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Research · Medication

Laxatives

Pooled trials found polyethylene glycol and bisacodyl raised response in chronic constipation against placebo, and polyethylene glycol outperformed lactulose. Senna and magnesium oxide rest on small trials, magnesium citrate on none, and docusate did not differ from placebo. Bisacodyl caused diarrhea in about half. Long-term trials are few, with an observational dementia link and mixed cancer findings.

Add to Bio HackChecked 2026-11-14
Status
Polyethylene glycol 3350 (MiraLAX), senna (Senokot), bisacodyl (Dulcolax), docusate (Colace), magnesium citrate and psyllium are sold over the counter in the US for occasional constipation, and their Drug Facts labels say to stop and ask a doctor if a laxative is needed for more than 1 week. Lactulose solution is a prescription drug, FDA-approved to treat constipation.
Also called
polyethylene glycol 3350, PEG 3350, MiraLAX, senna, sennosides, Senokot, bisacodyl, Dulcolax, docusate sodium, Colace, stool softener, psyllium, Metamucil, magnesium citrate, Citroma, magnesium oxide, milk of magnesia, lactulose, sodium picosulfate, osmotic laxative, stimulant laxative
Taken for
constipation, chronic constipation, occasional constipation, regularity, stool softening, constipation in children, constipation in pregnancy, long-term laxative use

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help9

Reported risks9

What people take it for, and what was found

Shown to help9

ModerateVery common

Chronic constipation: polyethylene glycol

Shown to raise response in adults with chronic constipation against placebo, 52% against 11% over 6 months in the largest trial.

Compared with placebo [1][2]

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Pooled across 3 placebo-controlled trials, polyethylene glycol raised spontaneous bowel movements by 2.30 a week (95% CI 1.55 to 3.06) and responders (RR 3.13, 95% CI 2.00 to 4.89, 2 trials), 312 more responders per 1,000. One trial found 2.90 more complete bowel movements a week (95% CI 2.12 to 3.68). Certainty was moderate [1]. In the largest trial, 52.0% on polyethylene glycol 17 g a day and 11% on placebo met the success definition over 6 months [2].
Population
3 trials with 55, 70 and 304 adults [1]; 304 adults with chronic constipation at 50 US centers, including 75 older adults [2].
Sources
[1], [2]
Caveats
The 2 Italian trials used polyethylene glycol with electrolytes, and responder definitions differed between trials [1]. All three trials are in one review, so the grade rests on one pooled analysis.
Strong

Chronic constipation: bisacodyl

Shown to raise complete bowel movements in adults with chronic constipation, from 1.1 to 5.2 a week on bisacodyl against 1.9 on placebo over 4 weeks.

Compared with placebo [1][3][4]

The numbers and sources
Effect
Complete spontaneous bowel movements rose from 1.1 a week to 5.2 on bisacodyl 10 mg and to 1.9 on placebo [4]. Pooling bisacodyl with sodium picosulfate, complete bowel movements rose by 2.54 a week (95% CI 1.07 to 4.01) and responders by RR 2.60 (95% CI 2.05 to 3.30), 359 more per 1,000, on moderate certainty evidence [1]. In a network meta-analysis, bisacodyl and sodium picosulfate 10 mg ranked first at 4 weeks for failure to reach 3 complete bowel movements a week, against placebo (RR 0.55, 95% CI 0.48 to 0.63) [3].
Population
368 adults in a 4-week UK trial [4]; 2 trials, 368 and 362 adults [1]; 33 trials with 17,214 patients [3].
Sources
[4], [1], [3]
Caveats
Both pooled analyses combine bisacodyl with sodium picosulfate, which is not sold alone in the US, and both rest on the same two 4-week trials [1][3]. Trials may have enrolled people with milder symptoms [3].
Limited

Chronic constipation: senna

One trial found 69% responded to senna against 12% on placebo over 4 weeks, at 1 g of senna a day, a higher dose than common tablets.

Compared with placebo [5][1]; magnesium oxide [5]

The numbers and sources
Effect
Overall symptom improvement was reported by 69.2% on senna, 68.3% on magnesium oxide and 11.7% on placebo, and bowel movements rose more on senna than placebo [5]. The AGA review found 7.60 more complete bowel movements a week (95% CI 5.90 to 9.30) and a higher response (RR 5.25, 95% CI 2.05 to 13.47), with 83% of senna patients reducing their dose during the trial [1]. After shoulder surgery, constipation was as common on senna (66.7%) as with no laxative (64.3%) [6].
Population
90 Japanese adults with chronic constipation, mean age 42, 93% women [5]; 107 adults after rotator cuff repair [6].
Sources
[5], [1], [6]
Caveats
One small trial. Commercial tablets hold 8 to 9 mg of sennosides, and the dose in the trial is not directly comparable [1][7]. The surgical trial measured short-term constipation after an operation, not chronic constipation [6].
Limited

Chronic constipation: magnesium oxide

Small trials found more people improved on magnesium oxide than placebo, 68% to 71% against 12% to 25%, on very low certainty evidence.

Compared with placebo [8][5][1]; senna [5]

The numbers and sources
Effect
Overall improvement occurred in 70.6% on magnesium oxide 1.5 g a day and 25.0% on placebo over 28 days [8], and in 68.3% and 11.7% in a second trial [5]. Pooled, response was higher (RR 3.93, 95% CI 2.04 to 7.56), and diarrhea leading to dose change or stopping did not differ (RR 1.07, 95% CI 0.65 to 1.74) [1].
Population
34 Japanese women with mild to moderate constipation [8]; 90 Japanese adults [5].
Sources
[8], [5], [1]
Caveats
The review rated overall certainty very low [1]. Both trials were small and in Japan.
Limited

Chronic constipation: lactulose

Limited evidence: two trials found more responders on lactulose than placebo, about 267 more per 1,000, while one found no change in weekly bowel movements.

Compared with placebo [1]

The numbers and sources
Effect
One trial found little or no change in spontaneous bowel movements (MD 0.35 a week, 95% CI -0.91 to 1.61). A second found more global relief (RR 2.42, 95% CI 1.29 to 4.54). Across both, lactulose gave 267 more responders per 1,000 than placebo [1]. The label states that lactulose raises the number of bowel movements per day and of days with bowel movements in people with chronic constipation [10].
Population
2 placebo-controlled trials in adults [1].
Sources
[1], [10]
Caveats
The trials defined response differently and did not report diarrhea or serious adverse events [1].
Strong

Polyethylene glycol compared with lactulose

Shown to give more weekly stools than lactulose and less need for extra laxatives, in adults and children with chronic constipation.

Compared with lactulose [11][12]

The numbers and sources
Effect
Across 10 trials, polyethylene glycol outperformed lactulose on weekly stool frequency, stool form, relief of abdominal pain and need for added products, in adults and in children except for abdominal pain [11]. In children, polyethylene glycol gave 0.70 more stools a week (95% CI 0.10 to 1.31, 6 trials, 465 children), and 18% needed added laxatives against 31% on lactulose (RR 0.55, 95% CI 0.36 to 0.83) [12].
Population
10 randomized trials in adults and children [11]; 25 trials with 2,310 children [12].
Sources
[11], [12]
Caveats
The adult review's abstract gives no pooled numbers [11]. The children's evidence was low or very low quality with short follow-up [12].
ModerateStudied in children

Constipation in children

Shown to raise weekly stools in children with constipation, by about 2.6 against placebo and slightly more than milk of magnesia, on low-quality evidence.

Compared with placebo [12]; milk of magnesia [12]; lactulose, for senna [12]

The numbers and sources
Effect
Polyethylene glycol gave 2.61 more stools a week than placebo (95% CI 1.15 to 4.08, 2 trials, 101 children) and 0.69 more than milk of magnesia (95% CI 0.48 to 0.89, 3 trials, 211 children). A higher dose, 0.7 g/kg, gave 1.30 more stools a week than 0.3 g/kg. Senna and lactulose did not differ in one trial of 21 children [12].
Population
25 randomized trials with 2,310 children aged 0 to 18 [12].
Sources
[12]
Caveats
Fourteen of the 25 trials were at high risk of bias, and follow-up was short [12].
LimitedStudied in pregnancy

Constipation in pregnancy

One trial found more improvement on stimulant laxatives than bulk-forming laxatives in pregnant women, with more abdominal discomfort and diarrhea.

Compared with bulk-forming laxatives [16]

The numbers and sources
Effect
Against bulk-forming laxatives, stimulant laxatives raised improvement in constipation (RR 1.59, 95% CI 1.21 to 2.09), abdominal discomfort (RR 2.33, 95% CI 1.15 to 4.73) and diarrhea (RR 4.50, 95% CI 1.01 to 20.09), with no difference in satisfaction [16].
Population
140 pregnant women in one trial, within a review of 4 trials [16].
Sources
[16]
Caveats
The review found no trials of osmotic laxatives or stool softeners in pregnancy, and the trial's randomization method was unclear [16].
Limited

Use beyond 4 weeks

One 6-month trial found response held on polyethylene glycol, 52% against 11% on placebo, with no lab changes. No stimulant laxative trial ran past 4 weeks.

Compared with placebo [2][17]

The numbers and sources
Effect
Over 6 months, 52.0% on polyethylene glycol and 11% on placebo met the success definition, with similar results in 75 older adults. Monthly blood tests, including GGT, uric acid, amylase and lipids, showed no significant differences from placebo [2]. A review of bisacodyl and sodium picosulfate trials found none longer than 4 weeks. In those trials, 78% to 99% on the drugs and 46% to 54% on placebo gave a positive global rating [17].
Population
304 adults [2]; 5 trials with 1,008 adults, 26% of whom dropped out [17].
Sources
[2], [17]
Caveats
One long trial. The review's authors found no trial evidence for stimulant laxatives beyond 4 weeks [17].

Not shown to help1

Moderate

Docusate (stool softener)

Not shown to change stool frequency or consistency against placebo in hospice patients, and it raised stool water less than psyllium in chronic constipation.

Compared with placebo, with both groups also on sennosides [13]; no laxative after surgery [6]; psyllium [14]

The numbers and sources
Effect
Over 10 days, stool frequency, volume and consistency did not differ between docusate and placebo in people also taking sennosides [13]. After shoulder surgery, constipation occurred in 71.4% on docusate and 64.3% with no laxative (p = 0.88) [6]. Against psyllium over 2 weeks, docusate raised stool water content 0.01% against 2.33%, and bowel movements in week 2 were 2.9 a week against 3.5 [14]. A systematic review of 4 small trials in chronically ill people found only a small trend toward more stools and could not pool them [15].
Population
74 hospice patients [13]; 107 adults after rotator cuff repair [6]; 170 adults with chronic idiopathic constipation [14]; 4 controlled trials with 15 to 74 participants [15].
Sources
[13], [6], [14], [15]
Caveats
The trials were small and in different settings. The AGA review found too few data on docusate to pool [1].

Claimed, not studied in people1

Untested

Chronic constipation: magnesium citrate

Not studied in people for chronic constipation. Like magnesium oxide, unabsorbed magnesium draws water into the bowel.

No study in people. This rests on how it acts in the body.

The numbers and sources
Effect
The AGA review found that only magnesium oxide has been tested in randomized trials for chronic constipation, and that the efficacy of other forms, citrate among them, is unknown. Magnesium that is not absorbed creates an osmotic gradient that pulls water and salts into the gut [1]. The over-the-counter label lists relief of occasional constipation, with a bowel movement in 30 minutes to 6 hours [9].
Population
A guideline review of randomized trials [1]; a Drug Facts label [9].
Sources
[1], [9]
Caveats
Its use for bowel preparation before colonoscopy is outside this page.

Doses studied

Polyethylene glycol 3350 was given at 17 g once a day in the 6-month US trial [2], the dose on the over-the-counter label, which limits use to 7 days without a doctor [18]. The Italian trials used 17.5 g of polyethylene glycol with electrolytes twice a day [1]. Children's trials used 0.3 to 0.7 g/kg [12]. Bisacodyl trials used 10 mg once daily for 4 weeks [4][1]. The over-the-counter tablet is 5 mg, starting at 1 a day for adults [19]. The senna trial used 1 g of senna a day for 28 days [5]. Senokot tablets contain 8.6 mg of sennosides, starting at 2 a day for adults [7]. Magnesium oxide trials used 1.5 g a day [8][5]. Magnesium citrate solution is labeled at 6.5 to 10 fl oz in 24 hours for adults, with 290 mg of magnesium per fl oz [9]. The docusate trials used 100 mg twice daily [14], and the over-the-counter label allows 50 to 300 mg a day for adults [20]. The lactulose label gives 10 to 20 g (15 to 30 mL) a day, up to 60 mL [10].

Risks

Reported risks7

StrongVery common

Diarrhea and abdominal pain with bisacodyl

Shown to raise diarrhea and abdominal pain, with diarrhea in 53% on bisacodyl 10 mg against 2% on placebo, mostly in the first week.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
At 10 mg, diarrhea occurred in 53.4% on bisacodyl and 1.7% on placebo, and abdominal pain in 24.7% and 2.5%, mostly in the first week. Pooled with sodium picosulfate, diarrhea leading to stopping treatment rose (RR 8.76, 95% CI 4.99 to 15.39) [1]. In the network meta-analysis, bisacodyl ranked last for total adverse events and abdominal pain [3]. Across 5 trials, adverse events were mostly mild but reached 72%, mostly diarrhea and abdominal pain [17].
Population
Adults with chronic constipation in 4-week trials [1][3][17].
Sources
[1], [3], [17]
Caveats
Trial doses were 10 mg, twice the over-the-counter starting dose [1][19].
LimitedVery common

High blood magnesium

Linked to high blood magnesium in 23% of hospitalized patients prescribed magnesium oxide, more often with weaker kidneys, and to severe cases in older adults.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Of 320 hospitalized patients prescribed magnesium oxide, 75 (23%) developed hypermagnesemia, 13 (4%) at grade 3. Risk rose with eGFR at or below 55.4 mL/min (OR 3.105), blood urea nitrogen at or above 22.4 mg/dL (OR 3.490), doses of 1,650 mg a day or more (OR 1.914) and use for 36 days or more (OR 2.198) [21]. Four older adults with kidney impairment developed symptomatic hypermagnesemia on magnesium oxide, and one died [22]. The magnesium citrate label tells people with kidney disease or a magnesium-restricted diet to ask a doctor first [9].
Population
320 hospitalized patients in Japan [21]; 4 case reports [22]; label statements [9].
Sources
[21], [22], [9]
Caveats
A hospital cohort with no comparison group, mostly grade 1 cases [21]. Rates in healthy people using magnesium citrate occasionally were not sourced.
LimitedHow often is not known

Gas, cramps and salt changes with lactulose

The label warns of gas and cramps when starting and, with excess doses, diarrhea with low potassium and high sodium. It gives no rates.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The label states that precise frequency data are not available, that early doses may cause flatulence and intestinal cramps, and that excess doses can cause diarrhea with fluid loss, hypokalemia and hypernatremia. It advises periodic electrolyte checks in elderly, debilitated people using it for more than 6 months [10]. The AGA review describes bloating and flatulence as very common in clinical practice, without trial rates [1].
Population
Label statements [10]; guideline review [1].
Sources
[10], [1]
Caveats
No trial rates were sourced.
LimitedHow often is not known

Dementia

Linked in one large cohort to 51% higher dementia risk with regular laxative use, highest with osmotic laxatives or several types at once.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Over a mean 9.8 years, 1.3% of regular laxative users and 0.4% of non-users developed dementia (adjusted HR 1.51, 95% CI 1.30 to 1.75). Vascular dementia rose (HR 1.65, 95% CI 1.21 to 2.27) and Alzheimer disease did not (HR 1.05, 95% CI 0.79 to 1.40). Among users of one type, only osmotic laxatives were linked to dementia (HR 1.64, 95% CI 1.20 to 2.24) [23].
Population
502,229 UK Biobank participants aged 40 to 69, 18,235 of them regular laxative users [23].
Sources
[23]
Caveats
Observational. Laxative use was self-reported once at baseline, and constipation itself may be tied to early disease [23].
LimitedHow often is not known

Allergy to polyethylene glycol

Case reports: one child in the pooled pediatric trials was allergic to polyethylene glycol, and the label carries an allergy alert.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
One child was noted to be allergic to polyethylene glycol, with no other serious adverse events in those trials [12]. The label states not to use it if allergic to polyethylene glycol [18].
Population
Children in randomized trials [12]; label statement [18].
Sources
[12], [18]
Caveats
A single report gives no rate.
LimitedHow often is not known

Timing with other medicines

The labels warn that magnesium citrate can change how other drugs act, with doses 2 hours apart, and that bisacodyl tablets not follow antacids or milk within 1 hour.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The magnesium citrate label directs taking it 2 or more hours before or after other drugs and states laxatives may affect other drugs [9]. The bisacodyl label says not to use it within 1 hour after an antacid or milk [19]. The docusate label says not to use it with mineral oil unless told to by a doctor [20]. The lactulose label states non-absorbable antacids may blunt its effect on colon pH [10].
Population
Label statements [9][19][20][10].
Sources
[9], [19], [20], [10]
Caveats
Label statements, not outcome trials.
LimitedHow often is not known

Use in pregnancy

Limited evidence: in one trial, stimulant laxatives in pregnancy raised abdominal discomfort and diarrhea against bulk-forming laxatives. Lactulose animal studies found no fetal harm.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Stimulant laxatives raised abdominal discomfort (RR 2.33, 95% CI 1.15 to 4.73) and diarrhea (RR 4.50, 95% CI 1.01 to 20.09) against bulk-forming laxatives [16]. The lactulose label reports no harm to the fetus in mice, rats and rabbits and no adequate studies in pregnant women [10]. The AGA guideline states sennosides are not advised in pregnancy because similar compounds had weak genotoxic effects in animals [1]. The over-the-counter labels tell pregnant or breastfeeding women to ask a health professional first [18][7].
Population
140 pregnant women [16]; animal reproduction studies [10]; guideline and label statements [1][18][7].
Sources
[16], [10], [1], [18], [7]
Caveats
One small trial in people. The other statements rest on animal data.

Mixed results2

ModerateHow often is not known

Diarrhea, gas and nausea with polyethylene glycol

Mixed results: diarrhea, gas and nausea were the most frequent effects on polyethylene glycol, but none differed significantly from placebo in the 6-month trial.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Diarrhea, flatulence and nausea were the most frequent adverse events on polyethylene glycol, though not individually significant against placebo [2]. Pooled, diarrhea was more frequent on polyethylene glycol (158 more per 1,000, 95% CI 6 fewer to 896 more), and serious adverse events were too few to judge (RR 0.47, 95% CI 0.16 to 1.33) [1]. The label warns of loose, watery, more frequent stools [18].
Population
304 adults over 6 months [2]; 3 trials [1].
Sources
[2], [1], [18]
Caveats
The pooled interval for diarrhea is very wide [1].
LimitedHow often is not known

Colorectal cancer

Limited evidence: one cohort and one case-control study linked non-fiber laxatives to more colorectal cancer, while two US cohorts found no link with laxative use.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In a US cohort, non-fiber laxative use 1 to 4 times a year was linked to more colorectal cancer (HR 1.49, 95% CI 1.04 to 2.14), while frequent fiber laxative use was linked to less (HR 0.44, 95% CI 0.21 to 0.95) [24]. In a case-control study, regular non-fiber laxative use was linked to more colorectal cancer (OR 2.17, 95% CI 1.47 to 3.19) [25]. In the Nurses' Health Study and Health Professionals Follow-up Study, laxative use weekly to daily was not linked to colorectal cancer (HR 0.98 in women, 1.41 in men, intervals crossing 1) [26].
Population
75,214 adults in the VITAL cohort [24]; 4,930 cases and 4,025 controls [25]; 88,173 women and 23,722 men [26].
Sources
[24], [25], [26]
Caveats
Observational studies that do not separate laxative types the same way. Constipation and the reasons for using laxatives may confound the links.

Claims tested and not found

  1. That docusate softens stools or eases constipation. In hospice patients, docusate did not change stool frequency, volume or consistency against placebo [13], and it raised stool water content less than psyllium [14].
  2. That docusate or senna prevents constipation after surgery. After shoulder surgery, constipation rates did not differ between docusate, senna and no laxative [6].
  3. That adding polyethylene glycol to docusate speeds the first bowel movement after surgery. After urogynecologic surgery, time to first bowel movement did not differ (2.77 against 2.92 days), though fewer women on polyethylene glycol took extra laxatives [27].

Related

Fiber supplements

Sources

  1. Chang L, Chey WD, Imdad A, et al. American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. Gastroenterology. 2023. https://doi.org/10.1053/j.gastro.2023.03.214
  2. DiPalma JA, Cleveland MV, McGowan J, Herrera JL. A randomized, multicenter, placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation. The American Journal of Gastroenterology. 2007. https://doi.org/10.1111/j.1572-0241.2007.01199.x
  3. Luthra P, Camilleri M, Burr NE, et al. Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis. The Lancet Gastroenterology & Hepatology. 2019. https://doi.org/10.1016/s2468-1253(19)30246-8
  4. Kamm MA, Mueller-Lissner S, Wald A, et al. Oral bisacodyl is effective and well-tolerated in patients with chronic constipation. Clinical Gastroenterology and Hepatology. 2011. https://doi.org/10.1016/j.cgh.2011.03.026
  5. Morishita D, Tomita T, Mori S, et al. Senna Versus Magnesium Oxide for the Treatment of Chronic Constipation: A Randomized, Placebo-Controlled Trial. The American Journal of Gastroenterology. 2021. https://doi.org/10.14309/ajg.0000000000000942
  6. Weekes DG, Campbell RE, Giunta NJ, et al. The efficacy of docusate sodium and senna glycoside for the treatment of constipation after rotator cuff repair: A randomized controlled study. Journal of the American Association of Nurse Practitioners. 2022. https://doi.org/10.1097/jxx.0000000000000575
  7. US Food and Drug Administration label. Senokot (standardized senna concentrate) tablet, Drug Facts. DailyMed. 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c18dd7fa-993b-440b-8cdd-f1551abb99ca
  8. Mori S, Tomita T, Fujimura K, et al. A Randomized Double-blind Placebo-controlled Trial on the Effect of Magnesium Oxide in Patients With Chronic Constipation. Journal of Neurogastroenterology and Motility. 2019. https://doi.org/10.5056/jnm18194
  9. US Food and Drug Administration label. CVS magnesium citrate oral solution, Drug Facts. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c5156f8-806a-ddd9-e063-6394a90aaff4
  10. US Food and Drug Administration label. Lactulose solution, Rx only. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8b79d0d6-b9e3-436e-bab7-01451b6f45cd
  11. Lee-Robichaud H, Thomas K, Morgan J, Nelson RL. Lactulose versus Polyethylene Glycol for Chronic Constipation. Cochrane Database of Systematic Reviews. 2010. https://doi.org/10.1002/14651858.cd007570.pub2
  12. Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.cd009118.pub3
  13. Tarumi Y, Wilson MP, Szafran O, Spooner GR. Randomized, double-blind, placebo-controlled trial of oral docusate in the management of constipation in hospice patients. Journal of Pain and Symptom Management. 2013. https://doi.org/10.1016/j.jpainsymman.2012.02.008
  14. McRorie JW, Daggy BP, Morel JG, et al. Psyllium is superior to docusate sodium for treatment of chronic constipation. Alimentary Pharmacology & Therapeutics. 1998. https://doi.org/10.1046/j.1365-2036.1998.00336.x
  15. Hurdon V, Viola R, Schroder C. How useful is docusate in patients at risk for constipation? A systematic review of the evidence in the chronically ill. Journal of Pain and Symptom Management. 2000. https://doi.org/10.1016/s0885-3924(99)00157-8
  16. Rungsiprakarn P, Laopaiboon M, Sangkomkamhang US, Lumbiganon P, Pratt JJ. Interventions for treating constipation in pregnancy. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.cd011448.pub2
  17. Noergaard M, Traerup Andersen J, Jimenez-Solem E, Bring Christensen M. Long term treatment with stimulant laxatives - clinical evidence for effectiveness and safety? Scandinavian Journal of Gastroenterology. 2019. https://doi.org/10.1080/00365521.2018.1563806
  18. US Food and Drug Administration label. MiraLAX (polyethylene glycol 3350) powder for solution, Drug Facts. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d69ce3d4-7ca4-4fe3-b49e-6655e48d6963
  19. US Food and Drug Administration label. Dulcolax (bisacodyl) tablet, Drug Facts. DailyMed. 2025. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d285651b-7ccc-4ae5-a862-7a38dffefa28
  20. US Food and Drug Administration label. Colace (docusate sodium) capsule, Drug Facts. DailyMed. 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a1591da0-a1a9-9583-3cf5-788b8fee3814
  21. Wakai E, Ikemura K, Sugimoto H, Iwamoto T, Okuda M. Risk factors for the development of hypermagnesemia in patients prescribed magnesium oxide: a retrospective cohort study. Journal of Pharmaceutical Health Care and Sciences. 2019. https://doi.org/10.1186/s40780-019-0133-7
  22. Yamaguchi H, Shimada H, Yoshita K, et al. Severe hypermagnesemia induced by magnesium oxide ingestion: a case series. CEN Case Reports. 2019. https://doi.org/10.1007/s13730-018-0359-5
  23. Yang Z, Wei C, Li X, et al. Association Between Regular Laxative Use and Incident Dementia in UK Biobank Participants. Neurology. 2023. https://doi.org/10.1212/wnl.0000000000207081
  24. Citronberg J, Kantor ED, Potter JD, White E. A prospective study of the effect of bowel movement frequency, constipation, and laxative use on colorectal cancer risk. The American Journal of Gastroenterology. 2014. https://doi.org/10.1038/ajg.2014.233
  25. Citronberg JS, Hardikar S, Phipps A, Figueiredo JC, Newcomb P. Laxative type in relation to colorectal cancer risk. Annals of Epidemiology. 2018. https://doi.org/10.1016/j.annepidem.2018.06.011
  26. Zhang X, Wu K, Cho E, et al. Prospective cohort studies of bowel movement frequency and laxative use and colorectal cancer incidence in US women and men. Cancer Causes & Control. 2013. https://doi.org/10.1007/s10552-013-0176-2
  27. Edenfield AL, Siddiqui NY, Wu JM, et al. Polyethylene Glycol 3350 and Docusate Sodium Compared With Docusate Sodium Alone After Urogynecologic Surgery: A Randomized Controlled Trial. Obstetrics & Gynecology. 2016. https://doi.org/10.1097/aog.0000000000001565

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