A Primary Care Approach to Constipation in Adults with Intellectual and Developmental Disabilities

Table 1

Laxative choices.

Class	Class 2	Class 3
Bulk-forming laxatives
Psyllium	12 to 72 hours	Impaction above strictures, excessive gas
Methylcellulose	12 to 72 hours
Polycarbophil	24 to 48 hours
Surfactants
Docusate sodium	24 to 72 hours	Contact dermatitis has been reported
Docusate calcium	24 to 72 hours
Osmotic agents
Sorbitol	24 to 48 hours	Bloating, excessive gas
Polyethylene glycol	1 to 4 days	Nausea, bloating
Glycerin (suppository)	15 to 60 minutes	Local site irritation at the rectum
Magnesium sulfate	0.5 to 3 hours	Mag toxicity if used in excess, urgent defecation
Magnesium citrate	0.5 to 3 hours	The same as above
Stimulants
Bisacodyl (oral)	6 to 10 hours	Gastric irritation
Senna	6 to 12 hours	Melanosis coli
Secretagogues
Lubiprostone	24 to 48 hours	Nausea, diarrhea, and bloating
Linaclotide	12 to 24 hours
Plecanatide	12 to 24 hours