Constipation that is not secondary to underlying disease, or caused by factors such as side effects of drugs or laxative abuse, is known as simple or functional constipation.

WHAT’S AVAILABLE

A wide range of laxatives is available without prescription. They can be broadly classified into four groups, depending on their mode of action:

• Bulk-forming
• Osmotic
• Stimulant
• Faecal softeners.

Laxatives in the first two groups will be dealt with in this article and the rest in part 2 of this training module.

Reflection point

Can you name one or two laxatives from each of the four groups? When do you recommend each type of laxative and why? What type of laxative do your counter staff recommend? Which constipated patients do they refer to the pharmacist?