Constipation medicines: what should you know about them?

Constipation is not just about infrequent bowel movements; hard stools, straining and a feeling of incomplete evacuation all make everyday life less comfortable. Although treatment is based on lifestyle changes, medication is often needed.

From Endomedix Gastroenterology Centre an expert guide to the types of laxatives and their safe use.

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When do we talk about constipation?

In medical terms, the problem exists if:

• Weekly less than three times there is defecation.
• The stool has a hard, berry-like consistency.
• Emptying it takes considerable effort.
• The symptoms have persisted for at least three months (chronic constipation).

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Types of laxatives and their mechanism of action

Not all laxatives are the same. The choice must take into account the nature of the problem and the individual response of the body.

1. Volume-enhancing laxatives

Natural or synthetic fibres (e.g. plantain seed husks - psyllium, methylcellulose).

• How does it work? They absorb water, swell, soften the stools and stimulate bowel movements.
• Advantage: It is gentle and safe in the long term.
• Important: They are only effective if you drink plenty of fluids (at least 2 litres a day).

2. Osmotic laxatives

They draw water into the intestinal cavity, diluting the stool.

• Sugar alcohols (e.g. lactulose): They are effective but can cause bloating and gas.
• Polyethylene glycol (PEG): Non-absorbent and non-puffy, it is often the first choice in chronic cases.
• Salty laxatives (e.g. bitter salt): They are fast but can upset electrolyte balance, so prolonged use is not recommended.

3. Stimulant (stimulant) laxatives

They directly stimulate nerve endings in the intestinal wall (e.g. senna, bissacodil).

• Advantage: Fast (6-12 hours) and powerful effect.
• Dangers: In the longer term, they can cause habituation, the bowel can become „lazy”, so they are only recommended for occasional use.

4. New generation prescription-only medicines

In severe cases of chronic constipation or IBS-C that do not respond to other medications, the gastroenterologist may prescribe specific medicines to stimulate bowel movements or increase fluid secretion (e.g. prucalopride, linaclotide).

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When is it important to see a doctor?

Constipation can sometimes be a symptom of a more serious illness. See your Endomedix specialist if:

• Constipation develops suddenly, and it will not go away.
• Blood appears in the faeces.
• You experience unexplained weight loss, severe abdominal pain or nausea.
• The first symptoms occur above the age of 45-50.

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5 tips for safe use

1. Liquid, liquid, liquid: In addition to taking laxatives, water consumption is critical.
2. Start gently: Try fibres or PEG-based agents first.
3. Avoid addiction: Do not use a stimulant laxative every day for weeks.
4. Get moving: Physical activity is the best natural bowel movement stimulant.
5. Ask a question: If your symptoms do not improve after two weeks, stop trying and seek specialist help.