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Are there any over-the-counter treatments for constipation?

Constipation means having infrequent bowel movements, with stools that are hard and sometimes painful to pass. Over-the-counter fiber products such as Metamucil (generic name psyllium), >Fibercon (polycarbophil), and >Citrucel (methylcellulose) are usually the best first choice for constipation. They add bulk to the stool and stimulate the intestine to contract. These laxatives work gently and slowly, and are safe for long-term use. Please note that it may take one to three days to notice an effect. It's very important to take each dose with a full glass of fluid and to drink plenty of water throughout the day.

Stool softeners such as >Colace (docusate sodium) often help to prevent constipation. They are generally taken on a daily basis, and it may also take a few days for these to work. Be sure to consult your doctor if you don't get results after one to two weeks of using a stool softener.

>Milk of magnesia targets two symptoms: upset stomach and constipation. As a laxative, it pulls water into the intestine and increases the urge to have a bowel movement. It can take anywhere from 30 minutes to one hour to get results. For constipation, the usual dose is two tablespoons taken once or twice daily. Don't use it for more than two weeks unless your doctor prescribes it.

>Dulcolax (bisacodyl), >Senokot (senna) are last resorts to treat occasional constipation. These products work by stimulating the bowel. They generally take from six to eight hours to notice an effect. You shouldn't use this type of laxative frequently or for long periods of time. That's because they don't treat the cause of constipation, and may cause the bowel to become "lazy." This can lead to severe constipation over time.

Sources:
Pharmacotherapy: A Pathophysiologic Approach. Appleton and Lange, 1999.The Handbook of Nonprescription Drugs. The American Pharmaceutical Association, 2000.
The Johns Hopkins Complete Home Encyclopedia of Drugs. Medletter Associates Inc., 1998.
Washington Manual of Medical Therapeutics. Lippincott-Raven, 1998.
Medline Plus. Medline, 2006.
Diseases and Conditions. “Constipation”. www.mayoclinic.com. Mayo Clinic Health. Last accessed 12/2006.

This answer prepared 8/6/2001.
This information updated 12/7/2006.