Use of over-the-counter laxatives by community-dwelling adults to treat and prevent constipation: a national cross-sectional study

Eur J Clin Pharmacol. 2020 Jul;76(7):1003-1010. doi: 10.1007/s00228-020-02865-5. Epub 2020 Apr 15.

Abstract

Purpose: Constipation is commonly self-managed with over-the-counter laxatives. The study aim was to explore laxative choice, healthcare professional recommendations in laxative selection, and laxative effectiveness when laxatives are used for treatment and for prevention of constipation by community-dwelling adults.

Methods: A nationally representative sample of community-dwelling adults in Australia was surveyed. Participants completed an online questionnaire. Z tests for differences in proportions were used to compare the proportion of laxatives by class when used either for treatment or for prevention of constipation by choice of laxative, healthcare professional recommendation, and perceived effectiveness.

Results: The questionnaire was completed by 2024 participants. Laxatives were used by 37% (n = 747) of participants with 31.3% using laxatives for treatment, 19.3% for prevention, and 49.7% using laxatives for both purposes. The most common laxatives used for treatment and prevention were contact laxatives (39.8% and 31.1% respectively) and bulk-forming laxatives (34.3% and 44.6% respectively). Of all laxatives used, 56.4% of laxatives were chosen with healthcare professional recommendation, and 53.5% of laxatives were found effective.

Conclusion: Laxatives were used both for treatment and for prevention of constipation. However, laxatives are often perceived to be ineffective and healthcare professionals are not always involved in laxative choice. Modified guidelines which address the use of laxatives for both treatment and prevention, and increased healthcare professional involvement in appropriate choice and use of laxatives, may be required to improve constipation management in the community.

Keywords: Adult; Australia; Community; Constipation; Healthcare surveys; Laxative.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia
  • Constipation / drug therapy*
  • Cross-Sectional Studies
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Independent Living / statistics & numerical data
  • Laxatives / therapeutic use*
  • Male
  • Middle Aged
  • Nonprescription Drugs / therapeutic use*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Laxatives
  • Nonprescription Drugs