Table of ContentsView AllTable of ContentsHow They WorkPrescription vs. OTCOther Types of LaxativesWhen to See a ProviderSide EffectsPreventing Constipation
Table of ContentsView All
View All
Table of Contents
How They Work
Prescription vs. OTC
Other Types of Laxatives
When to See a Provider
Side Effects
Preventing Constipation
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OTC Stimulant Laxative Brands
A variety of stimulant laxatives are available for purchase over-the-counter (meaning without a prescription from a healthcare provider). Various brands are available, each with different ingredients and dosages. Stimulant laxatives also come in many forms and can be taken as tablets, liquids, powders, chewables, or rectal suppositories.
Some stimulant laxatives may contain two different types of active ingredients (the part of the medication that does the work). For instance, docusate is an ingredient used in some OTC laxatives, but it is a stool softener, not a stimulant laxative. It is sometimes combined with a stimulant laxative to have two different forms of action in one dose.
Some of the active ingredients and brand names of OTC stimulant laxatives include:
How They Stimulate the Bowels
The goal of alaxativeis to move stool out of the colon (large intestine). It might be used when there’s difficulty with abowel movement(constipation). There are many reasons for being constipated. Alaxativecould help move the bowels, but it may not address the source of the constipation. So,laxativesmight be used until the cause of the constipation is understood or solved.
The active ingredients senna and bisacodyl make the muscles in the intestines contract, which is calledperistalsis. These muscle contractions move stool through the intestines and out of the body via the bottom (the anus).
Castor oilacts similarly. It contains a substance called ricinoleic acid, which is thought to trigger a response in the colon. It stimulates the nerves in the intestines to trigger the release of natural lubricant secretions. This helps move stool along.
Timing of Relief
The point of a laxative is to have a bowel movement. You may prefer to do this in the comfort of your home. For that reason, the timing of a laxative is important. Generally, taking a laxative at night is recommended in the hopes that it will work in the morning.If you worry about the urge to have a bowel movement at work or school, it may be best to try to take a laxative when there’s more time. The night before a day off from work, school, or activities might be the best time to consider using a laxative.
Prescription vs. OTC Stimulant Laxatives
Most stimulant laxatives are available OTC. However, when laxatives are needed long-term, they should be used under the care of a healthcare provider. It may make sense to get a prescription to make sure that they are taken in the right dosage and as needed.
People with health insurance may also find they save money in getting a prescription medication compared with buying a stimulant laxative OTC.
Compared to Other Types of Laxatives
Types of laxatives that aren’t stimulants include bulk-forming laxatives, stool softeners, and osmotic laxatives.
Bulk-forming laxatives, which often are a form of fiber, add bulk and water to stools to make them easier to pass.They take longer to work than other laxatives. They tend to work more gently than stimulants and can be used every day.
Stool softenersbring more water into the stool, making it easier to move along the digestive system and pass. They take more time to work than stimulant laxatives (sometimes a few days). They might also be used for longer periods under the guidance of a healthcare provider.
Osmoticor hyperosmotic laxatives bring more water into the intestines to soften stool. They come in both OTC and prescription strength. Prescriptions are usually given to people who need to clear their intestines of stool before a procedure (such as a colonoscopy). An OTC osmotic laxative such as Miralax contains polyethylene glycol and may take between 2 and 4 days to result in a bowel movement.
When to Stop Laxatives and Consult Provider
Constipation is a common problem. A laxative could be helpful when constipation occurs occasionally, as it does for many adults. Only use laxatives according to directions and when they are needed.
Constipation that lasts a few days is not always a cause for concern. But when the bowels aren’t moving for several days in a row, and laxatives are not working, it could turn into a serious problem. More help may be needed to determine what is causing the constipation and resolve it.
If you have constipation and any of these symptoms, see a healthcare provider as soon as possible:
Short and Long-Term Risks
Short-term (defined as less than four weeks), occasional use at recommended doses to treat constipation isn’t thought to carry many health risks. The goal should be to use stimulant laxatives to solve an acute problem and then move to a more sustainable long-term solution.
However,poor outcomesmay occur when using stimulant laxatives long-term or in higher than recommended doses. In high doses or when used for extended periods, stimulant laxatives might damage the nerves that help the muscles in the intestines contract, making constipation even worse.
Some lower-quality studies show harm from stimulant laxatives, but not all experts agree.
When Laxatives or Other Constipation Medications Work too WellA variety of OTC medications are available to treat occasional constipation. Prescription drugs are also used for constipation related to a disorder, such as chronic idiopathic constipation (CIC) or irritable bowel syndrome (IBS). These are not used for occasional constipation but for a diagnosed condition of which constipation is a part.For instance,Linzess(linaclotide) could be prescribed for CIC or IBS with constipation (IBS-C). However, it has the potential for side effects, including diarrhea.Trulance(plecanatide) is another drug that may be prescribed for CIC or IBS-C. Trulance also may cause diarrhea and is not approved for use in children because of the risk of dehydration.It’s important to see a healthcare provider to find the best way to manage constipation. OTC or prescription medications should only be used as directed. If laxatives or prescription medications lead to diarrhea, it’s important to see a healthcare provider for guidance, especially in children, and ifdehydrationis a concern.
When Laxatives or Other Constipation Medications Work too Well
A variety of OTC medications are available to treat occasional constipation. Prescription drugs are also used for constipation related to a disorder, such as chronic idiopathic constipation (CIC) or irritable bowel syndrome (IBS). These are not used for occasional constipation but for a diagnosed condition of which constipation is a part.For instance,Linzess(linaclotide) could be prescribed for CIC or IBS with constipation (IBS-C). However, it has the potential for side effects, including diarrhea.Trulance(plecanatide) is another drug that may be prescribed for CIC or IBS-C. Trulance also may cause diarrhea and is not approved for use in children because of the risk of dehydration.It’s important to see a healthcare provider to find the best way to manage constipation. OTC or prescription medications should only be used as directed. If laxatives or prescription medications lead to diarrhea, it’s important to see a healthcare provider for guidance, especially in children, and ifdehydrationis a concern.
A variety of OTC medications are available to treat occasional constipation. Prescription drugs are also used for constipation related to a disorder, such as chronic idiopathic constipation (CIC) or irritable bowel syndrome (IBS). These are not used for occasional constipation but for a diagnosed condition of which constipation is a part.For instance,Linzess(linaclotide) could be prescribed for CIC or IBS with constipation (IBS-C). However, it has the potential for side effects, including diarrhea.Trulance(plecanatide) is another drug that may be prescribed for CIC or IBS-C. Trulance also may cause diarrhea and is not approved for use in children because of the risk of dehydration.
It’s important to see a healthcare provider to find the best way to manage constipation. OTC or prescription medications should only be used as directed. If laxatives or prescription medications lead to diarrhea, it’s important to see a healthcare provider for guidance, especially in children, and ifdehydrationis a concern.
The various forms of stimulant laxatives may cause side effects. Every person’s experience with stimulant laxatives will be different.
Bisacodyl may be associated with:
Senna may be associated with:
Castor oil may be associated with:
Lifestyle Reminders for Easier Poops
You makelifestyle and diet changesto help avoid constipation. You might also work with a healthcare provider, especially while taking medications that might lead to hard stools (such asopioid medications).
Relatively low-risk suggestions that support better bowel movements include:
Abdominal Massage for Constipation
Consider asking a healthcare provider about using abdominal massage for constipation relief. Some licensed massage therapists may administer massage techniques that may help with constipation.
People can also learn “I Love You” orILU abdominal massage, which they can perform on themselves to try to relieve constipation.It’s called “ILU” because the technique involves tracing those letters on the abdomen while applying finger pressure. This massage may be recommended for use in the morning after breakfast for 10 or 15 minutes to stimulate a bowel movement. It is done while lying on the back on a firm surface:
Summary
Stimulant laxatives are one choice for prompting a bowel movement when constipated. They come in a variety of forms and generally work to help bowels move within a day. They’re not usually recommended for long-term use, but the evidence on whether or not they may be harmful is still poorly understood.
Self-treating occasional constipation with over-the-counter laxatives is generally considered safe. However, constipation that is ongoing or associated with other symptoms (abdominal pain, fever, or blood in or on the stool) is a reason to seek help from a healthcare provider.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Bisacodyl.MedlinePlus.Bisacodyl rectal.MedlinePlus.Castor oil overdose.MedlinePlus.Senna.Harvard Health Publishing.Laxatives: what to know about choosing the right one.Chang L, Chey WD, Imdad A, et al.American Gastroenterological Association-American College of Gastroenterology clinical practice guideline: pharmacological management of chronic idiopathic constipation.Gastroenterology. 2023;164(7):1086-1106. doi:10.1053/j.gastro.2023.03.214.MD Anderson Cancer Center.What to know about castor oil health claims.DailyMed.Label: castor oil liquid.National Cancer Institute.Bulk-forming agents.MedlinePlus.Stool softeners.MedlinePlus.Polyethylene glycol 3350.National Institute of Diabetes and Digestive and Kidney Diseases.Constipation.Gibson D, Benabe J, Watters A, Oakes J, Mehler PS.Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients-a pilot study.J Eat Disord. 2021;9(1):146. doi:10.1186/s40337-021-00502-9.Whorwell P, Lange R, Scarpignato C.Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge.Therap Adv Gastroenterol. 2024;17:17562848241249664. doi:10.1177/17562848241249664.Tian X, Chen WQ, Liu XL, Chen H, Liu BL, Pi YP.Comparative efficacy of combination of 1 L polyethylene glycol, castor oil and ascorbic acid versus 2 L polyethylene glycol plus castor oil versus 3 L polyethylene glycol for colon cleansing before colonoscopy: study protocol of a randomized, double-blind, single-center study.Medicine (Baltimore). 2018;97(17):e0481. doi:10.1097/MD.0000000000010481.Gu X, Zhang L, Yuan H, Zhang M.Analysis of the efficacy of abdominal massage on functional constipation: a meta-analysis.Heliyon. 2023;9:e18098. doi:10.1016/j.heliyon.2023.e18098.Women’s College Hospital.“I love you” (ILU) abdominal massage.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Bisacodyl.MedlinePlus.Bisacodyl rectal.MedlinePlus.Castor oil overdose.MedlinePlus.Senna.Harvard Health Publishing.Laxatives: what to know about choosing the right one.Chang L, Chey WD, Imdad A, et al.American Gastroenterological Association-American College of Gastroenterology clinical practice guideline: pharmacological management of chronic idiopathic constipation.Gastroenterology. 2023;164(7):1086-1106. doi:10.1053/j.gastro.2023.03.214.MD Anderson Cancer Center.What to know about castor oil health claims.DailyMed.Label: castor oil liquid.National Cancer Institute.Bulk-forming agents.MedlinePlus.Stool softeners.MedlinePlus.Polyethylene glycol 3350.National Institute of Diabetes and Digestive and Kidney Diseases.Constipation.Gibson D, Benabe J, Watters A, Oakes J, Mehler PS.Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients-a pilot study.J Eat Disord. 2021;9(1):146. doi:10.1186/s40337-021-00502-9.Whorwell P, Lange R, Scarpignato C.Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge.Therap Adv Gastroenterol. 2024;17:17562848241249664. doi:10.1177/17562848241249664.Tian X, Chen WQ, Liu XL, Chen H, Liu BL, Pi YP.Comparative efficacy of combination of 1 L polyethylene glycol, castor oil and ascorbic acid versus 2 L polyethylene glycol plus castor oil versus 3 L polyethylene glycol for colon cleansing before colonoscopy: study protocol of a randomized, double-blind, single-center study.Medicine (Baltimore). 2018;97(17):e0481. doi:10.1097/MD.0000000000010481.Gu X, Zhang L, Yuan H, Zhang M.Analysis of the efficacy of abdominal massage on functional constipation: a meta-analysis.Heliyon. 2023;9:e18098. doi:10.1016/j.heliyon.2023.e18098.Women’s College Hospital.“I love you” (ILU) abdominal massage.
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Harvard Health Publishing.Laxatives: what to know about choosing the right one.
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Whorwell P, Lange R, Scarpignato C.Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge.Therap Adv Gastroenterol. 2024;17:17562848241249664. doi:10.1177/17562848241249664.
Tian X, Chen WQ, Liu XL, Chen H, Liu BL, Pi YP.Comparative efficacy of combination of 1 L polyethylene glycol, castor oil and ascorbic acid versus 2 L polyethylene glycol plus castor oil versus 3 L polyethylene glycol for colon cleansing before colonoscopy: study protocol of a randomized, double-blind, single-center study.Medicine (Baltimore). 2018;97(17):e0481. doi:10.1097/MD.0000000000010481.
Gu X, Zhang L, Yuan H, Zhang M.Analysis of the efficacy of abdominal massage on functional constipation: a meta-analysis.Heliyon. 2023;9:e18098. doi:10.1016/j.heliyon.2023.e18098.
Women’s College Hospital.“I love you” (ILU) abdominal massage.
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