Stool Softener vs. Laxative: What Is the Difference?

You may not like talking about it, but just about everyone experiences constipation from time to time. In fact, 16% of all adults and 33% of adults over age 60 have symptoms of constipation, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Many people think of constipation as difficulty having a bowel movement. However, constipation actually can have a few symptoms:

Abdominal bloating and, in some cases, back pain.

— A feeling that you haven’t completely emptied out.

— Bowel movements that are painful to pass.

— Fewer than three bowel movements a week.

— Pellet-like, hard stools.

Causes of Constipation

Constipation can have many causes. It isn’t a disease. Instead, it indicates another medical problem. Some of those problems are connected to the gastrointestinal tract, while others are not.

Here are some possible causes of constipation:

— A change in your daily habits and routine. For instance, you’re traveling.

— A decrease in your physical activity level.

— Pregnancy. Constipation was two to three times higher in pregnant women and in the period immediately after childbirth, according to an October 2020 study published in BJOG.

Colon cancer. However, there usually are other symptoms that will occur with colon cancer, including weight loss and fatigue.

Irritable bowel syndrome, which is a medical problem that can cause constipation, diarrhea or both.

— Medication. Opioid medications and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen are among the medications that can cause constipation.

— Not drinking enough water.

— Not getting enough fiber. This is a common problem for those who eat a typical American diet, says Dr. Satish S.C. Rao, the J. Harold Harrison, MD, Distinguished University Chair in Gastroenterology and professor of medicine at the Medical College of Georgia, Augusta University, in Augusta, Georgia. The average fiber intake for Americans is 16 grams a day, although experts say women should consume at least 25 grams a day and men, 38 grams.

You may turn to over-the-counter remedies for constipation to help get things moving. There are many choices, so it’s natural to wonder how remedies such as stool softeners and laxatives are different — and which ones may help you the most.

[See: What to Eat, Drink and Do to Relieve Constipation.]

Stool Softener vs. a Laxative: What’s the Difference?

A laxative is a broad term for any medicine that facilitates having a bowel movement, says Dr. Benjamin Lebwohl, a gastroenterologist and Louis and Gloria Flanzer Scholar at Columbia University Medical Center in New York City.

A stool softener is an emollient type of laxative. That means it helps the stool to become more hydrated, thus making it softer. A stool softener is considered the most mild among the choices to treat constipation and has the fewest side effects.

There are several other types of laxatives, including:

Fiber supplements such as psyllium or methycellulose. You may use these to treat occasional constipation and to help your body get more fiber.

— Osmotic laxatives, which help to increase stool bulk by pulling fluid from the body into the intestines. Polyethylene glycol is a common ingredient in osmotic laxatives.

— Stimulant laxatives are the strongest type of laxative. They directly stimulate nerves in the large intestine, helping the body to push out stool more quickly. Two common ingredients in stimulant laxatives are bisacodyl and sennosides. These usually work the quickest but also have more potential side effects, such as dehydration and electrolyte imbalances.

Although prescription-strength laxatives are generally more powerful than over-the-counter ones, laxatives sold over the counter still often help people break the constipation cycle, Lebwohl says.

If you have occasional constipation and mild symptoms, you may do well with a fiber supplement or stool softener. Beyond that, you may need a stronger type of laxative, such as for constipation that is severe or that lasts more than a few weeks, says Dr. Jesse P. Houghton, senior medical director of gastroenterology at Southern Ohio Medical Center Gastroenterology Associates in Portsmouth, Ohio.

[READ: Causes of Chronic Constipation.]

A Few Tips for Using Stool Softeners or Laxatives — and When to See a Doctor

1. First try some common-sense moves to get your digestive system moving.
That means drinking more water, getting more physical activity and eating enough fiber. Consuming more fruits and vegetables can help add fiber to your diet, Rao suggests.

2. Always read the packaging and follow any dosing suggestions.
Start with the lowest possible dose. Overdoing your use of a laxative could cause diarrhea or cramping. Plus, when you take certain laxatives long term, such as those that contain the herb senna (the package may say sennosides), your bowel may eventually need the laxative just to prompt a bowel movement.

3. Find out how fast it’ll work.
You take a laxative and hope it’ll work immediately, right? The truth is that the length of time to get things moving varies. You may experience a difference within just hours. Or it may take a couple of days using a laxative before you have a change to your bowel movements. Read the packaging to get more guidance on how long it should take to work, Houghton advises.

[See: How Often Should I Poop, and Other Toilet Topics.]

4. Make sure it’s safe for you to take a laxative.
Although laxatives are generally safe, you’ll want to avoid it if you have an allergy to the medication or an ingredient in it, Houghton says. You also should avoid a laxative if you have a suspected bowel blockage. Constipation is one symptom of a bowel blockage; other symptoms include a lack of appetite, a swollen belly and nausea or vomiting. Let your doctor know if you think you have a bowel blockage.

If you have kidney disease, avoid laxatives with magnesium, Rao cautions. They could cause your body to have too much magnesium. Get in touch with your health provider if you’re unsure whether a laxative is safe for you.

5. Always check with a doctor before giving a laxative to children.
The U.S. Food and Drug Administration cautions that this is especially important for children ages 5 and under. Find out which laxative or stool softener your pediatrician recommends for children, if any.

6. Know when to see your health provider for help.
Occasional constipation is normal, but there are times when you want to schedule an appointment with your health provider to discuss what’s going on:

— You have blood in your stool.

— Your constipation lasts more than a few weeks.

— In addition to constipation, you have weight loss, fatigue, severe abdominal pain or black stool.

— You have a pattern of constipation that lasts a short time, goes away for a while and then comes back.

— You have regular constipation issues and you’re over age 50. Rao advises seeing a doctor in this case because the chance of colon cancer increases with age.

More from U.S. News

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