Laxatives - Types, Uses, Side Effects, and Warnings

Overview:

Laxatives are drugs that are used for constipation, it works either by stool softening or by stimulating the lower intestines to move out stool. They can accomplish more damage than useful if utilized improperly. Read this article to get the realities, and the myths, about laxatives.

What Are Laxatives?

Laxatives are substances that loosen the stools and improve bowel movements. They are utilized to manage and control constipation. Laxatives alter based on the mechanism of action and the side effects. Oral laxatives are medications intaken by mouth to promote bowel movements and reduce constipation. Osmotic laxatives or stimulant laxatives are regarded first-line. Prokinetics and secretagogues are the following treatment when osmotic laxatives or stimulants cannot control constipation. Laxatives can even be helpful in cases with irritable bowel syndrome, chronic idiopathic constipation, and opioid-induced constipation. In addition to relieving constipation, laxatives are utilized to remove the bowels before the procedures like colonoscopy.

What Are the Types of Laxatives?

• Stimulant Laxatives: These include castor oil, cascara sagrada, and senna. They are hazardous, even though they are non-prescription drugs. These are the most typically manipulated laxatives. They enable the nerves in the large intestines walls, induce intestinal contractions and fluid and electrolyte differences, and can be habit-forming. In expansion, tolerance evolves, indicating that increased doses are required to acquire the exact outcome.

• Natural stimulant Laxatives: They typically have senna. They are stimulant laxatives that are derived from plant sources. Their hazards are the exact same as synthetic stimulant laxatives. Non-stimulant laxatives are secure if utilized precisely and in proper doses. They involve the following:

1. Bulk-forming Laxatives: Fiber is the laxative that most doctors suggest for standard and slow-transit constipation. Abdominal cramping or bloating can happen when suddenly improving or altering dietary fiber intake. Fiber is obtainable in fruits and whole grains. Bulk-forming Laxatives are typically secure and a source of dietary fiber. When utilized in more elevated than advised doses, it can induce intestinal issues and block the absorption of additional nutrients. They maintain fluid in the stool and improve stool weight and texture. It is significant to take ample water for bulk-forming laxatives to function. Insufficiency of water, in turn, guides to bloating and can induce bowel obstruction. It can be helpful in cases with hemorrhoids, anal fissures, chronic diarrhea connected with diverticular disorder, and irritable bowel syndrome. They are not suggested for constipation induced by opioids or in individuals who are not able to sustain satisfactory fluid intake, are at hazard of dehydration, or with difficulties in swallowing.

2. Osmotic Laxatives: They include milk of Magnesia and Epsom salts. These act by drawing fluid into the intestines and are little habit-forming but can even induce fluid and electrolyte imbalances when utilized inaccurately. Some mandate a prescription. This drug category is inadequately absorbable and draws water into the bowel lumen. These drugs may take more than two days to act.

3. Lubricant and Emollient Laxatives: They include mineral oil, or docusate, which act by softening the stool. These are typically secure to utilize for a restricted period. Lubricant laxatives produce slippery stools. The mineral oil in these products creates a slippery coating on the intestine's walls and controls the stool from drying. Though favorably effective, lubricant laxatives are nicely utilized as a short-term remedy for constipation. Over a more extended period, mineral oil absorbs fat-soluble vitamins from the intestine, reducing particular prescription medications from being totally absorbed into the body. Do not take mineral oil simultaneously as additional drugs or supplements.

What Are the Indications of Laxatives?

Constipation is a typical diagnosis that demands correct assessment and proper therapy. It is significant to mention that laxative treatment is not the only remedy for constipation. The chronic constipation therapy method involves proper education of the patient, behavior transformation, dietary modifications, and laxative treatment. Initial treatment of constipation should involve lifestyle modifications such as improving fluids and fiber-rich diets such as asparagus, cabbage, and leafy vegetables. When constipation is not managed by lifestyle change, therapy with laxatives can be done. Osmotic laxatives or stimulant laxatives are assessed first-line. Prokinetics and secretagogues are the following measures when osmotic or stimulants cannot prevent constipation.

Laxatives except saline laxatives may be utilized to deliver relief:

• At pregnancy.

• For short periods of days post delivery.

• Before any surgery or before any investigative procedure.

• For constipation caused by other medicines.

• Post-surgery if straining should be avoided.

• After insufficient eating habits or a deficiency of physical activity, develop a regular bowel process.

What Are the Contraindications of Laxatives?

• Typically, cases with hypersensitivity responses to any functional medicine or excipients should bypass that medication.

• Laxatives should be avoided in pregnancy, and bulk laxatives are considered secure. Stimulant laxatives are supposed to be second-line therapy.

• Contraindications to bulk-forming drugs involve bedridden cases and those with changed awareness.

• Certain agents are not given to patients having any allergic reactions.

• Utilize lactulose with caution in geriatric, pediatric, debilitated cases, and hepatic impairment.

• Sorbitol should be utilized with vigilance in cases with renal impairment.

• Prucalopride is not given in intestinal obstruction or intestinal perforation cases, Crohn's disease, and toxic megacolon.

• Lubiprostone is not given in cases with intestinal obstruction and extreme hepatic impairment.

For Patients:

What Is Constipation?

Constipation signifies that an individual has three or reduced bowel movements per week. The stool may be hard and waterless. Occasionally it is aching to pass. At each time or another, nearly everyone gets constipated. In most patients, it lasts a short time and is not severe.

Steps to prevent constipation involve:

• Consuming more fruits and grains rich in fiber.

• Having plenty of fluids.

• Doing regular exercise.

What Should Be Considered Before Taking Laxatives?

It depends on how frequently bowel movement alters in an individual, but individuals typically have as many as three bowel movements daily to as periodic as three per week. Constipation is considered if more infrequent bowel movements occur than the standard. In expansion, constipation may include stools that are complicated to pass because they are rigid, waterless, or smallish.

Nevertheless, prior to having laxatives, certain lifestyle modifications are suggested. They are:

• Having a fiber-rich diet, like wheat bran, fruits, and vegetables. The average grown-up should get 25 to 31 grams of fiber daily. Have a good quantity of fluids every day; it is around eight to 10 glasses of non-caffeinated, nonalcoholic drinks.

• Follow a regular exercise habit.

• Lifestyle modifications reduce constipation.

• But in spite of all these, if the issue persists, then a mild laxative is suggested.

How Laxatives Cure Constipation?

Laxatives act in various patterns, and the significance of each laxative kind differs from individual to individual. In broad, bulk-forming laxatives, also meant to be fiber supplements, are the most delicate to the body and securest to utilize for a long period.

• Oral Osmotics: Add water into the colon to permit a more effortless stool passage. It has certain side effects like bloating, cramping, loose motion, sickness, and elevated thirst.

• Oral Bulk Formers: Fascinate water to create soft, hardy stool, stimulating regular contraction of intestinal muscles. The side effects involve bloating and cramps, and if adequate water is not taken, then there is an increased risk of constipation.

• Oral Stimulants: Trigger rhythmic contractions of muscles of the intestine to remove the stools. Side effects are diarrhea, nausea, and discoloration of urine.

• Rectal Suppositories: Activate rhythmic contractions of muscles of the intestine and soften the stool. Side effects are diarrhea, cramping, and irritation in the rectum.

• Oral Laxatives: They may interrupt the body's absorption of certain medicines and nutrients. Some laxatives can lead to an electrolyte imbalance, particularly after long-term usage.

How to Use Laxatives Safely?

Consume a Large Amount of Water:

• While having laxatives, the patient should drink at least eight to ten cups of water daily. In particular, an osmotic laxative can induce dehydration.

• In the case of bulk-forming laxatives, there is no need to have enough liquid. This can induce a gut blockage as it makes stool dry and tough to pass.

Usage of Laxatives for Short Periods of Time:

• Long-term usage can create the body dependent on them, so the bowel no longer functions typically without them.

• Typically, it is suggested that there is no need for laxatives for more than five to seven days in a row.

• In case of persistent constipation, even after having laxatives for several days, then reach a doctor for guidance.

Which Laxative Should Be Used for a Better Result?

It is tough to comprehend that a particular laxative is better and acts more efficiently than the other. It depends on certain factors and varies from patient to patient.

Initiate the usage of a laxative with a bulk-forming laxative. Following this, if the stool remains hard, then use an osmotic laxative along with or in place of a bulk-forming laxative. If the stool becomes soft but it is still difficult to pass, then there is a need for the use of a stimulant laxative along with a bulk-forming laxative.

What Are the Side Effects of Laxatives?

The expected side effects of laxatives are stomach aches or cramps, bloating, tummy gas, and flatulence. Additional side effects involve:

• Constipation: Continued usage of laxatives can induce constipation due to the loss of muscle response and nerve response in the bowel and cannot drive the stools out. This causes dependence on the laxative so that more increased dosages are required to poo.

• Diarrhea and Dehydration: Intake of certain laxatives in large amounts can lead to diarrhea and losing a large amount of salt from the body.

Describe Laxative Abuse.

Certain individuals accept large quantities of laxatives at one period. Others have small amounts of laxatives, maybe not more additional than the suggested dosage, but on a relatively frequent basis. Most youthful and healthy individuals should infrequently if ever, demand a stimulant laxative, and laxatives should not be utilized in more elevated than directed dosage or over extended periods of time. Once the practice has been initiated, individuals frequently find it challenging to quit accepting laxatives even if they desire to. They may evolve physically dependent and psychologically dependent on laxatives. Certain people utilize laxatives with the false belief that they will assist them with weight loss. Laxatives rinse water and debris from the intestine but do not remove calories from the body.

For Doctors:

Drug Interaction:

• Although particular medications should not be utilized concurrently, in additional circumstances, two distinct drugs may be utilized concurrently, even if an interaction may occur. In these points, a doctor may like to alter the dosage, or additional precautions may be required. When accepting any of these medications, it is particularly significant that healthcare professionals should be informed if the patient is taking any other medications. Utilizing medications in this class with any of the following medications is not suggested. They are certain anticholinergic drugs, Belladonna, and calcium channel blockers.

• There are other groups that are also not recommended with laxatives, but if it is required, alteration of dosage is done. These include:

  • Nonsteroidal anti-inflammatory drugs.

  • Certain antimuscarinic agents.

  • A potassium-sparing diuretic.

  • Phenothiazine antipsychotic drugs.

What Are the Treatment Done for Constipation in Kids?

• Over-The-Counter Fiber Supplements or Stool Softeners: If the child does not get enough fiber from the diet, giving an over-the-counter fiber supplement may help to relieve constipation. Glycerin suppositories can be utilized to soften the stool in kids who do not consume pills.

• A Laxative or Enema: If an accumulation of fecal material forms a blockage, then a laxative or enema is suggested to remove the blockage. Never give this enema without the presence of a doctor.

• Hospital Enema: In certain cases, kids may get severe constipation and need to get hospitalized for a short period, and in those cases, a stronger enema is given.