Just as you need to eat every day, you must take laxatives every day for them to work.
The first laxative you should try is the stimulant type called sennosides. It is mild and works for most people. You can buy sennosides in pills or in liquid.
If you have a history of frequent bowel cramps (also known as “Irritable Bowel Syndrome”), you may want to try an osmotic laxative first, such as PEG.
Each person has a different bowel pattern. What is “normal” for you will be different than what is “normal” for another person. However, when having a bowel movement, it should be comfortable to pass. You should not have to push too hard and your stool should be soft but formed.
It is important to tailor your laxative doses based on your bowel pattern and goal. The way your treatment is tailored just for you is called a protocol.
Look at the diagram below.
to enlarge diagram.
Each step up the protocol has a higher dose so you can work up to the level you need to maintain a comfortable bowel pattern. If you move up the protocol as shown, you will not risk over-treatment, which could cause diarrhea.
You should start EITHER the sennosides protocol OR the PEG protocol. Do not start both at the same time
Most people find the sennosides protocol to be the easiest to take. Sennosides cost less than PEG but PEG works just as well.
Whichever protocol you choose, start at step 1. Wait 24 hours. If you have a bowel movement within 24 hours that is soft and comfortable to pass, stay at step 1.
If you do not have a comfortable bowel movement within 24 hours, go to the next step in the protocol.
Only go to the next step if you are still feeling constipated after 24hrs.
Keep moving up a step every 24 hours until you feel your bowel pattern is good for you.
If you have diarrhea, stop taking laxatives until you have a normal bowel movement. Restart the protocol at a lower step than you were on when the diarrhea happened. Do not take pills for diarrhea.
If you have very bad stomach cramps, stop taking sennosides and call your health care team.
- Are not sure how much laxative to take or when you should move to the next step of the protocol.
- Are still constipated after getting to the top step of the protocol. You may need a combination of laxatives or a different approach to your pain management.
- Start having watery stools after a period of being constipated. There may be hard stool stuck in your rectum. If this happens, do not take pills for diarrhea.