Medicines for Constipation

What it is

Constipation means going to the toilet less often than is normal for you, or having stools that are hard, lumpy, large or difficult and uncomfortable to pass, sometimes with a feeling that the bowel has not emptied. It is very common and often short-lived, triggered by not enough fibre or fluid, being less active, ignoring the urge to go, stress, pregnancy or certain medicines (such as some painkillers). Most cases are not caused by serious disease, but persistent or new constipation — particularly later in life or alongside warning signs — should be checked. In some people it becomes long-standing and needs ongoing management rather than a one-off fix.

How it is treated

The first steps are not medicines at all: more fibre, more fluid and more physical activity, together with allowing time and privacy to respond to the urge to go, resolve many cases. Any contributing medicines are reviewed. When a laxative is needed, the type is chosen by how it works rather than at random. Bulk-forming laxatives add fibre and need plenty of fluid to work; osmotic laxatives draw water into the bowel to soften stools; stimulant laxatives encourage the bowel muscle to move things along; and stool softeners help where stools are hard. They are often started with a bulk-forming or osmotic agent, with a stimulant added or substituted if needed, and stepped down once things improve. Laxatives are usually a short-term aid alongside the lifestyle measures, though some people with long-standing constipation use them regularly under guidance.