Can laxatives be taken for longer periods?

If you live with constipation, you may wonder whether it is appropriate to take a laxative for a longer period of time. Laxatives work in different ways and are backed by differing amounts of evidence, and some carry risks that increase with excessive use or misuse.^1-3 This article looks at some of the types of laxatives available, what the research and guidance say, and when to speak to a healthcare professional.

Can laxatives be taken for longer periods?

Research has not established whether any laxative is suitable for indefinite daily use — most studies have been conducted for only a few weeks or months, and guidelines note that long-term use is not well studied.^{1, 4} Whether a laxative is appropriate to take for a longer period depends on the type, the dose, and the situation.⁵ Guidelines recognise that some people may need a laxative over the longer term — for example, when constipation is caused by a medical condition or a medicine that cannot be changed — but this should be decided together with a healthcare professional rather than assumed.⁵

Is It Harmful to Take a Laxative for a Longer Period?

At the correct dose and for genuine constipation, laxatives are generally well tolerated when used short term.¹ Reported side effects include bloating, stomach cramps, diarrhoea, and nausea.¹ However, side effects associated with long term use have not been studied.¹

The main risks come from taking more than needed, overusing, or misusing laxatives.^{2, 3} Overuse can upset the balance of the body’s salts (electrolytes), such as potassium, which can cause symptoms like muscle weakness and an irregular heartbeat.^{2, 6} Regular use of senna-type (anthraquinone) stimulant laxatives can darken the lining of the bowel which is not thought to be harmful in itself and fades after the laxative is stopped.⁷ Liquid paraffin is advised to be used with caution because of its possible side effects.²

Some people worry about becoming dependent on laxatives with long-term use.⁸ Anyone using laxatives regularly should have their use reviewed by a healthcare professional, and should see a doctor about new or worsening symptoms such as stomach pain, bleeding from the bottom, or unexplained weight loss.^{2, 5}

Which Laxatives Are OK for a Longer Period?

There are no guidelines which recommend taking daily laxatives for longer periods of time.^{1, 4} The main types used for constipation are described below — how each works, and what is known about taking it regularly.¹ This is not a list of laxatives confirmed as suitable for long term use: what the evidence shows differs from one type to another, and how long to take any of them is something to decide with a healthcare professional rather than deciding on your own.^{1, 4, 5}

Osmotic laxatives work by drawing water into the bowel, which softens the stool and makes it easier to pass.² Examples include macrogol (also called polyethylene glycol, or PEG) and lactulose (Duphalac).² Because they are poorly absorbed by the body and act only in the bowel, osmotic laxatives are among the types used when diet and fibre are not enough.^{1, 2, 5} International gastroenterology guidelines recommend osmotic laxatives, including lactulose, as a first-line medicine option when diet and fibre are not enough.^{9, 10} Some laxatives have been studied with daily use over several months — PEG in a trial lasting up to 52 weeks, and lactulose in studies of up to six months in older adults — with reported side effects that were usually mild.^{1, 11, 12}

Stimulant laxatives, such as bisacodyl and senna, encourage the bowel muscles to move stool along.³ They are used to treat constipation.³ A 2024 review of 43 papers found no good evidence that, at recommended doses, they cause lasting damage to the bowel, its nerves, or its muscle in humans, or that they cause cancer.³ Their long-term safety and tolerability, however, has not been fully studied.⁴

Fibre-based, or bulk-forming, laxatives — such as ispaghula (psyllium) husk, methylcellulose, and bran — add bulk to the stool and help it hold water, making it softer and easier to pass.^{1, 2} Fibre laxatives can take up to three days to work, so the effect is gradual rather than immediate.² They are often used as a first step.^{4, 5} It is important to drink enough fluid when taking them.⁵ Psyllium has been studied for constipation, while evidence for bran and inulin is limited.^{1, 4}

Stool softeners, such as docusate, work by helping water get into the stool, making it softer and easier to pass.² Other examples include arachis oil and liquid paraffin.² The evidence for docusate is limited — trials have found it no more effective than a placebo, and less effective than the fibre laxative psyllium.¹

What Can Be Taken Long Term for Chronic Constipation?

For people who need a laxative for chronic (long-lasting) constipation, it is suggested that the dose is adjusted according to the person’s response, and it is reviewed it regularly.⁵ The usual approach is a stepped one — starting with a bulk-forming laxative and adding or switching to another type if needed, with guidelines suggesting lactulose (Duphalac) for people who have not responded to, or cannot tolerate, other options.^{4, 5} This stepped approach is consistent with international gastroenterology guidelines, which recommend osmotic laxatives such as lactulose as a first-line medicine option.^{9, 10} How long to continue should be decided together with a healthcare professional, who can also check whether another condition or medicine is contributing.⁵ If a laxative is to be stopped, guidelines suggest reducing it gradually rather than all at once.⁵

Conclusion

Whether it is ok to take a laxative long-term depends on the type, the dose, and the situation,⁵ and no laxative has been shown to be suitable for indefinite daily use. ^{1, 4} Osmotic laxatives, stimulant laxatives, and fibre-based laxatives are all used for constipation, and studies have typically ranged between weeks and months.^{1, 4} At the recommended dose they are generally well tolerated; the main risks come from taking more than ^{1, 2} Adjusting the dose to what is needed to keep stools soft, drinking enough fluid, and having ongoing use reviewed by a healthcare professional help in using laxatives appropriately over time. ⁵

FAQ

Constipation means bowel movements that are infrequent, hard, or difficult to pass, or a feeling that the bowel has not emptied fully.² Normal bowel habits vary a lot from person to person, so going less often than someone else does not necessarily mean there is a problem.² It is more likely in women, older adults, and during pregnancy.²

Constipation can relate to diet and lifestyle — for example, not eating enough fibre, not drinking enough fluid, or being inactive.⁵ It can also be caused by another medical condition or by a medicine being taken, which is known as secondary constipation.⁵ Because of this, it can help to have the cause investigated, especially if constipation is new or persistent.^{2, 5}

See a doctor if constipation is new and ongoing, or if it comes with warning signs such as bleeding from the bottom, unexplained weight loss, tummy pain, or tiredness that could suggest anaemia (low levels of red blood cells).² These symptoms, particularly in people over 50, should be checked promptly.² A doctor can also review any medicines or conditions that might be contributing.⁵

Treatment usually starts with diet and lifestyle changes — eating more fibre, drinking enough fluid, and being more active.² If these are not enough, guidelines describe adding a laxative in steps, beginning with a bulk-forming (fibre) laxative, then an osmotic laxative such as macrogol or lactulose, and a stimulant laxative if needed.⁵ The choice depends on the person’s symptoms and preferences and is discussed with a healthcare professional.^{4, 5}

For some people, taking a laxative regularly is part of managing ongoing constipation, but how suitable this is depends on the type of laxative and the situation.⁵ Most studies have lasted only weeks to months, so the effects of taking any laxative every day indefinitely are not well known.^{1, 4} Anyone using a laxative daily should adjust it to the dose needed to keep stools soft and have it reviewed by a healthcare professional.⁵

This article was written with the assistance of generative AI technology and reviewed for accuracy.