Those taking senna were more likely than people taking a magnesium laxative to reduce their dose because of side effects.
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Senna and magnesium-based laxatives were equally effective, according to a randomized clinical trial of 90 people with chronic constipation published in January 2021 in The American Journal of Gastroenterology. Magnesium-based laxatives contain compounds that draw water into the stool, such as magnesium hydroxide (Phillips’ Milk of Magnesia and generic) and magnesium citrate (Citroma and generic.) The American Journal of Gastroenterology review found moderate evidence to support the use of magnesium laxatives for chronic constipation. “That said, they are effective.” The products generally start to work within 6 to 12 hours. “Because they stimulate the colon, sometimes they can cause spasms or cramps,” Lacy says. The downside to stimulant laxatives, according to the review, is that they can cause side effects such as abdominal pain and diarrhea. The recent review of OTC drugs found good evidence to recommend senna for chronic constipation and moderate evidence for bisacodyl. Stimulant laxatives such as bisacodyl (Dulcolax laxative tablets and generic) and senna (Ex-Lax, Senokot, and generic) trigger rhythmic contractions in the intestinal muscles that push stools through more quickly. That action stimulates sluggish bowels and keeps stools soft as the colon has less time to absorb the moisture. It can take a couple of days before you notice a difference in your bowel movements. Lacy recommends taking it after dinner so that it kicks in after your breakfast the next morning. The analysis found that it worked better than prescription laxatives. Its safety and effectiveness make it a first choice for many doctors and patients.Ī recent analysis of 41 studies of OTC laxatives published in The American Journal of Gastroenterology found robust evidence that polyethylene glycol works well for chronic constipation while causing minimal side effects. Polyethylene glycol (MiraLax and generic) works by pulling water into the colon, which softens the stool and stimulates the walls of the intestine to move it along. Here’s a summary of the types of laxatives you’ll find on your drugstore shelves: In some cases, your doctor may recommend combining different types of medications. “If someone does not improve after four weeks, then I recommend switching to another agent,” he says.
If you’re really uncomfortable, you can take an OTC laxative until things get back to normal.įor chronic constipation that has gone on for months, Lacy advises giving a drug time to work. Occasional constipation usually lasts only a few days and will resolve on its own, Lacy says. “Everyone’s colon is a little different,” he says. But you may find that one type works better for you or causes fewer side effects. All of them are safe and effective for most patients. In general, OTC laxatives work by increasing water content in the stool so that it’s softer and easier to pass, Wald says. When boosting fiber and exercise doesn’t do the trick, it’s reasonable to consider an over-the-counter laxative.
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