Laxatives: Help with Constipation

Laxatives (laxatives) are all substances that can accelerate defecation and thus help with constipation (constipation). One speaks of constipation when, over a longer period of time, defecation occurs no more than three times a week and is only possible with heavy pressing. In addition to chemical laxatives, natural home remedies can also help with constipation. Compared to laxatives, they are usually better tolerated and have fewer side effects. By the way, laxatives should in any case be used only to treat constipation and not to lose weight.

How laxatives work

Laxatives have been known for thousands of years. For example, constipation was treated with castor oil as far back as ancient Egypt. Even today, laxatives are still widely used, about nine million Germans regularly take laxatives, about a third even resort to laxatives daily. During digestion, water is gradually extracted from the fairly liquid stool in the large intestine. This causes the stool to thicken and become more solid. Most laxatives start at this point: They either ensure that the withdrawal of water from the stool is impeded or that water excretion into the stool is promoted. As a result, the stool becomes softer, gains volume and can be excreted more easily.

Use of laxatives

Laxatives can either be taken orally or inserted directly into the bowel. If a suppository or enema is used, laxatives usually work very quickly. If taken orally, on the other hand, it takes much longer before the effect sets in: It is best to take the tablet in the evening before sleeping, as the effect only sets in after six to ten hours, depending on the laxative. If you are taking a laxative for the first time, you should bear in mind that it may take longer than usual for the next bowel stimulus to set in after the bowel has been completely emptied. However, people often mistakenly believe that the bowel is still blocked after the first time and reach for a laxative another time. Exactly how a laxative is used and what the risks and side effects are also depends on what type of laxative it is. Generally, laxatives are divided into the following categories:

  • Swelling and bulking agents
  • Osmotic acting laxatives
  • Hydragogic laxatives
  • Lubricant

Below you will find more detailed information about each type of laxative.

Swelling and filling agents

Swelling and bulking agents include, for example, wheat bran, flaxseed, agar-agar or psyllium. They are all of plant origin. Swelling agents absorb water in the intestine and swell. This increases the amount of stool and the stool becomes softer. In order for the swelling agents to absorb enough water, it is particularly important to drink enough. This is because if there is too little water in the digestive tract, it can lead to intestinal obstruction in the worst case. Swelling agents offer the advantage that they act locally in the intestine and have hardly any side effects. However, the intake of swelling agents can cause flatulence. In addition, they show no effect in organic diseases of the intestine. Swelling agents can only be taken orally.

Osmotic laxatives

The group of osmotically acting laxatives includes lactose, lactulose, Epsom salts, Glauber’s salt, and sorbitol. They soften stool by binding water in the intestines. The increased stool volume triggers the stool stimulus. In addition, the stool can be excreted more easily due to the softer consistency. Just as when taking bulking agents and fillers, adequate fluid intake is important with osmotically acting laxatives. Osmotic-acting laxatives can be taken orally or inserted directly into the bowel. They are often used before surgery because they lead to complete emptying of the bowel. A disadvantage is that when osmotically acting laxatives are used, there is often also an increased loss of minerals and vitamins. Over time, this can lead to deficiency symptoms. In addition, some osmotically acting laxatives such as Glauber’s salt must not be taken in cases of high blood pressure, as otherwise the high blood pressure may worsen.In addition, it may interact with certain medications, such as birth control pills.

Hydragogue laxative

Hydragogenic laxatives include herbal agents such as aloe, rhubarb, sloth bark, and senna leaves, as well as synthetic laxatives such as bisacodyl or sodium picosulfate. The highly laxative castor oil also belongs to this group of intestinal irritant laxatives. Hydragogic laxatives prevent thickening of the stool in the colon by promoting the influx of water from the intestinal wall into the bowel. Some laxatives in this group also help improve the bowel’s own motility, making it easier to move the stool along. Anthraquinone-containing laxatives (senna leaves, sloth bark, aloe, and rhubarb) often produce diarrhea, resulting in high water and electrolyte loss. They also severely irritate the intestines and are suspected of being carcinogenic. Synthetic laxatives can also cause diarrhea and cramps. In addition, they lead to habituation over time.

Lubricants

Lubricants must be inserted directly into the bowel. They make hardened stool easier to empty by making the intestinal walls slippery and the stool softer. Lubricants include laxatives such as kerosene oil or glycerin. Taking laxatives with glycerin can cause severe irritation of the intestinal mucosa. In the case of agents with kerosene oil, the potassium as well as the calcium levels can drop sharply. In addition, long-term use can cause damage to the anal area and kerosene can be deposited in the body. The foreign bodies can cause chronic inflammation in the body, which in the long term can result in degeneration of cells and thus cancer.