Q: What are stool softeners, and can they be taken long term?
A: This over-the-counter product is supposed to work in the large intestine to make stool softer and more oily, so that bowel movements are easier and take place without straining. The active ingredient, called docusate, is safe, not habituating, and can be taken long term. While there is no good research showing that docusate actually makes bowel movements easier, many people find it helpful.
Doctors sometimes suggest stool softeners in cases where straining to have a bowel movement is not advisable—such as for people with chronic constipation, anal fissures, hemorrhoids, or heart disease.
While there is no harm in trying a stool softener, there are more effective, proven ways to deal with constipation, including better hydration, increased fiber consumption (from food or “bulk-forming” fiber supplements such as psyllium), and exercise. Polyethylene glycol (such as Miralax) and stimulant laxatives have been proven to be effective short-term treatments for constipation. Some stimulant laxatives contain a stool softener.
If you are often constipated or have to strain to move your bowels for other reasons and self-help doesn’t work, you may need medical evaluation and other kinds of treatment. If you have been taking a stool softener long term, you might try stopping it for a while—you may find that you don’t really need it. Don’t take mineral oil if you’re taking a stool softener (we don’t recommend mineral oil as a laxative, in any case).
This article first appeared in the UC Berkeley Wellness Letter.