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Stool Softener Vs. Laxative

Stool Softener Vs. Laxative

Laxatives are used to stimulate/increase the frequency of bowel movements. Stool softeners are nothing but laxatives, as they improve the movement of feces through the colon.
Sonia Nair
Laxatives and stool softeners are often viewed as different products that are used for treating constipation. In fact, laxatives are of different types, which include stool softeners too. So stool softeners are also laxatives. However, they differ from other types of laxatives in their mode of action and effectiveness.

Stool Softeners and Other Laxatives
Laxatives are used for loosening stools, so that they can easily move through the colon and/or increase the frequency of bowel movements. A laxative could be a drug or a natural remedy like prune juice. As far as drugs are concerned, laxatives can be of different types. They include bulk-forming agents, stool softeners, stimulants, lubricants and osmotics. Though they all aim at relieving constipation, their course of action differs.
  • Stool softeners: As the name rightly suggests, stool softeners are intended to soften stools so that they can easily pass through the colon.
  • Bulk-forming Laxatives: They absorb liquid and add bulk to the stools, which in turn stimulate bowel movements.
  • Stimulant/Irritant Laxatives: These laxatives stimulate bowel movements by increasing the frequency of intestinal muscle contractions.
  • Osmotic Laxatives: Hold up water in the intestine, so that the stools become soft and increase in volume, resulting in easy bowel movements.
  • Lubricant Laxatives: Being lubricants, they coat the stools and make them slippery, so that it becomes easier for them to pass through the colon.
Stool Softeners
Benefits: The ingredients in stool softeners do not stimulate bowel movement or irritate the intestine walls, but soften the stools and make their passage easier. These laxatives are often used to prevent constipation and not to treat it and are usually prescribed for patients who should not strain while passing stools (like heart patients, those who have undergone pelvic or rectal surgery and women after childbirth). Stool softeners are said to be effective in relieving pain associated with anal fissures and hemorrhoids.

Use and Effectiveness: Stool softeners must be used regularly, for better results. Increase in water intake is recommended for those who use these laxatives. Initially, it will take at least 24 to 72 hours for these drugs to work. If you are taking stool softeners, avoid use of aspirin, mineral oils and other lubricant laxatives. It is always better to consult a doctor before resorting to stool softeners. Pregnant and nursing women should seek the opinion of their doctor in this regard.

Side Effects: Though stool softener as a laxative is considered safe, this drug may cause side effects like stomach cramps, nausea and irritation in the throat. In case of severe side effects like skin rash, fever, vomiting, breathing trouble or rectal bleeding you must seek immediate medical attention. These laxatives may also react with certain over-the-counter medicines.

Bulk-forming Laxatives
Benefits: Bulk-forming laxatives swell up inside the intestine and increase the bulk of the stool. Bulky stools stimulate bowel movement. Some of these laxatives contain natural substances like guar gum, psyllium, etc. This type of laxative is found to be beneficial for those with conditions like IBS and diverticulosis. Bulk-forming laxatives are sometimes used as fiber supplements too. They are usually used as an initial treatment for constipation in those having a low-fiber diet. They are also preferred for pregnant women.

Use and Effectiveness: Adequate water intake is a must for those who use these laxatives. The dosage and mode of use must be as per the prescription. It is advisable to start with small doses that can be increased gradually. These laxatives have to be used regularly and may take a few days to work.

Side Effects: People suffering with conditions like narrowing of the digestive tract should not use this product, which may cause blockage of the gastrointestinal tract. Even those with kidney problems must avoid such laxatives, as their water intake could be restricted. Some of these products may contain sugar or artificial sweeteners. Those with diabetes must be beware of that. The possible side effects are bloating and flatulence. Use of these laxatives might cause decrease in sugar levels too. They may also interact with certain drugs and interfere with absorption of medicines like aspirin. Rarely, blockage of the esophagus may also occur. This is mainly seen in elderly people.

Lubricant Laxatives
Benefits: These laxatives act as lubricants that help easy passage of stools. So they are not directly used for treating constipation, but are useful as a preventive measure for those, who should avoid straining while passing stools. Most of these laxatives come in liquid form. Mineral oil is one of the commonly available lubricant laxatives. These laxatives are usually recommended for those who have undergone surgery in the pelvic area or rectum and those with high blood pressure.

Uses and Effectiveness: You should not take lubricant laxatives without consulting your doctor. With regard to dosage and use, strictly adhere to the instructions of the physician. These laxatives are not recommended for long-term use. Pregnant and nursing women must avoid them. Lubricant laxatives should not be taken by people, who use blood thinners. Mineral oil should be strictly avoided in kids, elderly and bedridden people.

Side Effects: These laxatives may cause pneumonia, if they are absorbed into the lungs (through aspiration). Some of the users may develop irritation of the skin around the anus. Mineral oil may hinder absorption of nutrients and so, it is better to avoid intake of this laxative within two hours before and after the meal.

Stimulant/Irritant Laxatives
Benefits: These laxatives stimulate bowel movements (by inducing contractions of muscles in the intestinal wall) and are usually used for quick relief from constipation. Stimulant laxatives are said to be beneficial for removal of intestinal parasites. They are also used to empty the bowel before a surgery or diagnostic procedure like colonoscopy.

Uses and Effectiveness: Stimulant laxatives must be used only under the supervision of a healthcare professional. The dosage and mode of use must be followed strictly. These laxatives take around six to 24 hours (vary with the dosage) to work. Long-term use and/or high doses may cause serious health problems. If used for a long period, laxative dependency may develop. Consult your doctor, if you are taking any prescription medication, as stimulant laxatives might interact with the drugs.

Side Effects: These laxatives may cause adverse effects like abdominal cramping, nausea, vomiting, irritation and bloating. In some users, urine may change to reddish-yellow or brownish in color. Severe reactions like bloody stools, dizziness, fainting, excessive sweating and fast heartbeat, must be reported to the doctor, as soon as possible. In some cases, allergic reactions like itching, swelling of face and trouble breathing may also occur. Long-term use of these laxatives may lead to loss of electrolytes, especially potassium.

Saline Laxatives
Benefits: These laxatives are mainly used for cleansing bowel before a surgery or a diagnostic procedure. Usually, they contain magnesium, phosphate and citrus ions that draw water to the intestine, thereby stimulating bowel movements. Milder forms of saline laxatives are sometimes used for treating occasional constipation. In large doses, these laxatives can empty the bowel completely. In some types of poisonings, these laxatives are used for speedy removal of poison from the gastrointestinal tract.

Use and Effectiveness: The dosage is decided as per the requirement of the user. Saline laxatives are usually mixed with fluids before use. Follow the instructions of the doctor, as far as the dose and method of usage is concerned. It takes around 30 minutes to three hours (vary with dosage) for this laxative to work. Saline laxatives should not be used by people with impaired kidney function and high blood pressure. Those who have suffered congestive heart failure should also avoid this type of laxative.

Side Effects: These laxatives may cause mild side effects like abdominal cramping, nausea and flatulence. Serious effects are very rare, but may develop in case of very high dosage or long-term use. They include rectal bleeding, confusion, swelling of the extremities, dizziness, etc. Those who are on sodium-restricted diet must avoid use of saline laxatives. Allergic reactions are also uncommon.

This is only a brief overview about stool softeners vs. laxatives. Whether it be stool softeners or others, excess use of any laxative may lead to many complications. Choice of laxative is always better done by a healthcare professional, according to the health condition of the user. Duration of use, safety and effectiveness are some of the major differences between the different types of laxatives.

How Long to Use?
Lubricant, stimulant and saline laxatives are recommended for occasional use and not for a long-term, bulk-forming laxatives are often used for long-term treatment. In some cases, doctors recommend long-term treatment using stool softeners too.

How Long Do They Take to Work?
While stool softeners and bulk-forming laxatives take at least 24 to 72 hours to work, other types are much quicker in action (only a few hours are required).

Are They Safe?
As far as side effects are concerned, bulk-forming agents are said to be the safest. Even others are safe, if used as per your doctor's prescription. It is always better to avoid long-term use and high doses of laxatives, so as to prevent side effects.

In short, it is advisable to go for natural constipation remedies (like prunes and psyllium), rather than habitual use of laxatives. However, you may be required to take prescription laxatives, if needed. In case of side effects or drug interactions, contact your doctor at the earliest. Even if the laxative is ineffective, you must consult your doctor for further advice. Regular exercise and adequate water intake will also prove beneficial.

Disclaimer: This article is for informational purposes only and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.