In an era where time is at a premium, life is typically as per worked out routines. When routines are delayed, it throws normal life out of gear and when these delays are on a regular basis, it severely impacts various areas of life. Constipation has dual effects – health as well as routines. Treatment of constipation typically involves treating the underlying cause and the use of stools softeners and laxatives on a short-term basis. Many individuals end up taking stool softeners on a long-term basis and there is the possibility of being exposed to stool softener side effects. Here is a good look at handling the potential side effects, with a detailed look at how the side effects may possibly manifest.

Overview of oral laxatives and stool softener side effects

The primary mechanism of action of stool softeners is either by increasing bulk or by increasing water absorption. This helps to reduce friction and increases motility which in turn help to ease constipation. One of the reasons for constipation is lesser water content in the stools; which is attributed to various reasons. By increasing the water content, either by water retention or by increased fiber intake, the stools are softened. When the fiber content intake is increased, it contributes towards water retention and this consequently helps in softening the stools. Before we look at stool softener side effects it is necessary to delve a little deeper into the oral formulations presently available in the market to soften the stool.

How do stool softeners work?

Stool softeners increase water absorption in the guts and this softens the stool, helping it to move smoothly. Administered orally, the formulations increase water and fat intake, and help to reduce friction and surface tension that is attributed to constipation and hard stool. It takes a minimum of six hours and maximum of three days for the onset of action of the softeners, from the time it is administered orally. When the patient consumes the oral formulation, after the mechanism of action starts, it brings about an increase in the secretion of water, minerals and electrolytes. For instance, secretion of potassium, chloride and sodium increase when the stool softeners are administered. Apart from the above mechanism of action, stool softeners also trigger a decrease in bicarbonate and levels of glucose being absorbed.

Stool softener side effects that are attributed to incorrect dosage

Across all medications and supplements, side effects are often the result of wrong dosage and improper practices. It is necessary to follow the prescribed or recommended dosage and the right way of taking the medications, to prevent stool softener side effects. Recommended dosages are often on the basis of a broad category of individuals or patients and the actual dosage may differ from person to person within a category-based on various parameters. The ideal dosages are only for the purpose of reference and will help individuals understand the maximum permissible dosage. Oral formulations of stool softeners are typically available as 10 mg/mL, 50 mg/mL and syrup forms of stool softeners are available as 60 mg/15 mL. Patients are advised to seek specialist advice regarding the correct dosage and frequency of use. In the case of children, there is no recommended dosage, and the dosage is determined specifically by the treating specialist based on assessment. It is therefore necessary to avoid using laxatives or stool softeners on children without specific medical assessment and recommendations.

Different types of stool softeners and laxatives

A better understanding of different types of stool softeners and laxatives will also help identify the right kind of remedy and help prevent stool softener side effects. The different types of stool softeners and laxatives include emollient laxatives, bulk forming laxatives, lubricant laxatives, hyperosmotic laxatives, saline laxatives and stimulant laxatives. Each form of stool softener or laxative has a different mechanism of action. For instance, emollient laxatives, that are commonly known as stool softeners work by increasing the moisture content and softening the stool. This is ideally used by individuals to prevent constipation, and is effective enough for mild and moderate constipation.

Bulk forming laxatives work by forming a gel in the stool that builds up water content, which in turn results in increasing the volume of stool. Consequently, there is better motility of the stool and it passes through the intestines smoothly and quickly. These laxatives are ideal for treating bouts of constipation that last longer. In other words, individuals with chronic constipation can consider this option. Lubricant laxatives work by forming a coating on the stool and the intestines. This helps to arrest water loss, and also acts as a lubricant which helps the stool pass through smoothly, with less discomfort. This type of laxative is not suitable for use on a long-term basis as this will have an impact on various functions in the body. The ability of the body to absorb various vitamins will be affected when taken on a long- term basis, and this is therefore suitable only for immediate relief and on a short-term basis.

Hyperosmotic laxatives work in a manner that is similar to emollient laxatives – increased water absorption. The laxative increases the amount of water that is drawn in the intestines and this in turn helps soften the stool, helping it move through smoothly. This option is considered as a safe option as patients can use the formulation for a longer period with the apprehension of side effects. It is suitable for use by patients with chronic cases of constipation; but the onset of action may take a little longer than other laxatives, due to the mechanism of action.

Saline laxatives work in the same manner, by drawing more water into the intestines and this in turn softens the stools. This facilitates smoother movement of the stool, eliminating discomfort. However, saline laxatives are not ideal for long-term use. By virtue of the mechanism of action of the laxative, it may result in dehydration and will also result in causing electrolyte imbalance in the body when taken on a long-term basis. Stimulant laxatives work by facilitating the movement of stool in the intestines, with less discomfort. Similar to saline laxatives, stimulant laxatives are not suitable for long-term use. Armed with the above information, it will now be possible for patients to reduce the possibility of stool softener side effects by identifying the right product or formulation for specific conditions.

Stool softener side effects that are commonly experienced

Stool softener side effects are typically divided into two broad categories – common and rare. The commonly reported side effects are mostly mild or moderate in nature and may not require any medical intervention in most cases. Only when the side effects persist or if the symptoms are intense will it require medical intervention. Rare side effects are typically experienced by a small section of patients and in some instances may require some kind of medical intervention. Here is a look at stool softener side effects that are relatively common in occurrence.

Individuals on stool softeners may experience rashes on the body. Only when the rashes are not attributed to other existing conditions will it be narrowed down to possible stool softener side effects. Other commonly reported side effects include the possibility of patients not experiencing relief from abdominal cramps that occurs along with constipation. As mentioned earlier, the mechanism of action of stool softeners is limited to the movement of the stools and it may therefore not be effective enough in tackling the issue of abdominal cramps. As a result, the cramps may persist and in event that the cramps are severe, patients may require other remedies to overcome the pain and discomfort of the cramps.

In a majority of the cases, individuals are known to use stool softeners for a longer period and this may result in some kind of dependence among patients. In other words, patients may find it difficult to pass stools without the assistance of stool softeners as a result of dependence and this is one of the possible stool softener side effects. It is necessary to ensure that use of medications and formulations for any purpose are restricted to only the duration required for the purpose of relief or treatment. One of the outcomes of stool softener side effects is impact on electrolyte levels, as mentioned earlier. When patients take stool softeners for a longer period, this will in turn affect electrolyte levels in a stronger way. It is therefore necessary to use the right kind of stool softeners or laxatives to reduce this impact.

Possible stool softener side effects include bouts of diarrhea. This is mainly attributed to the increased levels of water and fats that are facilitated by stool softeners. When the body ends up with higher levels of water and fat, there is the possibility of increased bowel movements and this could result in possible diarrhea. While all of the side effects mentioned above are possible, it is not necessary that every individual will experience the side effect. Some may end up with the side effects, while some may not experience any kind of side effect whatsoever.

Stool softener side effects as a result of drug interactions

Drug interactions of stool softeners can trigger side effects. It is important to understand possible stool softener side effects as a result of interaction with other substances or medications. Mineral oil is not to be taken along with stool softeners, as it causes undesirable effects. The mechanism of action of mineral oil and the mechanism of action of stool softeners will result in undesirable side effects and it is essential to stop mineral oils when on stool softeners.

How to avoid stool softener side effects with precautionary measures

Best practices and precautions help avoid stool softener side effects. For instance, it is best to use the formulations for a short period and avoid use for more than a week without specific instructions or recommendations from a specialist. In the event that individuals are recommended to take the formulations for a longer period, it is essential to ensure that electrolyte imbalance is managed effectively. It would be a better option to use the most suitable type of formulation if treatment/remedy is required for a longer period. Women who are nursing infants or pregnant women are advised to seek specific medical advice before taking any form of stool softeners or laxatives. This is necessary as enough evidence has not been compiled on stool softener side effects on pregnant women and nursing mothers. It is therefore necessary to proceed with caution and only under medical advice.

Finally, individuals with certain pre-existing conditions are also advised to take the formulation only with medical advice or supervision. For instance, patients with inflammatory bowel disease, complications in the intestines, stomach, abnormal bowel movements, and allergies to active ingredients in the formulation are advised to consult specialists.


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