Constipation is a common condition in which you have fewer bowel movements (less than three bowel movements per week) with defecation problems such as dry, hard, lumpy stools, straining or pain while passing stools, and a sensation of not emptying your rectum completely.

Occasional constipation is not unusual. However, approximately 16% of Americans and 33% of older adults (age 60 plus) have chronic constipation.

Over-the-counter medications are available to provide relief from constipation. But not all laxatives are the same. Please keep reading to learn the differences between two widely used stool softeners and laxative options - Colace and Senokot.

What are the treatment options for constipation?

Over-the-counter medications for constipation

There are several types of over-the-counter laxatives available for treating constipation.

Fiber supplements and bulk-forming laxatives such as psyllium (Metamucil), methylcellulose (Citrucel), and calcium polycarbophil (FiberCon) add bulk to stool and make it easier to pass.
Stimulant laxatives such as bisacodyl (Dulcolax, Correctol) and sennosides (Senokot, Perdiem, Ex-Lax) increase intestinal contractions and move stool through the colon.
Osmotic laxatives such as magnesium citrate, magnesium hydroxide (Milk of Magnesia), polyethylene glycol (Miralax, Glycolax), and lactulose (Constilac, Cholac) increase the secretion of fluid in the intestines to move stool along and stimulate bowel movements.
Lubricants such as mineral oil allow stool to pass more easily.
Stool softeners such as docusate sodium (Colace) and docusate calcium (Surfak) draw water from the intestines, making stool softer.
Enemas and suppositories such as glycerin or bisacodyl suppositories soften stool, produce a bowel movement, and make it easier to move stool by providing lubrication.

Prescription medications for constipation

If over-the-counter laxatives do not work, your primary care physician or digestive and kidney diseases specialist may prescribe the following prescription medications for chronic constipation.

Medications such as lubiprostone (Amitiza), plecanatide (Trulance), and linaclotide (Linzess) that pull water into the colon and make stool move out of the body faster.
Serotonin 5-hydroxytryptamine 4 receptors, such as prucalopride (Motegrity), that help move food and waste through the colon.
Peripherally acting mu-opioid receptor antagonists (PAMORAs) such as methylnaltrexone (Relistor) and naloxegol (Movantik) that reverse the effect of opioids on the colon and are used to treat constipation caused by opioid pain medications.

Are Senokot and Colace made by the same company?

Yes, Senokot and Colace are made by the same company. They are made by Avrio Health, which has been acquired by Atlantis Consumer Healthcare, Inc., a subsidiary of Arcadia Consumer Healthcare, Inc.

Are Colace and Senna the same?

Both Colace and Senna are over-the-counter constipation treatments, but they are not the same. Here are some of the key differences between them.

Ingredients and Brand Names

Colace is a brand name stool softener that contains docusate sodium as the active ingredient. Other products that also contain docusate are Correctol Soft Gels, Surfak, Diocto, Fleet Sof-Lax, Ex-Lax Stool Softener, and Phillips Liqui-Gels.

Senokot is a brand name stimulant laxative that contains sennosides (plant-based laxatives) as the active ingredient. Other products containing the same ingredients are Black Draught, Ex-Lax, Nature’s Remedy, Fletcher’s Castoria, Senna X-Prep, Senexon, and Perdiem Overnight Relief.

Combination products that contain both docusate and sennosides are also available under brand names such as Correctol 50 Plus, Gentlax S, Ex-Lax Gentle Strength, Senokot-S, and Peri-Colace.

Uses and mechanism of action

Colace is a stool softener that works as a surfactant. It increases the body’s deposition of moisture into stool. This helps soften the stool and makes it easier to pass. Colace is used to treat constipation.

Senokot belongs to a group of drugs called stimulant laxatives. These laxatives work by increasing contractions in the intestines to cause a bowel movement. Senokot is used for short-term constipation treatment.

Dosage form

Colace comes in capsules, tablets, and soft gels. Senokot comes as tablets, gummies, and tea.

Relief of symptoms

Colace does not work immediately. It takes up to three days for Colace to soften stools and make bowel movements easier. Therefore, Colace is not for quick relief of constipation.

Senokot works by stimulating muscle contractions in the intestines to move the stool along the digestive system. The effects of Senokot are typically seen within 8-12 hours of taking a dose.

Duration of treatment

Colace can be used long-term under the supervision of a healthcare provider.

Senokot should not be used for treating constipation long-term as it can make your bowel dependent on the medication.

Side effects

Common side effects of Colace include nausea and stomach cramps.

Possible side effects of Senokot include nausea, stomach cramps, stomach discomfort, brown discoloration of urine, and feeling faint. Long-term use of Senokot can lead to electrolyte imbalance (low potassium levels).

What is the best stool softener that works immediately?

Rectal enemas and suppositories usually take less than 15 minutes to produce a bowel movement but may take up to an hour in some cases. In addition, osmotic or saline laxatives such as magnesium citrate tend to work more quickly than other types of stool softeners. They usually take 30 minutes to 6 hours to cause a bowel movement. However, you should not take these laxatives for more than a week without your doctor’s approval.

What is the safest stool softener to use daily?

Bulk-forming laxatives or fiber supplements such as FiberCon, Metamucil, and Citrucel are generally safe for long-term, daily use. They are also considered safe for use by pregnant women because they are not absorbed by the body.

What precautions should I take while using laxatives?

Prolonged use of laxatives can be dangerous. If you are constipated, do not use laxatives for more than one week without consulting your healthcare provider. Give your doctor a list of your other medications to avoid drug interactions. Do not take higher doses or more frequent doses of laxatives than what is indicated on OTC products or your prescription.

Call your doctor if you have stomach pain, cramps, nausea, vomiting, bloating, or a sudden change in bowel habits, such as diarrhea alternating with constipation. Stop using laxatives and call your doctor if you do not have a bowel movement after using a laxative or develop rectal bleeding.

Keep all medications out of reach of children. In case of an overdose, call the poison control center at 1-800-222-1222 or get medical help immediately.

How to prevent constipation?

Here are some lifestyle changes that can help in maintaining regular bowel habits:

Eat fiber-rich foods such as fresh fruits and vegetables.
Drink plenty of water to prevent dehydration.
Get regular exercise to keep the intestine moving.
Don’t ignore the urge to use the bathroom for a bowel movement.
Take your time during bowel movements without rushing.

References:

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