Treatment Options
Constipation in itself is not life-threatening, but there can be serious
consequences if it is left untreated (including faecal impaction
and haemorrhoids).
There are a range of constipation remedies available, that work in different ways. Your pharmacist or doctor can advise
what’s best for you, depending on the severity and persistence of your constipation as well as factors like age, lifestyle
and other health concerns.
Some of the main treatment types are described below.
BULK-FORMING LAXATIVES
e.g. bran, ispaghula husk, psyllium, sterculia.
These work by increasing the amount of water in the stool, making it softer and easier to pass. Because fibre laxatives
work by absorbing water from your body, you need to stay well hydrated by drinking more than usual (otherwise the
constipation might actually get worse). For fit and healthy people with only mild constipation, fibre laxatives may be
an effective remedy, but they can take up to three days to work.
FAECAL (STOOL) SOFTENERS
e.g. docusate sodium, poloxamer
These kinds of laxatives also work in the intestine, enabling additional water and fat to be mixed into the stool,
making it easier to pass. Their efficacy on their own is limited, so they are reserved for mild constipation.
OSMOTICS LAXATIVES
e.g. glycerol, lactulose, magnesium sulfate, sorbitol
These may be liquids or suppositories. They work by attracting water from the body into the gut so that more water is
held there, softening the stool (so it’s important to keep your hydration while taking them). If used long term, some osmotic
laxatives can cause imbalances in your body salts, so be sure to ask your pharmacist or doctor for information.
ISO-OSMOTICS LAXATIVES
e.g. Macrogol 3350 with electrolytes (MOVICOL®)
They have a similar action to osmotic laxatives, but with iso-osmotic laxatives, there's no net gain or loss of water or
electrolytes – so there is less risk of dehydration and no extra fluid is needed for the laxative to work.
Macrogol 3350 with electrolytes is an iso-osmotic laxative, and like fibre laxatives, it’s gentle and works in harmony
with the body – but the way it works is different. The main active ingredient, macrogol, goes straight to the bowel
where, by retaining a set amount of water, it softens, expands and lubricates the stool to trigger peristalsis – in the
same way as your normal bowel movement. The macrogol is then expelled from your body virtually unabsorbed.
MOVICOL® does not ferment either, which means less likelihood of gas or bloating/wind.
MOVICOL® is currently the only iso-osmotic laxative available in Australia.
See video How MOVICOL works
STIMULANT LAXATIVES
Eg: bisacodyl, senna, sodium picosulfate
Stimulant treatments can be effective for the rapid relief of constipation. But rather than working with the body to
create a natural bowel movement, they cause the bowel contraction directly through nerve stimulation. Tablets
are usually taken at night and a bowel movement normally follows about 6-12 hours later. Stimulant laxatives are
usually a short-term remedy – do not use them on an ongoing basis without consulting your doctor or pharmacist.
References:
My Dr from MIMS. Constipation: self-care, available at http://www.mydr.com.au/pharmacy-care/constipation-self-care:
last accessed 25 Feb 2013.
