Overview of laxatives

A person with constipation faces a difficult choice. The range of pharmacy products that help get rid of the problem is simply huge. However, one cannot rely on chance. All drugs have a different mechanism of action, have certain indications and contraindications for taking.

The main disadvantage of all constipation drugs without exception is their symptomatic effect. They help to cope with stool retention, but do not eliminate the cause that provoked it. Therefore, constipation will return after a while.

It is necessary to resort to remedies for constipation with extreme caution. To begin with, it is recommended to find out the cause of the stool retention. Most often, chronic constipation is a consequence of diseases of the digestive system. Such disorders should be treated by a gastroenterologist. The doctor will find out their cause and prescribe specific drugs.

If there is no time to visit a doctor, then you need to try to cope with constipation without medication, following simple recommendations:

• Every morning, immediately after waking up, you need to drink 1 or 2 glasses of water at room temperature. This should be done half an hour before the first meal. You can drink plain or mineral water, but it is important that it is gas-free. This procedure allows you to cleanse the intestines and start metabolic processes in the body.

• To normalize the stool, you need to massage the abdomen. Improves the discharge of feces coffee and honey.

• You need to eat right and lead an active lifestyle. The menu should include cabbage, beets, prunes, apricots. In general, eating raw fruits and vegetables allows the intestines to contract more actively. This is an excellent prevention of constipation.

• It is useful to drink a glass of kefir before going to bed, but it should be fresh.

• Castor oil helps to quickly cope with constipation.

Constipation drugs may have an osmotic or irritant effect, others are prebiotics. There are also fillers available. When choosing a specific drug, you need to decide not only on the mechanism of its action, but also take into account all possible indications and contraindications.

You need to ask the pharmacist how the drug works and what active substance it is based on. Before taking the chosen remedy for the first time, you should read the instructions.

It is not recommended to use laxatives for a long time. If constipation does not go away, you need to contact the doctor and eliminate the causes that led to the violation of the stool.

When a person suffers from chronic constipation, it is recommended to take probiotic preparations. They make the intestines work properly, while restoring the disturbed microflora.

If you need an immediate effect, you need to do an enema. Alternatively, an oil microclyster is used.

Irritant constipation drugs

Irritant laxatives are used by people with stool disorders more often than others. Their selection is huge. These drugs are taken in violation of intestinal motility, with its atony. Medicines from this group include: drops, suppositories, syrups, tablets. An example of such drugs is Sodium picosulfate, Bisacodyl, etc. ^[1].

Many plants have a laxative effect, for example, senna leaves, rhubarb root, buckthorn bark, castor oil. The effect after taking laxatives comes quickly. If you take the drug at night, the chair will happen in the morning.

How do irritant laxatives work? The components that make up laxatives irritate the colon receptors. This causes the organ to contract. Therefore, after a few hours, a person has a stool.

Side effects. Doctors strongly recommend to refrain from regular use of laxatives. Otherwise, the receptors of the large intestine will be exhausted and its tone will decrease. If laxatives are used for longer than 10 days, then a person may develop intestinal atony, the nervous tissue undergoes degeneration, and the electrolyte balance is disturbed.

Laxatives contribute to the rapid development of addiction. The dose that helped to cope with constipation at the initial intake will no longer cause the desired effect. Therefore, it will have to be increased.

Taking irritating drugs leads to intense pain in the abdomen. It is difficult to withstand it, so many patients refuse such treatment.

Contraindications and indications for admission. You can take an irritant laxative, but only if constipation is a one-time occurrence. Chronic stool retention is a contraindication to such treatment.

It is forbidden to take drugs from this group to infants, women during pregnancy and lactation.

Other contraindications include:

• Peritonitis.

• Cystitis.

• Perforation of the digestive organs.

• Inguinal hernia.

• Intestinal obstruction.

• Bleeding (uterine, intestinal, gastric).

• Diseases of the peritoneal organs in the acute phase.

• Anal fissures and hemorrhoids.

• Acute proctitis.

• Pain in the abdomen, the causes of which are unknown.

Before using any laxative for the first time, you should consult a doctor.

Bisacodyl (Laxatin, Laxacodil, Dulcolax, Bisacodyl, Pirilax, Laxbene, Stadalax)

These drugs are recommended to be taken when you need to prepare the intestines for examination. They can be used against constipation caused by surgery, as well as errors in diet and idiopathic stool retention.

Take the drug 1 tablet at bedtime. If the desired effect does not occur, then the dose is increased to 2 or 3 pieces. ^[2].

Side effects include:

• Flatulence and abdominal pain.

• Intestinal colic.

• Heaviness in the abdomen.

• The appearance of blood and mucus in the stool.

If the drug is taken uncontrollably and for a long time, dehydration, electrolyte leaching from the body, intestinal atony may develop.

Pros

The advantage of the drug is that the intestines are cleaned qualitatively. After taking the drug, you can undergo organ diagnostics, for example, a colonoscopy. The effect comes quickly, after 6 hours. Depending on the individual characteristics of the body, stools can happen even after half an hour or an hour. This brings relief. In general, the drug acts gently and completely copes with the task. It can be used to treat young children.

Cons

If you take Bisacodyl for a long time, a person will develop addiction to it, which manifests itself in the form of intestinal atony. As a result, the natural urge to defecate may disappear altogether. Without the next dose, you will not be able to go to the toilet. Also, taking the drug threatens to remove useful substances from the body. If Bisacodyl is used uncontrollably, then the likelihood of developing acute inflammation of the intestine increases. In addition, it has many side effects that have been described above.

Sennosides A and B (Senade, Regulax, Herbion Laxana, Antrasennin, Tisasen, Ex-Lax, Senna chewable lozenges, Senna holly leaves, Senalex)

All of these drugs in their composition contain anthraglycosides, which are present in the leaves of the senna plant. Its laxative properties have been known for a long time. Taking drugs based on senna contributes to the rapid elimination of feces. A person does not develop addiction. The effect occurs within 6-12 hours.

They take drugs to normalize the stool against the background of hemorrhoids, with weak intestinal motility, with atony of the organ and with spastic constipation. The dose depends on the drug chosen. It is best to take it before bed.

Side effects and contraindications are the same as for Bisacodyl.

Pros

Senna-based preparations are of plant origin, that is, the basis of laxatives is a natural component. Their use allows you to quickly cope with constipation. The effect comes in a few hours. Drug addiction does not develop. Senna is a plant whose properties are well studied. Therefore, such a laxative is time-tested, and doctors are well aware of its strengths and weaknesses.

Cons

Many patients complain of abdominal pain that precedes a bowel movement. In addition, the drug has many side effects. In overdose, a person develops severe diarrhea.

Sodium picosulfate (Guttalax, Guttasil, Laxigal, Regulax Picosulfate, Slabikap, Slabilene)

These drugs increase intestinal peristalsis, due to which it is emptied. Their use reduces the absorption of water and electrolytes.

Take preparations based on sodium picosulfate for the same purposes as Bisacodyl. The effect comes in 10-12 hours ^[3].

Side effects:

• Abdominal pain.

• Dehydration.

• Convulsions.

• Weakness.

• Diarrhea.

• Drop in blood pressure.

• Electrolyte imbalance.

Pros

Preparations based on sodium picosulfate do not have a systemic effect on the body, they work exclusively in the intestines. The body is cleaned qualitatively. Most patients tolerate this group of drugs well. The dose can be selected depending on the real need, that is, it can be reduced.

Cons

With prolonged use or non-compliance with the dosage, dehydration develops, as well as an electrolyte imbalance. Compared to other irritant laxatives, the effect will take longer. The intestines will be cleared only after 10 hours, not earlier. In addition, these funds should not be taken by children under 4 years of age. Side effects can be quite serious.

Glycerol (candles Glycerin, Glitselaks)

Glycerol is used in the form of suppositories. Their use allows you to lubricate the intestines, soften the feces and facilitate its excretion. In addition, the drug stimulates the peristalsis of the body, irritates its mucous membrane.

Glycerol is prescribed to patients who are unable to strain the peritoneum to empty the bowels. It is used by people after a heart attack, with hemorrhoids, anal fissures. Glycerol is often prescribed to pregnant and lactating women. ^[4].

Contraindications to the use of candles:

• Neoplasms in the intestine.

• Hypersensitivity to the components of the drug.

• Acute phase of hemorrhoids or proctitis.

If a person has kidney failure, then candles should be used with caution.

To cope with constipation, you need to enter 1 suppository into the rectum. The procedure is carried out 20 minutes after the morning meal.

Glycerol causes such side effects as: itching and burning in the injection area, allergic reactions. If you use suppositories for a long time, independent bowel movements become difficult.

Pros

The drug acts gently, its use does not cause pain in the abdomen. Candles are small in size, so it is convenient to enter them. Glycerol has few contraindications and side effects. This is one of the few remedies that can be used by people who are not able to strain the abdominal cavity to empty the intestines. Candles are used in pediatric practice. The effect occurs almost instantly, the feces leave the intestines after 5-10 minutes.

Cons

With prolonged use of suppositories, the contractility of the intestine decreases, addiction develops. The use of suppositories can cause irritation of the organ.

Delayed-release laxatives – prebiotics

Prebiotics are safe drugs that can be used to relieve constipation in women during lactation and after childbirth. They are carbohydrates that the digestive organs are not able to absorb. Therefore, they enter the large intestine in their original form. There, prebiotics activate the growth of beneficial bacteria.

Prebiotics are represented by inulin, lactulose and fructooligosaccharides. They do not allow you to instantly cope with constipation, but do not pose a health hazard. The effect of their use lasts longer than that of saline or irritant laxatives.

How do prebiotics work? Taking prebiotics stimulates the growth of beneficial bacteria in the gut. The laxative effect is achieved due to the osmotic action and slight irritation of the intestinal wall. Fermentation of prebiotics leads to the fact that they produce organic acids, which cause the muscles of the body to contract. Lactulose is the most commonly used prebiotic. Its intake in a large dosage (45 ml) contributes to the fact that stools occur after 2 hours.

Side effects. The drugs have virtually no side effects. Their intake is associated with flatulence, but after three days the bloating disappears on its own. Constipation with standard doses can be dealt with in about 2 days. The effect is delayed in time, since lactulose must pass through the entire digestive system.

Indications, contraindications, advantages. Prebiotics are used to treat acute and chronic constipation, with intestinal dysbacteriosis, accompanied by a lack of stool. The undoubted advantage of such drugs is their detoxification effect. They are prescribed for hepatic encephalopathy, as they remove nitrogen-containing substances from the body. Phosphorus and calcium thanks to prebiotics are absorbed better. These substances are detrimental to pathogenic flora.

Lactulose (Normaze, Portalak syrup, Dufalak, Goodlak, Lactulose Poly, Livoluk-PB, Lactulose Stada, Romfalak)

Lactulose-based preparations act gently, they are prescribed for patients with constipation, with encephalopathy, and also to prepare the digestive system for diagnosis.

Lactulose removes ammonium ions from the body, allows better absorption of calcium and phosphorus, stimulates the intestines to work actively. The stool becomes softer, the feces swell, more bile is produced. All this has a positive effect on the functioning of the digestive system. ^[5].

Contraindications to the use of Lactulose are:

• Intestinal obstruction.

• Hypersensitivity to the components of the drug (to lactulose and fructose).

• Diabetes. This contraindication is not absolute, but diabetics should take lactulose-based drugs with caution.

The dose is determined individually. Appointments must be made by a doctor. Lactulose is recommended for constipation in children, as a safe and effective drug.

Pros

Lactulose acts gently, does not cause irritation of the intestinal walls. After taking it, a person does not develop diarrhea. The time-delayed effect can also be considered an advantage, not a disadvantage. The body does not experience stress, feces come out easily. Lactulose is not addictive. It regulates the work of the intestines, after its cancellation, atony of the organ does not develop, its peristalsis does not suffer. Constipation disappears, and the physiological rhythm of the intestine is restored. Beneficial microflora is activated and copes better with harmful microbes. The drug can be used to treat children and pregnant women.

Cons

The drug can cause bloating, which is accompanied by characteristic pain. The taste of Lactulose is not always pleasant, so children may refuse to take it. There are no other disadvantages of the drug.

Lactitol (Exportal, Importal N – powder for solution)

Lactitol can be found in the composition of products for diabetics. It acts as a sugar substitute. Doctors prescribe Lactitol to patients prone to constipation. Taking the drug allows you to make the feces softer, they swell and leave the intestines more easily. The chair happens a day after taking Lactitol. When it is possible to achieve a lasting effect, the dose of Lactitol is gradually reduced.

Side effects after taking the drug are reduced to bloating and the appearance of a certain discomfort against this background. ^[6].

Pros

The drug not only allows you to cope with constipation, but also has an antitoxic effect, removing nitrogen-containing compounds from the body. Its reception has a positive effect on the intestinal microflora. Harmful microbes die, and beneficial flora, on the contrary, multiply.

The drug acts exclusively at the level of the intestine, it does not have a systemic effect on the body. It is convenient to take Lactitol, as it can be mixed with almost any liquid, such as juice, coffee or tea.

Lactitol can be used to treat constipation in children and in people with diabetes. 

Cons

The effect does not come as quickly as we would like. A chair in a person happens only after a day. After the first intake of Lactitol, bowel movement will occur only after 2-3 days. The drug can cause increased gas formation, which leads to discomfort in the abdomen. Overdose may cause vomiting. During treatment, you need to drink plenty of water, which causes some difficulties for some patients.

Osmotic laxatives

If a person has diseases of the digestive system and is haunted by chronic constipation, one should not try to cope with the problem with the help of osmotic laxatives. They are recommended to be taken only once, when stool retention is acute, or a person has been poisoned (food or drug). Also, osmotic laxatives are prescribed for the qualitative preparation of the intestine for diagnostic measures.

The drugs of this group do not cause intestinal atony, so some of them, for example, Kolokit, Forlax, can be taken in a course of up to 3 months. However, it must be borne in mind that they do not affect the cause of constipation, but simply eliminate it. Patients do not develop addiction to the drug ^[7].

How do osmotic laxatives work? After taking an osmotic laxative, fluid begins to accumulate in the intestines, water is removed from fat cells and blood plasma. This allows you to soften the feces and make it more in volume. The emptying of the organ occurs against the background of increased osmotic pressure.

Side effects. The preparations of this group, with prolonged use, contribute to the removal of salts from the body, violate its water-electrolyte balance. Therefore, with extreme caution, they should be prescribed to children and people with heart disease.

After taking osmotic laxatives, abdominal pain occurs, which can be quite intense.

Indications and contraindications. Osmotic laxatives are prescribed for alimentary poisoning, or for drug intoxication. They are also used to relieve acute constipation. Polyethylene glycol is approved for the treatment of lactating and pregnant women.

Carlsbad salt artificial

This drug is a substitute for geyser Karlovskaya salt and belongs to saline laxatives. Its reception contributes to the increased separation of bile. The drug is prescribed for alimentary poisoning, constipation and chronic cholecystitis. It is forbidden to take salt to patients with intestinal obstruction, as well as at high body temperature.

Side effects from taking Karlovskaya salt:

• Atony of the large intestine.

• Violations of the water-electrolyte balance.

• Diarrhea.

Take salt on an empty stomach. A teaspoon is given to children over 2 years old, the indicated amount of the drug is diluted in half a glass of water. Adults are shown to take a tablespoon of salt, which is diluted in a glass of water. Start eating after 40 minutes.

Pros

The drug helps not only to cope with constipation, but also improves the functioning of the gallbladder. Charles salt makes it easier to endure poisoning caused by the intake of expired products, alcoholic beverages, medicines, etc.

The drug has practically no side effects. It does not cause allergies. It can be used to treat children, but salt is contraindicated for pregnant and lactating women.

Cons

Karlovskaya salt cannot be combined with other medicines, as it will reduce their effectiveness. It is forbidden to drink diuretics during treatment, as the likelihood of dehydration increases many times over. Violation of storage conditions leads to a change in the properties of salt, as a result of which it may lose its qualities. Therefore, the drug must be kept at a temperature of + 22-27 ° C.

Macrogol (Lavacol, Osmogel, Fortrans, Relaxan, Tranzipeg, Forlax, Forteza Rompharm)

Macrogol is often used as a laxative. It can be taken for a long time (up to 3 months). This will normalize bowel function. So that after the completion of the course there is no failure in the digestive system, a person will need to follow a diet, as well as play sports.

The drug is not absorbed into the blood, it works only at the level of the intestine. After taking it, patients do not experience discomfort in the abdomen, they do not increase gas formation. Macrogol softens feces and facilitates the process of bowel movement.

The drug does not lead to dehydration and does not interfere with metabolic processes. The effect develops 1-2 days after the first dose. It is recommended to drink Macrogol during breakfast. The dosage is determined by the doctor ^[8].

Pros

The drug allows you to qualitatively cleanse the intestines, completely remove all the contents from it. This is especially true for people who are about to undergo an examination of the organ. You can take Macrogol for a long time. The drug acts only in the intestine and is not absorbed into the systemic circulation.

Cons

Many patients report an unpleasant taste of the drug. To feel the laxative effect, you need to take a large amount of the drug. Most drugs based on Macrogol are prohibited for children, lactating and pregnant women.

Magnesium Sulfate Hyptahydrate (Bitter Salt, Epsom Salt, Magnesia, Epsom Salt)

The drug is prescribed for biliary dyskinesia, to get rid of constipation, with inflammation of the gallbladder, to prepare for a diagnostic examination of the intestine, for intoxication with salts of heavy metals.

In addition to the laxative effect, magnesium sulfate has a choleretic effect on the body. At the reception take one package of the drug, which is diluted in 100 ml of water ^[9].

Pros

Magnesium sulfate is an effective and fast acting remedy for constipation. It is widely used in medical practice. It liquefies even the hardest stones, does not cause inflammation of the intestines and the digestive tract as a whole.

Cons

The drug is not prescribed for children under 15 years of age, patients with heart disease and disorders of the central nervous system. It eliminates constipation, but does not affect its cause. With uncontrolled use of the drug, a person develops dehydration. If you take magnesium sulfate for more than 3 months, this will negatively affect the functioning of the kidneys and heart.

Fast acting laxative

Microlax – This is a microclyster, which is used for rectal administration. The effect develops within 15 minutes after its setting. Feces become soft and easily leave the intestines. One tube is enough to provide a laxative effect. Sodium citrate, which is part of the preparation, acts as a peptizer. Sodium lauryl sulfoacetate has a thinning effect, and sorbitol attracts water to the intestines. In combination, these substances contribute to the rapid cleansing of the body from feces.

Microlax is prescribed for patients with constipation, as well as for bowel cleansing before the upcoming study. For children over 3 years old, 1 microclyster is recommended, which is injected into the rectum ^[10].

Pros

The drug acts very quickly, so it can be used to get rid of constipation as soon as possible. Enemas are allowed to be given to children. There are no side effects from the treatment.

Cons

Not all patients are comfortable with an enema to relieve constipation. Sometimes certain circumstances do not allow this. Some individuals experience discomfort from the procedure, indicating a burning sensation and other unpleasant sensations. In addition, Microlax does not affect the very cause of constipation, the enema simply eliminates this symptom. No other deficiencies were found in the drug.

Intestinal fillers

Intestinal fillers are substances that the digestive tract cannot digest. They are not absorbed into the systemic circulation. The laxative effect is achieved by increasing the volume of feces. Fillers can be represented by both modified saccharides and herbal remedies.

Some patients suffering from chronic stool retention refuse to take these laxatives, as the effect of them does not always develop. There is also a high probability of flatulence, rumbling in the abdomen, pain along the intestines.

Intestinal fillers: agar-agar, flaxseed and fleaworth, wheat bran, sterculia, methylcellulose, psyllium husk (oval or ovoid) ^[11].

How do intestinal fillers work? Fillers, regardless of their variety, absorb water. The walls of the intestines are stretched, so the body seeks to get rid of excess fluid. Together with water, feces come out. However, with atony of the organ, these drugs are ineffective. To develop a laxative effect, you need to drink as much water as possible (at least 2 liters per day).

Fillers are classified as mild agents that do not allow you to instantly cope with constipation. Depending on the chosen drug, the effect develops after 12 hours (when taking agar-agar) or a day later (when taking fleaworth seeds). Methylcellulose will allow you to cope with constipation only after 1-3 days.

• Side effects. When taking fillers, the intestinal walls are stretched, the organ is filled with gases, and strong rumbling may occur. To develop a full-fledged effect, a person must drink a lot of water, which is not always possible. An obstacle to this can be various diseases of the urinary system and not only.

• Contraindications. Pregnant women should not take drugs for constipation, as this increases the likelihood of spontaneous abortion. Fillers are prohibited for people with IBS, as well as bedridden patients, people with intestinal obstruction and diseases of the nervous system.

Herbal laxatives

Herbal laxatives, which are most often used to treat constipation, include the following: ^[12]

• Buckthorn fruits, Buckthorn bark, syrup or extract, Ramnil, Jostera fruit.

• Kafiol. This drug contains senna leaves and fig fruits.

• Fitolax. This is a dietary supplement based on apricot fruits.

• Sea cabbage (kelp thallus). You can buy it in granules, tablets or in the form of an extract under the trademarks FitoTranzit or Mamoklam Laminaria thallus.

• Oval psyllium seed husk is a part of such preparations as: Mucofalk, Naturolaks, Fiberleks.

• Proctophytol. This herbal collection includes senna leaves, coriander fruits, licorice roots, alder buckthorn bark, common yarrow herb.

• Rhubarb Roots, which are available in the form of syrup, tablets and extract.

• Licorice root powder. It contains licorice root, senna leaves, fennel fruit (extract) and sulfur.

• Steel tincture. The drug has not only a laxative effect, but also allows you to relieve inflammation and stop bleeding.

• Laxative collection number 1. It contains yarrow herb, alder buckthorn bark, nettle leaves.

• Laxative collection number 2. It consists of bark and fruits of buckthorn, senna leaf, anise fruits, licorice root.

Video: Live great! Guide to choosing a laxative: