How effective are OTC laxatives?

A recent review of systematic reviews¹ concluded that:

• The majority of systematic reviews were of low or moderate methodological quality
• In adults and children with chronic constipation, polyethylene glycol (PEG) increased the frequency of stools on average by two to three stools per week, relative to placebo
• PEG may increase stool frequency compared to lactulose or milk of magnesia, but the magnitude of difference is small
• Limited data were available for bulk-forming laxatives and no conclusions could be drawn
• There was a lack of RCT evidence to support the use of stool softeners.

Reference

1. Canadian Agency for Drugs and Technologies in Health. Treatments for Constipation: A Review of Systematic Reviews. 2014 Nov 17.

Activity

Consider how you could advise local care homes and their patients on laxative use as part of a routine visit or during MURs. Are the most appropriate laxatives being used appropriately? Might your advice change after reading this article?