Constipation is one of the most common problems for which people buy something over the counter at the pharmacy. The good news: in most cases it resolves with fibre, water and movement, and laxatives have their role — if they are chosen and used correctly. Here are the types and the safety rules, for informational purposes.
First, the simple measures
Before any pill: fibre (vegetables, fruit, whole grains), hydration and movement. Many "chronic" cases of constipation improve with these three things alone.
The types of laxatives
Bulk-forming (fibre) — psyllium, bran: first line, but taken with plenty of water, otherwise they make things worse.
Osmotic — lactuloză, macrogol (PEG): they draw water into the intestine, are gentle and can also be used over longer periods.
Stimulant — bisacodil, senna: they act quickly, but should not be used daily for a long time (the intestine can become "lazy").
Local — glycerin suppositories, enemas: rapid effect, occasional use.
How to use them safely
The rule: the gentlest option that works, for as little time as possible. Stimulants are for occasional relief, not for every day. Drink enough water, especially with fibre. If you need a laxative almost daily for weeks, it is time to see a doctor.
When to see a doctor — warning signs
New-onset and persistent constipation (especially after age 50), blood in the stool, unexplained weight loss, severe abdominal pain, or alternating constipation and diarrhoea. In young children and during pregnancy, certain laxatives are preferred over others — ask your pharmacist or doctor for advice.
What is up to you
Fibre, water, movement and patience most often solve the problem. To compare product prices at pharmacies nearby, use the HartaFarmacii search.
- ANMDMR — SmPC for common laxatives (macrogol, lactuloză, bisacodil, senna)
- Gastroenterology guidelines on chronic constipation
- EMA — information about laxatives