5 Times to Avoid Taking Laxatives—and 5 Times They Can Help
Habitual laxative use can lead to dependence, yet there are times they are recommended. Here's the right type to take in certain situations.
What are laxatives?
Laxatives are substances that affect your digestive system. They loosen stool and stimulate bowel movements, so they’re helpful for constipation relief, but you shouldn’t necessarily take them all the time. Here’s everything you need to know about laxatives including when they can help and when you shouldn’t take them.
Don’t take laxatives daily
“Chronic laxative use can eventually cause the colon to become atonic—’worn out,’ if you will—and over time lead to paradoxically worsening constipation,” says Neilanjan Nandi, MD, a gastroenterologist and assistant professor of medicine and director of the Inflammatory Bowel Disease Center at Drexel University College of Medicine, in Philadelphia. “This can lead to increasing use of laxatives that may eventually not work. If you find yourself having to chronically use laxatives for a bowel movement, you should consult with your doctor to find out why.” (Here are 12 possible causes of constipation.)
Do take them if you need pain medicine after surgery
“One of the most common side effects of narcotic pain medications is constipation,” Dr. Nandi says. “Narcotic pain medications may be temporarily prescribed after surgery. Intra-abdominal surgeries (for example, appendectomy, cholecystectomy or gallbladder removal, hernia repair) or any intervention where there is manipulation of the bowels can commonly lead to a temporary ‘paralyzed bowel’ also known as an ileus. I recommend patients begin on a bowel regimen two to three days prior to receiving pain meds to prevent significant constipation.” Consult your surgeon to see if you might need a laxative for surgery-related pain medication. (See 50 secrets your surgeon won’t tell you.)
Don’t take them if you’re traveling
If access to a bathroom could be at all problematic, laxatives are not your friend. “Avoid stimulant, osmotic, and lubricant laxatives prior to travel as they work more quickly and have more side effects,” says Sheetal Sheth, MD, an assistant professor of obstetrics and gynecology at the George Washington University School of Medicine and Health Sciences in Washington, D.C. Try these 7 tips to avoid constipation while you travel.
Do be cautious about which types you use
“Fiber-based laxatives are safe, effective, and healthy,” Dr. Nandi says. “Ironically, introducing too much fiber too quickly in your diet or bowel regimen may lead to bloating, gas, or cramping. Slowly ramp up your fiber supplementation gradually, such as with weekly increases in dosing. Other laxatives that we call stimulant laxatives—like bisacodyl—or saline laxatives, which often contain magnesium or phosphate, may cause bowel dependence and/or lead to marked dehydration.” In a study published in 2019 in the Scandinavian Journal of Gastroenterology, researchers advised against taking stimulant laxatives for more than four weeks. (Here are some home remedies for constipation.)
Don’t take them if you’re prone to bowel obstructions
It may sound counterintuitive, but you shouldn’t take laxatives if you’ve had problems with bowel obstructions in the past. “Bowel obstructions can occur from scar tissue known as adhesions from previous abdominal surgery,” Dr. Nandi says. “Therefore, laxatives are contraindicated in this condition.” Not sure what your gut issues might be? Here are 7 types of stomach pain and what they mean.
Do be cautious about using them during pregnancy
Constipation is common during pregnancy, due to all the hormonal changes happening in your body. But you need to be careful about using laxatives during pregnancy. “Bulk agents and stool softeners are preferred,” says Dr. Steth. “Bulk laxatives, such as fiber and bran can be taken long-term—however, these may cause unpleasant side effects, including excessive gas and bloating. Stool softeners can be taken on a daily basis and are minimally absorbed systemically.” Dr. Steth recommends avoiding osmotic and stimulant laxatives during pregnancy. “Osmotic laxatives may cause excessive gas and bloating, and may lead to an electrolyte imbalance,” she says. “Stimulants should only be used rarely, as they can lead to intestinal cramping, uterine irritability, pain, electrolyte imbalance, and dehydration.” Learn about the pregnancy myths that you can safely ignore.
Don’t take them to lose weight
“Laxatives can unfortunately be abused—with the misconception that they can help promote weight loss,” Dr. Nandi says. “This is completely incorrect! The late night commercials selling colon cleansers to rid one of stool ‘spackled’ to the inside of the intestine are completely false and are purposefully creating misinformation in order to sell a solution to innocent and naïve customers.” If weight loss is your goal, try these 36 tips to lose weight instead.
Do take them after you give birth
Stool softeners are particularly helpful after C-sections, according to Dr. Steth. “Laxatives can be very helpful after birth, especially in women who have had a third- or fourth-degree laceration and should not strain to have a bowel movement.” Learn other secrets no one tells moms-to-be about birth.
Don’t take them if you have chronic kidney disease or heart disease
Doctors recommend avoiding osmotic laxatives if you have chronic kidney disease or heart disease, as they can lead to dehydration or a mineral imbalance. Watch for these 7 silent signs that your kidneys could be in trouble.
Do be cautious about using them if you’re on medications
“Some laxatives may bind up or interfere with medication absorption, such as some antibiotics or cardiac medications,” Dr. Nandi says. Always consult with your physician or pharmacist about any potential drug interactions. And be aware of these 11 signs that your medications could be making you sick.
- Neilanjan Nandi, MD, assistant professor of medicine and director of the Inflammatory Bowel Disease Center at Drexel University College of Medicine, in Philadelphia, PA.
- Mayo Clinic, "Intestinal Obstruction."
- Sheetal Sheth, MD, assistant professor of obstetrics and gynecology at the George Washington University School of Medicine & Health Sciences in Washington, D.C.
- Scandinavian Journal of Gastroenterology: "Long Term Treatment with Stimulant Laxatives - Clinical Evidence for Effectiveness and Safety?"
- Mayo Clinic, "Pregnancy Week by Week."
- Harvard Health Publishing: "Don't Bomb the Bowel with Laxatives."