From the Guidelines
Docusate works as a stool softener by allowing water and lipids to penetrate the stool, thereby hydrating and softening the fecal material. This medication, also known by brand names like Colace or Docusol, functions by acting as a surfactant in the intestines 1. When taken orally, docusate sodium or docusate calcium helps water mix into the stool, making it softer and easier to pass. The typical adult dose ranges from 50-500 mg daily, often divided into smaller doses, with effects usually occurring within 1-3 days of starting treatment.
Key Points
- Docusate is particularly useful for preventing constipation in situations where straining should be avoided, such as after surgery or childbirth, or for patients with hemorrhoids or heart conditions.
- Unlike stimulant laxatives, docusate doesn't directly stimulate bowel contractions, making it gentler on the digestive system.
- However, it's essential to maintain adequate fluid intake while taking docusate to ensure its effectiveness, as the medication relies on available water to soften the stool.
- Some studies suggest that docusate may not be as effective as other laxatives, such as sennosides, in preventing constipation 1.
- The American Gastroenterological Association recommends using laxatives, including docusate, as first-line agents for opioid-induced constipation, due to their low cost and few safety concerns 1.
From the Research
Mechanism of Action
- Docusate is a stool softener that works by increasing the amount of water the stool absorbs in the gut, making it softer and easier to pass 2.
- It is often used to treat constipation, but its effectiveness has been questioned in several studies 3, 4, 5.
Efficacy
- Studies have shown that docusate is not as effective as other treatments, such as psyllium or sennosides, in increasing stool water content and improving bowel movement frequency 2, 3.
- In some cases, docusate has been found to be no more effective than a placebo in preventing or treating constipation 4, 5.
- However, one study found that the combination of senna and docusate was effective in reducing the time to first bowel movement after pelvic reconstructive surgery 6.