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Over-the-counter laxatives for constipation: Use with caution

How laxatives relieve constipation

Laxatives work in different ways, and the effectiveness of each laxative type varies from person to person. In general, bulk-forming laxatives, also referred to as fiber supplements, are the gentlest on your body and safest to use long term. Metamucil and Citrucel fall into this category.

Here are some examples of types of laxatives. Even though many laxatives are available over-the-counter, it's best to talk to your doctor about laxative use and which kind may be best for you.

Type of laxative (brand examples) How they work Side effects
Oral osmotics (Phillips' Milk of Magnesia, Miralax) Draw water into the colon to allow easier passage of stool Bloating, cramping, diarrhea, nausea, gas, increased thirst
Oral bulk formers (Benefiber, Citrucel, FiberCon, Metamucil) Absorb water to form soft, bulky stool, prompting normal contraction of intestinal muscles Bloating, gas, cramping or increased constipation if not taken with enough water
Oral stool softeners (Colace, Surfak) Add moisture to stool to allow strain-free bowel movements Electrolyte imbalance with prolonged use
Oral stimulants (Dulcolax, Senokot) Trigger rhythmic contractions of intestinal muscles to eliminate stool Belching, cramping, diarrhea, nausea, urine discoloration with senna and cascara derivatives
Rectal suppositories (Dulcolax, Pedia-Lax) Trigger rhythmic contractions of intestinal muscles and soften stool Rectal irritation, diarrhea, cramping

Oral laxatives may interfere with your body's absorption of some medications and nutrients. Some laxatives can lead to an electrolyte imbalance, especially after prolonged use. Electrolytes — which include calcium, chloride, potassium, magnesium and sodium — regulate a number of body functions. An electrolyte imbalance can cause abnormal heart rhythms, weakness, confusion and seizures.

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