What is the best stool softener for daily use?  Is it safe to use every day?  And when do I take it? These are questions patients frequently ask. Why?  Because constipation is one of America’s most common digestive complaints. 

At least 16 percent of people in the United States struggle with constipation on a regular basis.  Patients who are preparing for common surgeries, like joint replacement, gall bladder removal, or bunion surgery are prescribed stool softeners as a routine part of their post-surgery protocol. Surgeons know that struggling to have a bowel movement is a regular consequence of surgery and the use of prescription pain medications.

Does this mean then that stool softeners are a good idea? Should you use one every day?  The answers are sometimes, and no. 

Stool softeners

There are four main types of medical laxatives:

  • Osmotics, such as MiraLAX, draw water into your bowel.
  • Stimulant laxatives like Senokot, irritate the walls of your intestines, making the intestinal muscles constrict and push stool down through your bowel.
  • Bulk-forming laxatives, such as Metamucil, increase the size and weight of your stool, stretching the intestinal wall and leading to contractions and the passing of stool.
  • Stool softeners draw water into your stool, making it easier to pass. Stool softeners are also known as emollient laxatives, emollient being a term that means to soften, often heard associated with moisturizing lotions and creams for the skin.  The most common medical stool softeners are made from docusate and sold under the names Colace and Surfak. 

When is the best time to take a stool softener?

The best time to take a stool softener is at night. This gives the softener time to work while you sleep, resulting generally in a morning bowel movement.

Stool softeners, as with any laxative, should not be used on a daily, long-term basis. The best use for stool softeners is in short-term medical situations where constipation is a problem.  Examples are pregnancy, post-surgery pain medication use, the development of hemorrhoids, or an illness that affects bowel function.  The overuse of stool softeners can lead to dependence and disruption of normal bowel function.  Common side effects with even short-term use are nausea, vomiting, diarrhea, and abdominal cramping.  

In my experience, the best stool softener is taken through the daily consumption of this prescription:

  • A fiber and probiotic rich diet
  • One or more tablespoons of olive or flax oil
  • At least 90 ounces of water.

This approach provides the properties of stool-softening laxatives as well as the effects of stimulant and bulk-forming laxatives. You can use this natural form of laxative every day for the rest of your life.  An added benefit: It provides nutritive, disease-protective help as well.

Remember though, with a nutritional approach to medicine, it is never “one food fits all.” I’ve seen patients who attribute their bowel regularity to their daily consumption of yogurt. I have also had patients who cannot digest dairy in any form and for whom yogurt has a constipating effect. Those folks do better with probiotic rich foods such as sauerkraut, tempeh, or miso.  Finding the fruits, vegetables, and whole foods that you like and digest well is truly the best stool softener you can consume.

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