Constipation Supplements, Laxatives and Stimulants. Oh My!

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Sometimes kids can be eating and drinking all the right things for good gut health and they are still constipated!  They’re eating high fiber foods, like fruits, vegetables and whole grains and drinking enough fluids and their body is still struggling to have regular soft poop.  This is where a little help from over-the-counter supplements, laxatives and stimulants may come in to lend us a hand.

If you’ve ever gone to the digestive health section at the pharmacy, you likely have been overwhelmed with all the available products and rightly so!  There are so many digestive health remedy options to choose from that are used to attain a variety of results that it really could make your head spin.  It makes a lot of sense to talk to a medical professional to guide you in this area before you spend a ton of money on products that may or may not be the right solution.  Well, we’re here to give you some guidance on the more common supplements, laxatives, and stimulants out there.  We did a Facebook Live recently where we went into all the details.

We’ll begin with supplements!

Supplements

Adding a supplement that contains prebiotic fiber can assist in boosting the amount of overall fiber in your kiddo’s day.  Prebiotics are a type of fiber that feeds the probiotics (friendly bacteria) in our gut.  Prebiotic fiber can be found in foods such as onions, bananas, garlic, leeks, soybeans, chicory root, honey, and some artichokes.  Inulin and chicory root are common types of prebiotic fiber found in supplements. Adding prebiotic fiber in supplement form can be a first step in changing the consistency of the stool to ease constipation before trying laxatives.  It is very important to remember that water should always accompany fiber to help things keep sliding through the bowel. Also adding fiber supplements should be done slowly to reduce any possible gas or bloating, especially if your child is not eating many fruits, vegetables, or whole grains already. Here are a few of the supplements that we recommend.

  • Genuine Health Gut Superfoods is an organic prebiotic fiber supplement that comes in both flavored and unflavored powder that you can mix into water, smoothies, yogurt, applesauce, etc. to add more fiber to your child’s diet. It also contains vitamins and minerals as well as 22 fermented superfoods.

  • Begin Health Growing Up Prebiotics is a brand of prebiotic fiber that we often recommend. It comes in powdered form in individual packets. It is flavorless so it can be mixed into foods or drinks, and you can even add it into baked goods!  This is a great option for adding fiber to your child’s diet especially for those younger kids and more selective eaters!  According to Begin Health’s website: “Growing Up Prebiotics help feed beneficial gut bacteria, for digestive comfort, regularity, and softer stools.” 

Osmotic laxatives

Osmotic laxatives work to soften stool by pulling water into the stool from the intestines.  This type of laxative does not stimulate a bowel movement.  The goal in using osmotic laxatives is to soften the stool but not turn it into liquid, stools should be formed. Here are several options to consider:

  • MiraLAX is a very common osmotic laxative recommended for children and seems to be the first choice of pediatricians and gastroenterologists.  MiraLAX consists of a substance called polyethylene glycol. According to Wikipedia, “Polyethylene glycol is a polyether compound derived from petroleum with many applications, from industrial manufacturing to medicine.”  MiraLAX can be effective if your doctor has recommended a clean out to assist with moving dry hardened stool through. While many of the kids we work with come to us on MiraLAX, most parents desire a more natural solution.

  • Natural Vitality Calm is a magnesium citrate supplement that we support as a more natural approach.  Magnesium works as an osmotic laxative by drawing water into the stool from the intestine.  It comes in Natural Vitality Calm Powder that comes in multiple flavors or unflavored.  The powder form also can be very effective for clean outs.  There is a Natural Vitality Calm Gummies that is well accepted by kids and can be used daily to maintain soft stools.

  • Mag Go Kids Powder is another osmotic laxative that we recommend. It is a slightly different supplement in the form of magnesium oxide which works in much the same way. Take a look at this article by Dr. Wiggy of Raise Them Well which speaks to the difference between Mag Citrate and Mag Oxide.

  • Dulcolax Soft Chews is a third option for a natural osmotic laxative product which consists of a third kind of magnesium called magnesium hydroxide.  This product has more ingredients than the Natural Vitality Calm and Mag Go Kids however can have similar resulting soft stools.   

The goal for softening the stool can be measured by looking at the Bristol Stool Chart with a goal of # 3 or 4. 

For slow motility or a very slow movement of food through the bowel, adding fiber is not the answer and will not produce the desired effect. This is where stimulant laxatives can play a role.  

Stimulant Laxatives

Stimulant laxatives encourage peristalsis to stimulant the gut to have a bowel movement. When using a stimulant laxative, you want to make sure the stool is soft so that you’re not stimulating a hard poop which could be painful to pass. These should be used when the stool is soft but is still not moving through the bowel.  There are several options for stimulant laxatives that are composed of a medication called Sennoside. 

  • ExLax comes in chocolate, so it is well accepted by kids’ palates.  It works by causing peristalsis in the bowel and pushes the stool along. 

  • Dulcolax stimulant laxative (Same brand name as the osmotic laxative above) comes in a tablet form so can be used for kids who are old enough to swallow a pill.

  • Genexa Lax-Aid comes in small tablets and is an option with more organic ingredients.

 Suppositories/Enemas

Last but not least and always there in a pinch are suppositories and enemas!  If a bottoms up approach is needed, then a suppository/enema can be used where a liquid is inserted into the rectum to produce a bowel movement quickly.  Some options for suppositories/enemas are:

  • Pedialax liquid glycerin suppository.  This suppository is intended for children and can produce a bowel movement within 2-5 minutes.  It’s the suppository we use most often in our clinic

  • Saline enema.  This enema is more likely to be needed in an older child or adults. It is larger than the glycerin suppository and uses a saline solution to wash stool from the rectum rather than glycerin.

For kids who withhold and need more than just stool softening and/or stimulation, we often employ two different protocols. One is Dr. Hodge’s MOPs protocol. The other is Dr. Collin’s Soiling Solutions method. Both of these have worked very well for kids we work with, but they do require strict adherence and guidance. If you think your child would benefit from either of these methods, we’d be happy to help you with that.

As with any supplement or medication, it is important that you talk to your doctor about any of these options before using them.  Hopefully this discussion has cleared up any confusion and has given you some more information and a better understanding of the available supplements, laxatives and stimulants used to treat you constipated child.

Need help deciding which of the many options will work best for you child’s situation? Wondering how much to use? Book a consult with Annette & Jess by sending an email or join the Private Facebook group by clicking this link. 

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