Laxatives

[prunus]

There seem to be two kinds of laxative. Lactulose which comes in liquid form in a bottle and the other is a white powder which comes in sachets. Does anyone know the difference?

[SnazzyD]

If the white powder is called a macrogol eg. Movicol, they are two kinds of the same laxative type that work by drawing water back into the bowel. Lactulose is a sugary compound and the other is polyethylene glycol. Lactulose can sometimes make people feel windy and some don’t like the cloying sweet liquid. Movicol is like a bland white drink and a few doses can be given through a day if no result occurs. I find it is the kindest.

There are other laxatives that increase the bulk in the bowel because it needs bulk to stimulate the muscles to move the poo along. A common one is the orange flavoured Fybogel. Some people find it bungs them up if their fluid intake is poor.

There are also stimulants that make the bowel into overdrive. ‘Some are Dynamite’ often used for bowel prep before investigations Eg Picolax. Others like Senna and Bisocodyl are gentler. It is best not to over use these as the bowel can become dependent.

There are softeners which like arachis oil and Docusate sodium. Not so popular these days.

[whitefishbay in reply to SnazzyD]

Wow. Laxatives must be one of your specialist subjects. Super informative.

[Thelmarina in reply to whitefishbay]

Good point 😂

[SnazzyD in reply to whitefishbay]

Luckily it was part of my ‘trade’ rather than being a ‘customer’! 🙂

[PMRpro Ambassador in reply to SnazzyD]

Was going to say - I always feel happier when the nurse knows her stuff. Doctors don't usually have a clue!!!!

[whitefishbay in reply to SnazzyD]

Knowledge is power whatever the subject.

[prunus in reply to whitefishbay]

Couldn't agree more.

[whitefishbay in reply to prunus]

With a call sign like Prunus maybe you could’ve in charge of laxatives. 🤣

[prunus in reply to whitefishbay]

You made me smile because although I take your point the name was actually taken from the tree at the bottom of my garden which is a prunus. It has beautiful pink blossom in the Spring and reddish brown leaves.

[prunus in reply to SnazzyD]

I really appreciate all the trouble you have gone to to give me such a thorough answer. Yes the white powder is macrogol. I've also got lactulose. I have a pessary fitted down there and can have problems. My gynaecologist has suggested I take something regularly to help. I've been experimenting in order to find a minimum daily dose. I do wonder what the long term effect will be. I also wondered if I should do any alternating with lactulose. So your help is invaluable. In the light of what you've said I will stick as I am. I had been having Movicol but the Dr said it was £7 a box more expensive so was reluctant now to prescribe.

[SnazzyD in reply to prunus]

Oh yes, know that one. I am trying to avoid said pessary since my pelvic floor was finally seen off by Pred muscle wasting and a prolapse is trying to happen. Currently seeing a specialist physio in pelvic health and so far am buoyed by her drive to get women sorted. Turns out most of the trouble lies with lax lower abdo muscles so I’m doing all sorts targeted exercises.

Anyway, so I know how constipation is a no no. I have to keep myself well hydrated and even one day lacking I’m in trouble. My go to, is 4 prunes first and dried prunes are very tasty. Then I have a Senna at most once every 4-6 weeks. I’ve not needed anything else so far but in the past should have when I was recovering from two babies and chemo. High dose Pred had the opposite effect.

[prunus in reply to SnazzyD]

Hope your specialist physio can prevent you needing a pessary. I drink a glass of water first thing in the morning but it is not enough on its own.

[SnazzyD in reply to prunus]

I have 1500-2000 ml a day.

[Telian in reply to SnazzyD]

I take Docusate x 3 daily - prescribed the same time as Mirabegron which causes constipation. Why is Docusate not so popular now? It is gentle but I know if I don’t take it. Never been a constipation sufferer before all this drug taking!

[PMRpro Ambassador]

There are several kinds of laxative - not as simple as just 2. Snazzy has explained it very well.

[prunus in reply to PMRpro]

These were the only two I have been prescribed. I could not have appreciated her reply more. I had also wondered what long term use the lactulose would have on my teeth. I'm going to stick with macrogol for long term daily use. Thanks.

[Daffodilia]

Have you tried prunes? Effective and more natural

[prunus in reply to Daffodilia]

Will have to try and get hold of some. Dependent at the moment on others doing the shopping. Thanks

[Dorsetgirl17]

I was going to type the same thing, prunes, much more natural, can’t say I like them but 6 eaten in the evening does the trick!

[prunus in reply to Dorsetgirl17]

Thanks for that and when to take.

[Marijo1951 in reply to prunus]

Prunes also support bone health by slowing bone loss, especially important for women of our age. If you Google 'prunes and bone health' you'll find plenty of articles to support this.

I eat the recommended number of 6 per day, usually prunes tinned in fruit juice with my porridge. Apparently eating 12 per day actually helps to reverse bone loss, but this can have too much of a laxative effect for most people.

I love the fact that such a simple remedy helps with two entirely separate problems.

[prunus in reply to Marijo1951]

Didn't know that - thanks.

[prunus]

Thanks for that. I do also drink a cup of water first thing in a morning which a physio recommended. I agree that relaxation is vital.