

3. Stimulant Laxatives

Stimulant laxatives work by increasing intestinal contractions, speeding up the movement of stool through the digestive tract. Examples include bisacodyl and senna.

Stimulant laxatives are generally fast-acting, with effects typically occurring within 6-12 hours.

4. Stool Softener Laxatives

These laxatives work by increasing the water content of stools, making them softer and easier to pass. Docusate sodium is a common example.

Stool softeners usually take effect within 12-72 hours.

5. Less Common Laxative Types

Other types of laxatives include:

• Lubricant laxatives: These coat the intestinal walls and stools with a slippery film, making passage easier.
• Saline laxatives: Often used as enemas to empty the bowel before medical procedures.
• Prokinetic laxatives: Used for severe constipation in conditions like irritable bowel syndrome (IBS).

Potential Side Effects of Laxative Use

While laxatives can be effective in relieving constipation, they may also cause side effects. The specific side effects can vary depending on the type of laxative used and individual factors.

Common side effects of laxatives include:

• Bloating and gas
• Abdominal cramps
• Nausea
• Dehydration
• Electrolyte imbalances

Is it possible to minimize laxative side effects? Yes, starting with a low dose and gradually increasing it can help reduce the likelihood and severity of side effects. It’s also important to stay well-hydrated when using laxatives.

Proper Use and Potential Misuse of Laxatives

Laxatives are intended for occasional use to relieve constipation. However, some individuals may misuse these medications, which can lead to serious health consequences.

Proper use of laxatives involves:

1. Using them only as directed for constipation relief
2. Starting with the lowest effective dose
3. Avoiding long-term use without medical supervision
4. Combining laxative use with lifestyle changes (e.g., increased fiber intake, hydration, exercise)

Laxative misuse often involves using these medications for weight loss or as part of disordered eating behaviors. This can lead to various health issues, including:

• Chronic diarrhea
• Dehydration
• Electrolyte imbalances
• Damage to the digestive system
• Dependency on laxatives for bowel movements

Alternatives to Laxatives for Constipation Relief

While laxatives can be effective for occasional constipation relief, there are several natural alternatives and lifestyle changes that can help promote regular bowel movements:

• Increasing dietary fiber intake through fruits, vegetables, and whole grains
• Staying well-hydrated by drinking plenty of water throughout the day
• Engaging in regular physical activity
• Establishing a consistent bathroom routine
• Using natural remedies like prunes or prune juice
• Practicing relaxation techniques to reduce stress

Can dietary changes alone effectively relieve constipation? In many cases, yes. Increasing fiber intake, staying hydrated, and maintaining an active lifestyle can significantly improve bowel regularity without the need for laxatives.

When to Seek Medical Advice for Constipation

While occasional constipation is common and often resolves on its own or with over-the-counter remedies, there are situations where it’s important to consult a healthcare provider:

• Persistent constipation lasting more than two weeks
• Severe abdominal pain or cramping
• Blood in the stool
• Unexplained weight loss
• Alternating constipation and diarrhea
• Constipation accompanied by fever or vomiting

A healthcare provider can help determine the underlying cause of chronic constipation and recommend appropriate treatment options, which may include prescription medications or other interventions.

The Impact of Laxatives on Gut Health and the Microbiome

The use of laxatives, particularly when used frequently or for extended periods, can have effects beyond simply promoting bowel movements. Research has shown that laxatives can influence the delicate balance of bacteria in the gut microbiome.

How do laxatives affect gut bacteria? Some studies suggest that certain types of laxatives, particularly osmotic and stimulant laxatives, may alter the composition of gut bacteria. This can potentially lead to:

• Changes in the diversity of gut microbiota
• Alterations in the production of beneficial short-chain fatty acids
• Potential impact on immune function and overall gut health

While more research is needed to fully understand the long-term effects of laxative use on gut health, these findings underscore the importance of using laxatives judiciously and exploring alternative methods for maintaining regular bowel movements when possible.

Laxatives and Special Populations: Considerations for Children, Pregnant Women, and the Elderly

The use of laxatives requires special consideration in certain populations due to potential risks and differences in metabolism:

Children

Constipation is common in children, but laxative use should be approached cautiously. Are laxatives safe for children? While some laxatives are approved for pediatric use, it’s crucial to consult a pediatrician before administering any laxative to a child. Dosages may need to be adjusted, and certain types of laxatives may not be suitable for young children.

Pregnant Women

Constipation is a common complaint during pregnancy due to hormonal changes and the growing uterus putting pressure on the intestines. While some laxatives are considered safe during pregnancy, others may pose risks. Pregnant women should always consult their healthcare provider before using any laxative.

Elderly Individuals

Older adults are more prone to constipation due to factors such as decreased mobility, medication use, and changes in diet. They may also be more susceptible to the side effects of laxatives. Careful consideration should be given to the type and dosage of laxatives used in this population, and medical supervision is often necessary.

The Future of Constipation Treatment: Emerging Therapies and Research

As our understanding of gut health and the mechanisms underlying constipation continues to evolve, researchers are exploring new approaches to treatment. Some promising areas of research include:

• Probiotics and prebiotics: These may help restore balance to the gut microbiome and improve bowel function.
• Targeted drug therapies: New medications that act on specific receptors in the gut to promote motility are being developed.
• Biofeedback and pelvic floor therapy: These techniques can help individuals with chronic constipation related to pelvic floor dysfunction.
• Fecal microbiota transplantation: While primarily studied for other gastrointestinal conditions, this approach is being explored for certain types of constipation.

What advancements can we expect in constipation treatment? As research progresses, we may see more personalized approaches to treating constipation based on an individual’s gut microbiome profile, genetic factors, and specific underlying causes.

Educating Patients: The Importance of Proper Laxative Use and Bowel Health

Given the potential for misuse and the impact of laxatives on overall health, patient education is crucial. Healthcare providers play a vital role in:

• Explaining the proper use of laxatives, including dosage and duration
• Discussing potential side effects and warning signs
• Emphasizing the importance of lifestyle modifications for long-term bowel health
• Addressing misconceptions about laxative use, particularly in the context of weight loss
• Encouraging open communication about bowel habits and concerns

How can healthcare providers effectively educate patients about laxative use? Utilizing visual aids, providing written materials, and incorporating teach-back methods can help ensure patients understand the proper use of laxatives and the importance of overall bowel health.

By promoting a comprehensive approach to constipation management that includes proper laxative use when necessary, lifestyle modifications, and regular medical follow-up, healthcare providers can help patients maintain optimal digestive health and overall well-being.

Types, side effects, and misuse

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

They are generally used to relieve constipation. Most 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.

Was this helpful?

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:
  • metabolic diseases, such as diabetes
  • neurologic diseases, such as stroke, Parkinson’s disease, or multiple sclerosis
  • connective tissue disorders
  • eating disorders

Some medications can also contribute to constipation. These include:

• antidepressants
• iron
• bismuth
• anticholinergics
• opioids
• antacids
• calcium channel blockers
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• sympathomimetics
• antipsychotics

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:

• flatulence
• cramps in the abdomen
• feeling sick
• bloating
• dehydration, which can cause lightheadedness, headaches, and darker urine

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.

Types, side effects, and misuse

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

They are generally used to relieve constipation. Most 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.

Was this helpful?

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:
  • metabolic diseases, such as diabetes
  • neurologic diseases, such as stroke, Parkinson’s disease, or multiple sclerosis
  • connective tissue disorders
  • eating disorders

Some medications can also contribute to constipation. These include:

• antidepressants
• iron
• bismuth
• anticholinergics
• opioids
• antacids
• calcium channel blockers
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• sympathomimetics
• antipsychotics

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:

• flatulence
• cramps in the abdomen
• feeling sick
• bloating
• dehydration, which can cause lightheadedness, headaches, and darker urine

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.

How does a laxative work, which remedy to choose

What is constipation and why is it
arises?

To begin with, let’s deal with the direct cause of the use of
laxatives – constipation. According to various studies, they
suffer from
30 to 50% of the adult population in the world, with women among these
patients
2 times more than men ¹ .

The term “constipation” doctors characterize various disorders,
associated with
defecation, characterized by a change in the consistency of the stool,
difficulties
during the process, feeling of incomplete emptying of the bowels and
many
others ¹ . Norm for
a healthy person is considered to have a stool frequency from 3 times a day
to 3 times a week ² .

Possible causes of constipation

¹

Sedentary
lifestyle

Concomitant diseases
gastrointestinal tract
and other organs

Psychological disorders

Unbalanced diet
with a minimum amount of vegetable fiber

Taking certain groups of medicines

NB! If you are concerned about constipation, you should consult a doctor for
finding out its causes, type, possible concomitant diseases and
selection
optimal treatment, which includes not only the use of laxatives
drugs, but also lifestyle changes ¹ .

How to choose the right one
laxative drug?

There is no single answer to this question. Because
selection criteria are quite broad – it is desirable that
the drug was produced in a convenient form for taking, not
addictive, acted gently, but at the same time
effectively. And most importantly, it was safe to take,
so that it is suitable even for small children. At present
time the most popular group of laxatives
drugs in Russia are stimulant laxatives,
which include the drug Guttalax®, based on
of which the active ingredient is sodium picosulfate ^{1. 5} .

Guttalax® has a dual mechanism of action: it helps stimulate intestinal motility and helps soften stools ^1.5 . Taking Guttalax® is not addictive, besides, it can be used not in a course, but one-time as needed, when the problem of constipation directly arises. Guttalax® is available in both tablets and drops ⁵ . Drops can be used even for pregnant women from the second trimester and children from the first months of life, but after consulting a doctor, since these groups of patients require special medical attention and weighing the need to take medications ⁵ . In addition, Guttalax® can also be taken by breastfeeding mothers ⁵ .

By the way, choose the most appropriate dose of laxative
convenient
with drops – they are easier to dose, while
laxative
in tablets it is more convenient to take ^{1. 6} . What
As for enemas, they should be used with
caution, because their misuse
can lead to damage to the mucous membrane of the rectum
intestines ⁷ .

Safety of laxatives: a review | Academy Plus

Medical therapy for functional constipation

The main goals in the treatment of functional constipation are ¹ :

• providing painless defecation with soft stools,
• prevention of accumulation of feces.

This can be achieved as a result of a set of activities ² :

0084
• behavior correction,
• dietary changes,
• taking laxatives.

When developing tactics for the treatment of functional constipation, an individual treatment program is extremely important, taking into account the premorbid background and comorbidities.

Groups of drugs for the treatment of constipation in children

Laxatives with different mechanisms of action are presented on the modern pharmaceutical market.

For convenience, they are divided into groups:

1. lubricants ³ ;
2. osmotic agents ² ;
3. stimulants ² ;
4. complex preparations ^2.3 .

Consider contraindications and possible side effects from their use in children.

Absolute contraindications to the prescription of laxatives

³

abdominal pain syndrome of unclear etiology;

condition
“acute abdomen”;

threat of gastrointestinal bleeding, suspicion of occult (hidden) blood loss;

acute toxic and non-toxic megacolon;

paralytic ileus;

phenomena of peritonitis.

Safety of certain groups of laxatives

Group 1

Lubricants

A well-known representative of this group is mineral oil, which softens stool without increasing peristalsis. Mineral oil has features to keep in mind:

Medicine

Side effects ³

Contraindications

Course ⁴

Mineral oil

90 004 Malabsorption of fat-soluble vitamins
Violation of water-salt homeostasis
In case of overdose, leakage from the anus is possible

Children’s age
up to 1 year ³
Should not be taken lying down due to the possible ingress of oil into the respiratory tract with the development of “oil” pneumonia ⁴

Duration of administration no more than 5-10 days due to the likelihood of developing malabsorption syndrome

Group 2

Osmotic laxatives

macrogol – they have the ability to retain water in the intestinal lumen, which leads to an increase in the volume and improvement of the consistency of the stool ^1.2 . This group has no serious side effects ¹ , but not all of its representatives are shown from birth.

Drug

Side effects

Contraindications

Course administration

Lactulose

Flatulence, abdominal pain ³

Galactosemia, galactose or fructose intolerance, lactase deficiency or glucose-galactose malabsorption ⁵

The duration of admission is not limited ³

Laktiol

Flatulence, abdominal pain ³

Children under 1 year of age ³

Duration of administration unlimited ³

Macrogol

Liquid stool, flatulence, abdominal pain, nausea ³

Childhood up to 6 months ³

Duration of use not more than
3 months ³

Group 3

Stimulant laxatives

This class of laxatives has a double effect:

• secretory due to interaction with epithelial structures,
• locally irritating, due to direct stimulation of the synthesis of a number of substances that enhance peristalsis.

In fact, all of these drugs cause short-term, and with long-term use, persistent secretory diarrhea, leading to excessive fluid loss and electrolyte disturbances, primarily hypokalemia ⁶ .

Secretory laxatives are rarely used in pediatric practice ² .

Representatives of the class of stimulant (secretory) laxatives – senna preparations, bisacodyl, sodium picosulfate ² .

It has been proven that drugs of this group should not be used for a long time and regularly!

First of all, this is due to the development of tolerance to therapy:

• after 3 years of constant use of laxatives of this group, the effect is achieved in 73% of patients
• after 5 years – 50%,
• after 10 years – only in 11% of patients ³ .

Also, with the daily intake of drugs of this group, it is not possible to achieve the proper volume of intestinal contents, and this is associated with the appearance of cramping pains in the abdomen, tenesmus ^2.