0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Over-the-counter Laxatives FREE

Jill Jin, MD, MPH
JAMA. 2014;312(11):1167. doi:10.1001/jama.2014.2078.
Text Size: A A A
Published online

Laxatives are medications that are used to treat occasional constipation.

TYPES OF LAXATIVES

Many laxatives are sold over-the-counter (OTC) without a prescription. Different classes of OTC laxatives work in different ways.

  • Lubricants make it easier for stool to pass out of the body. A commonly used lubricant is mineral oil.

  • Stool softeners moisten and soften the stool, also making it easier to pass. They work well for people with hard stools, which can be the result of taking certain medications (for example, some prescription pain medications) or being too sedentary (for example, hospitalized patients). The most commonly used stool softener is docusate.

  • Fiber supplements are natural dietary supplements that absorb water and help maintain regular bowel habits. They are good for people who do not consume enough fiber in the diet.

  • Bulk-forming laxatives are special fiber products such as psyllium. These products are not absorbed by the intestines and as a result “bulk up” the stool, which makes having a bowel movement easier.

  • Stimulant laxatives cause the muscles of the intestinal wall to contract, which helps to push stool along. Examples include bisacodyl and sennosides. They sometimes cause cramps as a side effect. There is also some question of whether long-term use of stimulant laxatives can cause permanent damage to the intestinal wall.

  • Osmotic laxatives draw water into the intestinal tract, which makes it easier for stool to pass. Examples include polyethylene glycol, sorbitol, lactulose, and saline laxatives (which include sodium phosphate and magnesium products). Osmotic laxatives are very effective but if used in excess may cause problems with the body’s water and electrolyte balance.

SAFETY CONCERNS

Over-the-counter laxatives are generally safe to use, with few side effects. However, as with any OTC medication, it is very important to read the instructions on the drug label carefully, take the drug as recommended on the label, and not exceed the maximum dose. Overusing laxatives can lead to potentially serious side effects. Laxatives should not be used for weight loss.

As an example, in January 2014 the US Food and Drug Administration (FDA) released a safety warning about OTC sodium phosphate osmotic laxatives. The FDA warned that in rare instances, using more than 1 dose in 24 hours of these laxatives could cause serious harm to the kidneys and heart, and even death.

More information about this FDA safety warning can be found in the January 10, 2014, post of the news@JAMA blog (jama.md/19iJXVM) as well as at the FDA advisory link below.

CHOOSING A LAXATIVE

There is no single laxative that is best, and everyone responds differently to a particular laxative. If you have questions about which one is best for you, you can ask a pharmacist, doctor, or other health care practitioner.

Lifestyle changes such as a high-fiber diet and exercise can be just as helpful as laxatives in treating constipation.

Box Section Ref ID

For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish. A Patient Page on constipation was published in the October 2, 2013, issue of JAMA.

ARTICLE INFORMATION

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Source: Givel JC, Mortensen N, Roche B, eds. Anorectal and Colonic Diseases: A Practical Guide to Their Management. 3rd ed. Berlin, Germany: Springer; 2010.

Topic: Gastroenterology

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Spanish Patient Page: Laxantes de venta libre

Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

18,537 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Collections
Jobs