What are osmotic laxatives?

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From the Guidelines

Osmotic laxatives are a type of medication that draws water into the gut to hydrate the stool, making it easier to pass.

Key Characteristics of Osmotic Laxatives

  • They work by increasing the amount of water in the large bowel, either by drawing fluid from the body into the bowel or by retaining the fluid that was administered 1
  • Examples of osmotic laxatives include:
    • Polyethylene glycol (PEG): an inert polymer of ethylene glycol that sequesters fluid in the bowel 1
    • Lactulose: a semi-synthetic disaccharide that is not absorbed from the gastrointestinal tract and produces osmotic diarrhea of low pH 1
    • Magnesium salts: useful where rapid bowel evacuation is required, but should be used with caution in patients with renal insufficiency and in pregnancy 1

Mechanism of Action and Guidance for Use

  • Osmotic laxatives increase the amount of water in the large bowel, making the stool softer and easier to pass 1
  • They are recommended for the treatment of chronic idiopathic constipation and can be used in combination with other medications if needed 1
  • The dose of osmotic laxatives may be adjusted based on symptom response and side effects, and there is no clear maximum dose for most of these medications 1

From the Research

Definition of Osmotic Laxatives

  • Osmotic laxatives are a type of laxative that works by holding water inside the bowel lumen 2
  • They are commonly used to treat chronic constipation and are considered effective and safe treatments 3, 4, 5, 6

Examples of Osmotic Laxatives

  • Lactulose is an example of an osmotic laxative 3, 5
  • Polyethylene Glycol (PEG) is another example of an osmotic laxative 3, 5, 6
  • Magnesium and phosphate containing laxatives are also osmotic laxatives 4

Mechanism of Action

  • Osmotic laxatives work by drawing water into the bowel lumen, softening the stool and making it easier to pass 2
  • They can also stimulate bowel movements by increasing the amount of water in the stool 4

Safety and Efficacy

  • Osmotic laxatives are generally considered safe and effective for the treatment of chronic constipation 3, 4, 5, 6
  • However, they can cause side effects such as bloating, diarrhea, and abdominal pain 4, 6
  • Polyethylene Glycol (PEG) is considered to be more effective than lactulose in some cases 3, 5, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Classification, pharmacology, and side-effects of common laxatives.

Italian journal of gastroenterology and hepatology, 1999

Research

Lactulose versus Polyethylene Glycol for Chronic Constipation.

The Cochrane database of systematic reviews, 2010

Research

Adverse effects of laxatives.

Diseases of the colon and rectum, 2001

Research

A literature review of two laxatives: lactulose and polyethylene glycol.

British journal of community nursing, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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