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

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

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.

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Acknowledgments

We thank Ms. Judith Fethney of The University of Sydney for assistance with statistical analysis.

Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia

    Barry L. Werth, Murray J. Fisher & Lisa G. Pont

  2. Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia

    Kylie A. Williams & Lisa G. Pont

Authors
  1. Barry L. Werth
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  2. Kylie A. Williams
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  3. Murray J. Fisher
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  4. Lisa G. Pont
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Contributions

All authors contributed to the study conception and design; BW contributed to data acquisition, data analysis, and drafting the manuscript. All authors contributed to data interpretation, editing, reviewing, and final approval of the manuscript.

Corresponding author

Correspondence to Barry L. Werth.

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The authors declare that they have no conflict of interest.

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Ethical approval for the study was obtained from the Human Research Ethics Committee of The University of Sydney (Protocol number 2015/006).

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Werth, B.L., Williams, K.A., Fisher, M.J. et al. Use of over-the-counter laxatives by community-dwelling adults to treat and prevent constipation: a national cross-sectional study. Eur J Clin Pharmacol 76, 1003–1010 (2020). https://doi.org/10.1007/s00228-020-02865-5

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  • DOI: https://doi.org/10.1007/s00228-020-02865-5

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