Constipation – what to try before reaching for laxatives
Normal ranges from three times a day to three times a week. What actually helps, why some laxatives should not be a habit, and the symptoms to take seriously.
There is no correct number
Anywhere from three times a day to three times a week is within normal range. Constipation is defined by difficulty and discomfort — hard, dry stools, straining, a sense of incomplete emptying — rather than by a frequency you have been told to hit.
A change from your own normal matters more than the number itself, which is why a new pattern is worth mentioning even if it is technically within range.
What to try first
- More fibre, increased gradually — beans, lentils, whole-grain bread, oats, fruit and vegetables. Adding a lot at once causes bloating and puts people off.
- More water. Fibre without fluid makes constipation worse rather than better.
- Move. Physical activity genuinely speeds transit through the bowel.
- Go when the urge comes. Repeatedly ignoring it trains the reflex away, and this is a common and fixable cause.
- Give yourself unhurried time, ideally after a meal when the bowel is naturally more active.
- Raise your feet on a low stool so the knees sit above the hips — it changes the angle and makes emptying easier.
The laxatives, and which to avoid long term
Laxatives are not all the same, and the differences matter for whether one is safe to use regularly.
The main types available in South Africa:
Macrogol (Polyethylene Glycol) — Osmotic Laxative — Movicol, Laxido, Miralax, Forlax
Chronic constipation; faecal impaction; bowel preparation
Lactulose — Duphalac, Laxette, Regulose, Lactulose Lennon
Constipation; hepatic encephalopathy (higher doses)
Bisacodyl — Dulcolax, Laxoberal, Correctol, Fleet Bisacodyl
Constipation; bowel preparation before procedures
- Bulk-forming — closest to dietary fibre, safe long term, needs plenty of water.
- Osmotic — draws water into the bowel, works over a day or two, generally safe for longer use.
- Stimulant — makes the bowel contract, works quickly, and is the one not to use daily for long periods without advice.
- Suppositories and enemas for occasional stubborn cases.
Causes worth finding, and warning signs
- Medicines: opioid painkillers including codeine, iron tablets, some antidepressants, calcium and antacids containing aluminium.
- An underactive thyroid, diabetes, low potassium.
- Pregnancy, and immobility.
- Dehydration, which is common in hot weather and in older adults.
Common questions
- Is it dangerous to go a few days without a bowel movement?
- Not in itself, if it is your normal pattern and you are comfortable. It is the difficulty, discomfort and any change from your own usual rhythm that matter, not the calendar.
- Can I use a laxative every day?
- Bulk-forming and osmotic types can generally be used long term under guidance. Daily stimulant laxatives over long periods should be discussed with a clinician rather than continued indefinitely on your own.
- Why did my constipation start after new medication?
- It is a very common side effect, especially of codeine-containing painkillers and iron tablets. Do not stop a prescribed medicine — tell the prescriber, because there is usually either an alternative or something to take alongside.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Clinical and public health guidanceWorld Health Organization
Last reviewed 4 August 2026.