Prescribe with care. The role of laxatives in the treatment of constipation.

The use of laxatives is widespread throughout North American hospitals and long-term care facilities. Although constipation is a frequent complaint among the elderly, the use of laxatives is not always warranted; increases in physical activity, fluid intake, and dietary fiber may be sufficient to control constipation. The occasional use of a laxative is not harmful, but the daily use of these drugs for achieving a bowel movement may be detrimental to the resident because of the side effects they can produce and drug interactions that can occur with other medications. Potential solutions to the overuse of laxative agents include the use of dietary bran; less regular administration of stimulant and osmotic agents; more regular administration of bulk-forming laxatives and stool softeners; an increase in the awareness of normal gastrointestinal physiology; and the role of non-drug factors.