AlzU Blog

The ABC's of Constipation/Tips for Caregivers-Part III (Laxatives)

When it comes to the need for taking laxatives for constipation, which type are best and when are they really needed?  There are various types of over the counter and prescription laxatives.  If your loved one with AD is constipated, it’s important to consult with the physician before giving laxatives. 

Below are the various types of laxative agents and how they work.

Types of Laxatives

Osmotic laxatives-these laxatives contain a type of sugar that work by drawing more water into the bowel to soften the stool making it easier to pass.  Prunes and prune juice works this way, as does the over the counter laxative Miralax and the prescription laxatives called lactulose and sorbitol.  Osmosis is the scientific term for this water moving process. 

Stool softening laxatives-such as Colace are common prescription laxatives that soften the stool making it a little easier to move.  Although stool softening laxative are the most commonly prescribed type of agent, they’re not known to be very effective-particularly for severe and chronic constipation.

Fiber-also called bulking agents work to promote bowel movements by increasing the bulk of the stool.  The colon works more efficiently with a proper amount of fiber roughage.  It’s important to note that with some types of constipation (such as the type caused by narcotic analgesics) using fiber could cause things to completely stop up.  For elderly folks who are prone to dehydration (due to lack of fluid intake), fiber laxatives are NOT recommended.  It’s important to drink plenty of water with bulk laxatives such as, Metamucil (a psyllium powder based laxative).  The natural way to ingest bulk laxatives is to eat plenty of whole grains, fruits and vegetables.  To learn more about whole grains, CLICK HERE to sign up for our 25 lesson course at today.

Stimulant laxatives-these drugs work to stimulate muscle activity in the colon.  Senna (an over the counter medication) and Bisacodyl are samples of stimulant agents.  Notoriously these agents are usually the last resort for constipation because of the possibility of damage to the nerves in the colon with regular use of this type of laxative.  However, many experts feel stimulant laxative are safe to use daily.  More research is required to be certain of long term effects of stimulant laxatives.

Which Type of Laxative is Best?

The answer to which type of laxative is best is different for each individual, depending on several variables.  One such factor is when taking prescription medications that cause constipation (like opiates).  With opiate pain medications (such as Vicodin), constipation is almost always a side effect. 

It’s important to note that fiber type laxatives are contraindicated in individuals taking medications such as narcotic analgesics unless an additional type of laxative is added.  The fiber alone probably won’t help and could possibly even cause a blockage.  Usually fiber is prescribed with prunes or another type of osmotic agents such as Miralax, particularly for those who are on pain killers such as Vicodin. 

Remember that laxatives are medications and it’s important to add them to the list of medications whenever your loved one is seen by any medical professional. 

Miscellaneous Factors About Laxatives

    It’s usually okay to slightly adjust your dose of laxatives on your own when needed, but always consult with the prescribing physician in advance to be sure. 

      Many types of constipation respond better when 2 different types of laxatives are used.

        Each person’s body is different when it comes to the need for laxatives, the dose may need to be experimented with before you know for sure the right amount for you or a loved one.

          The goal in treating constipation is one good sized bowel movement at least every one to two days, no less than three times per week. 

            Getting good results and proper laxative treatment can make all the difference in a loved one with AD.

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