Bulk laxatives present a risk if there is undiagnosed obstruction. Let the patient suggest their personal preference. Product selection Significant pathology must first be ruled out. The regular use of laxatives should be discouraged. Immediate relief Enemas and suppositories should not be the first line of attack these should only be used on the recommendation of a doctor or if there is some compelling reason.
Stimulant laxatives are useful for acute simple constipation.
Senna or bisacodyl are the drugs of choice. They should be taken about eight hours before the normal time of defaecation since they take about that time to act. Phenolphthalein, cascara and castor oil have adverse effects and should not be recommended. The lubricant laxative, liquid paraffin, has no place in modern treatment. It reduces vitamin absorption and is subject to anal leakage.