Constipation: self-care

by | Gastrointestinal Health, Pharmacy Care

General Information

Constipation is when your bowel motions take more effort than usual and your stools can be small and hard. Your bowel motions may be less frequent than usual, and you may have to strain to pass a bowel motion.

Not everyone has a bowel motion every day; some people have one every second or third day.

Symptoms of constipation can include:

  • headache
  • loss of appetite
  • build-up of wind or flatulence
  • bloating
  • stomach cramps
  • feeling generally unwell
  • irritability
  • diarrhoea, which may occasionally result from constipation, when liquid oozes out past hard stools
  • haemorrhoids (piles), which can also be a sign of constipation. Straining to pass stools can lead to haemorrhoids, which can cause pain and itchiness

Preventing constipation depends on some important factors. A diet high in fibre, including fruit, vegetables and grains, is a good way to stay ‘regular’. Exercising regularly is also an important way to help prevent constipation. Dehydration can contribute to constipation, so it is important that you drink enough water every day.

See Your Pharmacist or Medical Professional

  • if the person with constipation is a child or an elderly person
  • if you have constipation and vomiting
  • if you have lost weight
  • if your bowel motions change colour or contain blood
  • if you keep getting constipated, or it is getting worse
  • If you are over the age of 40 and have a sudden change in bowel movement with no obvious cause
  • if you have abdominal pain or bloating
  • if you are using laxatives and you feel they are not working
  • if your constipation alternates with diarrhoea
  • if you have a fever
  • if there is pain associated with a bowel movement
  • if you have been constipated for more than seven days
  • if you are pregnant or breastfeeding; some laxatives will not be suitable
  • if you have other medical conditions or begin taking new medicines
  • if you have allergies to any medicines

Treatment Tips

  • the best way to treat constipation is to treat the cause, such as dehydration, lack of fibre or lack of exercise
  • increase fibre gradually to avoid bloating and flatulence
  • if increasing fluid, fruit and vegetables and/or exercise does not work, short-term use of laxatives can treat the immediate problem

Treatment Options

  • laxatives are available as tablets, sachets, powders, granules, liquids, suppositories and enemas
  • always check the contents of laxatives and the dosage with your pharmacist
  • different laxatives work in different ways, which your pharmacist can explain
  • overuse of some laxatives may cause imbalances in your body salts, which can be dangerous

Bulk-forming laxatives


e.g. Benefiber, Blackmores Colon Care, H Bio-Juven Vascurem 2, Metamucil (sugar-free available), Fybogel, Normacol Plus, Normafibre

  • bulk-forming laxatives can be a good first choice, as they work like fibre
  • they start working in 24 hours but may take two or three days to reach full effect
  • they are not absorbed by your body and do not interact with other medicines
  • drink plenty of water when taking laxatives
  • do not lie down immediately after taking bulk-forming laxatives
  • bulk-forming laxatives commonly cause flatulence and bloating
  • some preparations contain bulk-forming laxatives combined with stimulant laxatives, such as Normacol Plus
  • bulk-forming laxatives are not suitable when constipation is caused by something serious, such as a blockage in the bowel or if you are confined to bed
  • bulk-forming laxatives should not be used if you have opioid-induced constipation
  • they are poorly tolerated in people with functional bloating (being bloated for more than 3 days in a month for 3 months in a row, or having bloating symptoms that significantly affect your life)
  • if you have diabetes, check which is an appropriate product, because most contain sugar

Faecal (stool) softeners


e.g. docusate sodium (Coloxyl Tablets, Coloxyl with Senna, Sennesoft, Co-Senna, Colaxsen, ColoxEase), poloxamer (Coloxyl Drops), liquid paraffin (Agarol, Parachoc)

  • stool softeners draw fluid into the stools and make them softer and easier to pass without straining
  • faecal softeners can help if you are straining to pass a stool, or if it is important for you not to strain
  • faecal softeners take effect in one to three days
  • some preparations contain faecal softeners and stimulant laxatives, such as Coloxyl with Senna
  • poloxamer (Coloxyl drops) is more appropriate for infants and children than liquid paraffin and is preferred for children under 3 years
  • liquid paraffin (Parachoc, Agarol) should not be given before lying down, such as at bedtime
  • may reduce absorption of fat-soluble vitamins (vitamins A, D, E and K)

Osmotic laxatives


e.g. glycerol (Glycerol Suppositories BP), lactulose (Duphalac, Dulose, Actilax, Genlac), magnesium sulphate (Epsom salts), sorbitol (Sorbilax); enemas (Fleet Ready-to-Use Enema, Microlax)


e.g. sodium picosulfate (Picolax)

  • osmotic laxatives are available as liquids, suppositories or enemas
  • they improve bowel motions by increasing the amount of fluid in your bowel
  • some osmotic laxatives can take up to two to three days of regular doses to reach full effect
  • lactulose can be mixed with water, fruit juice, lemonade or milk
  • lactulose contains some lactose, so people with lactose intolerance or diabetes should check with their pharmacist before taking it
  • regular small doses provide better symptom control than large intermittent doses
  • Microlax enema (which is safe for use in pregnancy) acts in 30 minutes, so it is advisable to stay on the toilet after inserting
  • glycerol suppositories act within 15–30 minutes
  • some osmotic laxatives are not tolerated in irritable bowel syndrome or functional bloating due to bloating and discomfort
  • if long-term use is required, check with your pharmacist, as some osmotic laxatives can lead to an imbalance in your body salts

Iso-osmotic laxatives


e.g. macrogol 3350 with electrolytes (Movicol, Movicol-Half)


e.g. macrogol 3350 with electrolytes (ColonLYTELY)

  • iso-osmotic laxatives are available as powders, which can be dissolved in water
  • they increase fluid and soften the stool, usually working in one to two days
  • iso-osmotic laxatives cause less of a salt imbalance than the osmotic laxatives
  • oral medicines taken during or within the hour before administration of a bowel preparation may be flushed from the gastrointestinal tract without absorption

Stimulant laxatives


e.g. bisacodyl (Dulcolax tablets, Dulcolax suppositories, Bisalax tablets and enemas), senna (Herbal Laxative, Herb-a-lax, Lax-Active, Senokot), sodium picosulfate (Dulcolax SP Drops), softener plus stimulant (Coloxyl with Senna)

  • stimulant laxatives directly stimulate your bowel to cause movement
  • they can be effective when constipation is severe and rapid action is needed
  • tablets work in about eight hours; suppositories work more quickly
  • tablets are normally taken at bedtime so they work the next day
  • stimulant laxatives can be used short term to return your bowel habit back to normal
  • they are not recommended in young children or during pregnancy
  • do not use stimulant laxatives regularly without checking with your pharmacist
  • stimulant laxatives are poorly tolerated in people with irritable bowel syndrome and functional bloating due to bloating and discomfort
  • people who abuse stimulant laxatives may have difficulty resuming a normal bowel pattern when the laxatives are stopped

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.

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