Treatment options

Constipation in itself is not life-threatening, but there can be serious consequences if it is left untreated (including faecal impaction and haemorrhoids).

There are a range of constipation remedies available, that work in different ways. Your pharmacist or doctor can advise what’s best for you, depending on the severity and persistence of your constipation
as well as factors like age, lifestyle and other health concerns.

Some of the main treatment types are described below.

Bulk-forming laxatives

e.g. bran, ispaghula husk, psyllium, sterculia.

These work by increasing the amount of water in the stool, making it softer and easier to pass. Because fibre laxatives work by absorbing water from your body, you need to stay well hydrated by drinking more than usual (otherwise the constipation might actually get worse). For fit and healthy people with only mild constipation, fibre laxatives may be an effective remedy, but they can take up to three days to work.

Faecal (stool) softeners

e.g. docusate sodium, poloxamer

These kinds of laxatives also work in the intestine, enabling additional water and fat to be mixed into
the stool, making it easier to pass. Their efficacy on their own is limited, so they are reserved for mild constipation.

Osmotic laxatives

e.g. glycerol, lactulose, magnesium sulfate, sorbitol

These may be liquids or suppositories. They work by attracting water from the body into the gut so that more water is held there, softening the stool (so it’s important to keep your hydration while taking them). If used long term, some osmotic laxatives can cause imbalances in your body salts, so be sure to ask your pharmacist or doctor for information.

Iso-Osmotic laxatives

e.g. Macrogol 3350 with electrolytes (MOVICOL®)

They have a similar action to osmotic laxatives, but with iso-osmotic laxatives, there's no net gain or loss of water or electrolytes – so there is less risk of dehydration and no extra fluid is needed for the laxative to work.

Macrogol 3350 with electrolytes is an iso-osmotic laxative, and like fibre laxatives, it’s gentle and works in harmony with the body – but the way it works is different. The main active ingredient, macrogol, goes straight to the bowel where, by retaining a set amount of water, it softens, expands and lubricates the stool to trigger peristalsis – in the same way as your normal bowel movement. The macrogol is then expelled from your body virtually unabsorbed.

MOVICOL does not ferment either, which means less likelihood of gas or bloating/wind.

MOVICOL is currently the only iso-osmotic laxative available in Australia.

See video How MOVICOL works

Stimulant laxatives

Eg: bisacodyl, senna, sodium picosulfate

Stimulant treatments can be effective for the rapid relief of constipation. But rather than working with the body to create a natural bowel movement, they cause the bowel contraction directly through nerve stimulation. Tablets are usually taken at night and a bowel movement normally follows about 6-12 hours later. Stimulant laxatives are usually a short-term remedy – do not use them on an ongoing basis without consulting your doctor or pharmacist.

My Dr from MIMS. Constipation: self-care, available at last accessed 25 Feb 2013.