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Medical Management

Stimulant laxatives

Osmotic laxatives

Overnight action laxatives

Plant-derived laxatives


Constipation can affect quality of life. It can make you feel uncomfortable and bloated; it can even have an effect on our emotions. A balanced diet, regular exercise and reduced stress may help to prevent constipation.

However, if you find that your problem with constipation keeps returning, or is accompanied by other symptoms such as painful cramps or traces of blood or mucus on your stools, you should seek medical advice.

Medical Management

Where medical advice is sought, several treatment options may be considered. These will depend on individual circumstances.

  • Rehydration -drinking more water
  • Dietary changes
  • Laxative treatment
  • Discontinuation of medicines that may have caused the problem
  • Treatment of underlying conditions
  • Manual evacuation

  • Research in the American Journal of Gastroenterology has indicated that measures such as increasing fibre intake, fluid and exercise may not always work to alleviate constipation. Fluids will only treat constipation where there is dehydration. In some cases increasing fibre may make matters worse. Exercise may only be effective to treat constipation in elderly people. Lifestyle may not always be the cause of general constipation.

    Effective laxatives can provide relief from constipation. There are four main types of laxative:

    Stimulant laxatives

    Laxatives containing bisacodyl or sodium picosulfate, promote intestinal function by stimulating the muscles of the colon. As a result the natural movement of the colon is supported and started again. As the water content of the stool is enhanced at the same time, the stool is also easier to pass.


    Osmotic laxatives

    These laxatives, which include Epsom salts work by pulling water into the colon, which softens the stool and makes it easier to pass.

    They work in a similar way to bulk-forming laxatives in that they attract water to the colon to soften and swell the stool. Osmotic agents, however, draw water not only from the colon itself, but also from surrounding tissue and blood vessels. As a result, it is very important that people using these types of laxatives drink plenty of liquids (water) to balance out any loss of fluid.

    As some of the sodium salts contained in this type of laxative may be absorbed into the system, it is advisable that people with high blood pressure, weak heart muscles or kidney disease check with their GP before using them.

    Overnight action laxatives

    There are two main categories of stimulant laxatives which have an overnight action: plant-derived anthraquinones (natural extracts of senna, cascara, aloe, and rhubarb) and synthetic derivatives of diphenylmethane (bisacodyl and sodium picosulfate).

    Plant-derived laxatives

    These laxatives have an irritant effect on the lining of the colon that stimulates the muscles of the colon. They also accumulate water in the colon. Plant-derived laxatives include remedies made from extracts of senna fruit or leaves, aloe, buckthorn or rhubarb.

    Plant-derived laxatives are activated by bacteria in the intestine. It is believed that the resulting chemical products stimulate the cells of the intestinal wall and allow water to penetrate the intestine so triggering elimination.

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