The Danger of Laxatives

Earlier this year, the Food and Drug Administration issued a warning about serious side effects of laxatives if not used according to the label or when used in the presence of certain comorbities. Sodium phosphate laxatives, according to the label, are to be taken as a single daily dose, and for no more than three days. In addition to the warning to contact a physician if the patient has kidney disease, cardiac conditions, or dehydration, the FDA advises patients to ask their physician before taking the drug with age older than 55, or when taking certain medications. These medications include: diuretics, angiotensin-converting (ACE) inhibitors, angiotensin receptor blockers (ARBs), and nonsteroidal anti-inflammatory drugs (NSAIDs).

Laxatives are grouped into different classes and have varied effects on a person's gastrointestinal system. The following is adapted from the Mayo Clinic's website and describes the main types of laxatives.

Laxative Type
Action
Brand Example

Oral osmotics Draw water into the colon to improve passage of stool Miralax
Oral bulk formers Absorb water to form soft, bulky stool Metamucil
Oral stool softeners Add moisture to stool Surfak
Oral stimulants Trigger rhythmic contractions of intestinal wall Senekot
Rectal stimulants Trigger rhythmic contractions of intestinal wall Dulcolax

Because laxatives can interact with medications, asking about medication lists (including supplements and herbals) is important for pelvic rehabilitation providers. Even the teas available at the grocery store that are marketed to help with digestion and specifically, constipation, may work well and may interact with a patient's medications. If you are interested in learning more about laxatives, constipation, and promotion of bowel health with rehabilitation techniques, sign up for the Bowel Pathology and Function continuing education course. This course, written by faculty member Lila Abbate, has been well-received and aims to further the knowledge of therapists who are treating patients with bowel dysfunction. The next course is coming up next month in California!

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