At any one time around one in 10 people think they have constipation. Lower abdominal symptoms are common, and patients frequently come to a pharmacy complaining of unsatisfactory or uncomfortable bowel emptying, bloating and abdominal discomfort.

Often, advice is all that is necessary or simple treatments for short-term use. Rarely, ‘red flag’ features may indicate a more serious cause and pharmacy teams need to stay vigilant. 

The main common, usually non-serious, cause of these symptoms is constipation, although irritable bowel syndrome may be a cause and frequently overlaps. Often the best way to manage constipation is through encouraging dietary changes and exercise.

For many, taking laxatives is unnecessary but patients often wish to buy a laxative, perhaps seeking a quick result for acute symptoms and also because making permanent lifestyle changes is hard. They may know what they should be doing but are unwilling to change.  

Concern about the regular buying of stimulant laxatives led to a safety review and action by the Medicines and Healthcare products Regulatory Agency (MHRA) in August 2020 to reduce abuse and overuse (see MHRA restrictions on access to stimulant laxatives).