TYPES OF LAXATIVES
Laxatives are medications or substances that help stimulate or facilitate bowel movements. They are classified according
to their mechanism of action into the following types:
1. Intestinal bolus increasers
What they do:They increase the volume of stool, stimulating the natural movement of the intestine (peristalsis).
Examples:Wheat bran, psyllium (plantago), methylcellulose.
Recommendation:Take with plenty of water to avoid intestinal obstructions.
2. Emollient agents or surfactants
What they do:They soften stool by facilitating the mixing of water and fat, making it softer.
Example:Docusate sodium.
Use:Indicated for people with restricted effort (such as after surgery).
3. Lubricating agents of fecal content
What they do:They facilitate the passage of feces by covering them with a fatty layer.
Example:Mineral oil.
Caution:Do not use for a long time, as it may interfere with the absorption of vitamins.
4. Osmotic agents
What they do:They attract water to the intestine, increasing volume and softening stool.
Examples:Lactulose, sorbitol, polyethylene glycol (PEG), magnesium salts (magnesium hydroxide).
Indication:Effective for chronic constipation or severe cases.
5. Substances that stimulate the intestinal mucosa
What they do:They irritate the wall of the intestine, stimulating bowel movements.
Examples:Bisacodyl, sennosides, cascara sagrada.
Use:Last option; not recommended for long-term use.
6. Saline and non-saline laxatives
Salines:They attract water to the intestine due to their high concentration of salts, such as magnesium hydroxide
and magnesium citrate.
o Use:Very effective for intestinal cleansing before colonoscopies.
o Caution:Not recommended for patients with hypertension or kidney failure.
Non-saline:They include osmotic agents such as lactulose and PEG, which are safer for long-term use.
7. Other laxatives
Prebiotics:They promote the growth of beneficial bacteria (e.g. inulin, fructooligosaccharides).
Rectal laxatives:Glycerin suppositories or enemas.
Indication:For one-off use for immediate evacuation.
Recommendations for specific cases
Pregnancy:Emollient agents (such as docusate sodium) and non-saline osmotic laxatives (such as lactulose) are
recommended. Avoid stimulant and saline laxatives.
Long-term use:Intestinal bolus enhancers and non-saline osmotic agents (such as PEG) are safer.
Colonoscopy:Use saline or PEG laxatives as directed by your doctor.
Hypertensive:Avoid saline laxatives; opt for alternatives such as lactulose or polyethylene glycol.
General Recommendations
Laxatives are medications or substances that help stimulate or facilitate bowel movements. They are classified according
to their mechanism of action into the following types:
1. Intestinal bolus increasers
What they do:They increase the volume of stool, stimulating the natural movement of the intestine (peristalsis).
Examples:Wheat bran, psyllium (plantago), methylcellulose.
Recommendation:Take with plenty of water to avoid intestinal obstructions.
2. Emollient agents or surfactants
What they do:They soften stool by facilitating the mixing of water and fat, making it softer.
Example:Docusate sodium.
Use:Indicated for people with restricted effort (such as after surgery).
3. Lubricating agents of fecal content
What they do:They facilitate the passage of feces by covering them with a fatty layer.
Example:Mineral oil.
Caution:Do not use for a long time, as it may interfere with the absorption of vitamins.
4. Osmotic agents
What they do:They attract water to the intestine, increasing volume and softening stool.
Examples:Lactulose, sorbitol, polyethylene glycol (PEG), magnesium salts (magnesium hydroxide).
Indication:Effective for chronic constipation or severe cases.
5. Substances that stimulate the intestinal mucosa
What they do:They irritate the wall of the intestine, stimulating bowel movements.
Examples:Bisacodyl, sennosides, cascara sagrada.
Use:Last option; not recommended for long-term use.
6. Saline and non-saline laxatives
Salines:They attract water to the intestine due to their high concentration of salts, such as magnesium hydroxide
and magnesium citrate.
o Use:Very effective for intestinal cleansing before colonoscopies.
o Caution:Not recommended for patients with hypertension or kidney failure.
Non-saline:They include osmotic agents such as lactulose and PEG, which are safer for long-term use.
7. Other laxatives
Prebiotics:They promote the growth of beneficial bacteria (e.g. inulin, fructooligosaccharides).
Rectal laxatives:Glycerin suppositories or enemas.
Indication:For one-off use for immediate evacuation.
Recommendations for specific cases
Pregnancy:Emollient agents (such as docusate sodium) and non-saline osmotic laxatives (such as lactulose) are
recommended. Avoid stimulant and saline laxatives.
Long-term use:Intestinal bolus enhancers and non-saline osmotic agents (such as PEG) are safer.
Colonoscopy:Use saline or PEG laxatives as directed by your doctor.
Hypertensive:Avoid saline laxatives; opt for alternatives such as lactulose or polyethylene glycol.
General Recommendations
