5 OTC and Alternative Options
Sometimes your doctor may recommend trying an over-the-counter medication, or you'll read about an alternative option that you want to try. While these options may help relieve symptoms, it's important to understand how they work and their potential side effects.
Generally, there are five categories that you can choose from. And remember, even though these are available over the counter without a prescription, you should still discuss taking them with your doctor.
Also called emollients, "stool softeners" increase both the water and fat content in the stool. Stool becomes softer and easier to pass, which can prevent constipation.
Stool softeners will be effective in helping to pass a bowel movement anywhere from 12 hours to three days. They are for short-term use because long-term use can result in needing more of the medication to have the same effect.
This type of medication is typically reserved for use after surgery, after childbirth, or in people who have an anal fissure or hemorrhoids. Some of the brand names include Colace, Correctol, Ex-Lax, Fleet, and Phillips.
There are several types of laxatives available over-the-counter that work by drawing more water into the intestine. These osmotic laxatives make stool softer so that constipation is prevented.
There are many different types of osomotic laxatives and some of the brand names include Miralax (polyethylene glycol 3350), Milk of Magnesia (magnesium hydroxide), Generlac, and Enulose (lactulose). In most cases, these laxatives appear to be effective and safe for treating constipation. Some of the side effects include nausea, bloating, abdominal discomfort, diarrhea, and gas.
A bulk laxative is a type of fiber that isn't broken down or absorbed in the digestive tract. Instead, this fiber absorbs water and turns into a gel-like substance. This prevents the stool from becoming too hard and also makes it easier to have a bowel movement.
Bulk-forming laxatives are available over-the-counter and are suitable for long-term use to treat both constipation and diarrhea. Some of the brand names include FiberCon (polycarbophil), Metamucil (psyllium), and Citrucel (methylcellulose fiber).
Just as with adding fiber to the diet through food sources, adding a fiber supplement can cause symptoms of bloating, abdominal pain, and gas in some people. For this reason, it's a good idea to start with a low dose and increase it slowly, if needed.
This type of laxative works by stimulating muscle contractions (peristalsis) in the intestines. When the motility in the bowel is increased, stool moves through it quicker and this helps to prevent constipation.
Some of the potential side effects include abdominal pain or incontinence. Stimulant laxatives do have some safety concerns, namely that they can be overused and result in more serious side effects. However, when used as directed for a short period of time (less than a week), they can be effective.
In most cases these products are used at bedtime so that they work overnight and a bowel movement occurs in the morning. Some of the different types of stimulant laxatives used in over-the-counter brands include bisacodyl, sodium bicarbonate, senna, and castor oil.
Herbal preparations are also used to relieve constipation. Herbal laxatives may be thought of as more "natural," but they can also have side effects. These herbs increase intestinal motility and the amount of liquid pulled into the large intestine. More liquid and a quicker transit time may result in softer stools that can be passed without straining.
Herbal laxatives should only be used short-term and only as directed. Overuse can result in symptoms such as abdominal pain, diarrhea, or vomiting.
Some herbs that may be used as laxatives include aloe latex, cascara sagrada, frangula, rhubarb (rhuem), and senna.