Bulk-forming laxatives are the most commonly recommended initial treatments for constipation. Bulk-forming laxatives may work as quickly as 12 hours or take as long as three days to be effective. Some bulk-forming laxatives are derived from natural sources such as agar, psyllium, kelp (alginates), and plant gum. Others are synthetic cellulose compounds such as methylcellulose and carboxymethylcellulose. Natural and synthetic bulk-forming laxatives act similarly. They dissolve or swell in the intestines, lubricate and soften the stool, and make the passage of stool easier and more frequent.
Examples of bulk-forming laxatives are methylcellulose (Citrucel) psyllium hydrophilic mucilloid (Metamucil), polycarbophil (FiberCon), guar gum (Benefiber) and malt soup extract (Maltsupex). Many of these agents are available as powders and are taken mixed with fluids. Fruit drinks, fruit juice, and soft drinks mask the gritty taste of these laxatives better than water. Some are available as wafers, which are designed to be eaten with a separate beverage.
The benefits of bulk-forming laxatives are:
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