axatives are believed to be amongst the ancient medications. A frequency of bowel movement affects the quality of health, and to make bowel movement a regular habit, laxatives had featured in the common medicine list for ages. It is impossible to leave chronic constipation untreated. However, unlike in the ancient world where laxatives were obtained from foods and herbs, in the modern terms, laxatives are pharmacological drugs that entail risk of abuse and associated adverse reactions. Therefore, to eliminate the risks of addiction and minimize harmful side effects of laxative intake more and more people prone to constipation are switching to natural remedies.
One of the earliest references to laxatives is found in the Ebers medical Papyrus from Egypt belonging to 1550 BC. It had listed a number of laxatives that work in adults and children. In the Victorian era lack of internal cleanliness was believed to cause autointoxication or poisoning from fecal matter. Health problems including indigestion, headaches, insomnia and even impotence were believed to be the result of autointoxication. Since the Victorian era, the increased obsession with inner cleanliness escalated laxative use. 
For much of the time ever since laxatives had been known to humans, it has been misused or abused. Nowadays, with the easy availability of over-the-counter laxatives, laxative abuse has become widespread. Individuals who tend to misuse laxatives are categorized into four groups. The largest numbers of individuals who abuse laxatives suffer from an eating disorder such as bulimia nervosa or anorexia. About 10% to 60% of individuals with an eating disorder take laxatives. The second group of laxative abuser comprises of middle-aged and older adults who initially used laxatives to treat constipation but continued to overuse them owing to the belief that daily bowel movement is essential for maintaining health. The third group contains people who are involved in certain athletic training and sports with specific body weight limits. Laxative abusers in the fourth group use laxatives surreptitiously to induce diarrhea. They are known to suffer from a factitious disorder. 
Types of Laxatives
Ideally, laxatives are recommended for individuals who are occasionally constipated. Different types of laxatives are available over-the-counter.
1. Lubricants or Rectal Suppositories
Lubricants are meant for external use. Lubricating agents such as mineral oil are applied into the rectum to enable the stool to pass with ease out of the body. They help in softening the stool and stimulate rhythmic contractions of the muscles of the intestinal wall.
2. Stool Softeners
By adding moisture to the stool, stool softeners allow strain-free defecation. These laxatives are best suited for individuals troubled by hard stools. 
3. Fiber Supplements and Bulk-forming Laxative
Fiber supplements are natural laxatives. They are ideal for individuals prone to constipation owing to inadequate fiber intake. These supplements are known to be safer than the other laxatives. They absorb water, thereby forming soft stools. The non-digestible fibers add bulk to the stool. The soft bulky stools stimulate normal intestinal muscle movement. Psyllium is the most common bulk-forming laxative.
4. Osmotic Laxatives
Osmotic laxatives help in making the stool soft by drawing out water from the colon. Though osmotic laxatives are known to be more effective than most of the other laxatives, they increase the risk of electrolyte imbalance and tend to reduce the body’s fluid level. Saline laxatives including magnesium and sodium phosphate based products, and sorbitol, glycol and lactulose are examples of osmotic laxatives. [
5. Stimulant Laxatives
By stimulating contraction of the muscles of the intestinal wall, stimulant laxatives help in eliminating stools.
Side Effects of Over-the-counter Laxatives
Even laxatives sold over-the-counter are not free from side effects and are known to be misused. Most of the side effects occur due to overuse of these products. Use of lubricants or rectal suppositories entails risk of rectal irritation, cramping, and diarrhea. Oral stool softeners, though considered safe for occasional use, can cause electrolyte imbalance when used for a prolonged period. Side effects of bulk-forming fiber supplements are minimal when consumed with plenty of water. Inadequate water intake causes gas, bloating or cramping, and can even worsen constipation. Gas, bloating, diarrhea, cramping, nausea and excessive thirst are the common side effects of osmotic laxatives. Stimulant laxatives are known to cause cramping, belching, nausea, diarrhea, and discoloration of urine.
Furthermore, laxative intake could reduce the absorption of nutrients and medications. Certain laxatives are known to interact with certain heart and bone medications and antibiotics. Electrolyte imbalance that may occur following laxative use causes weakness, confusion, abnormal heart rhythm, and seizures. Laxative use can worsen constipation associated with bowel obstruction or appendicitis. Prolonged laxative use could impair the ability of the colon to contract, thereby further aggravating constipation. 
Among the different types of laxatives, laxative abuse is higher among stimulant laxative users. As the stimulant laxatives are known to work faster than the other laxatives they are largely abused by individuals with eating disorders who believe that the fast-acting laxative could inhibit calorie absorption. Laxative abuse leads to electrolyte and acid/base imbalance. It harms the kidneys and the cardiovascular system that could even be fatal. When laxative users discontinue the drug, the rennin-aldosterone system activated due to excess fluid loss during the period of laxative overuse causes acute weight gain and edema. To avert weight gain, laxative users with eating disorders restart laxative intake that worsens their health condition further. Psychiatric treatment is frequently needed to reduce reliance on laxatives. 
Foods That Work Best as Laxatives
However, the adverse effects of laxative use can be averted by changing the diet and focusing on foods that are regarded as natural laxatives.
1. Prune Juice
Prune juice is the water extract of dried plums or prunes. The high concentration of mineral salts makes prune juice a mild laxative.  Drinking a mixture of ½-cup prune juice, one tablespoon of lemon juice and one cup of water before bedtime is known to relieve constipation. If you cannot access prune juice, soak a few prunes overnight in water and eat them in the morning. Stewed prunes are also known to ease bowel movement. 
2. Chia Seeds
Adding fiber-rich chia seeds to the diet is known to relieve constipation. One ounce, equivalent to 2 to 2 ½ tablespoons, of chia seeds, contains 10 grams of fibers. Chia seeds are capable of absorbing large amounts of water. When soaked in water, chia seeds form a soft gel that acts as a gentle laxative. About 50 to 60% fibers in chia seeds are insoluble. They add bulk to the stool that eases bowel movement. 
3. Aloe Vera
The dried and powdered aloe vera latex is traditionally used as a laxative. The US Pharmacopoeia recognizes the use of aloe vera latex as a laxative. The laxative effect of aloe vera is attributed to a compound called barbaloin. It stimulates peristaltic contraction and increases colon secretion. However, the cathartic action of aloe vera latex is quite powerful. Aloe should, therefore, be used sparingly to relieve constipation. Diarrhea and abdominal cramps are the possible side effects of aloe vera intake. This natural laxative is not recommended for pregnant and breastfeeding women. 
Flaxseed is known to be an effective and safe laxative for people suffering from chronic constipation. Unlike stimulant laxatives, flaxseed, also known as linseed, does not forcibly expel stools from the intestine. The only constituent of flaxseed, by binding with the undigested food residues in the stomach, adds bulk to the stool. An increased volume of the stool stimulates intestinal contraction, resulting in excretion. Furthermore, flaxseed oil acts as a lubricant in the large intestine that allows the feces to easily slide down the intestine. The oil is also known to form a protective coating on the mucous membrane, thereby assisting in healing the membrane damaged by chronic constipation and reducing further damage. Flaxseed is also believed to reduce inflammation of the mucous membrane associated with spastic constipation. To relieve constipation take two tablespoons of ground flaxseeds thrice a day. It usually takes two to three days to notice a result. 
The rhubarb rhizome is used as a laxative. It enhances colon motility by inhibiting stationary contraction and inducing propulsive contraction. It is also known to increase chloride secretion in the intestine that adds water and electrolytes to the fecal matter and makes it soft. Moreover, rhubarb contains tannin that helps in decreasing colon inflammation. To ease excretion, puree three stalks of rhubarb, and blend the purred rhubarb with a quarter of a peeled lemon, a cup of apple juice and a tablespoon of raw honey. Drink the tart mixture. 
6. Citrus Fruit Juice
Juices of citrus fruits are known for their mild laxative effect. Regular intake of citrus juices could help in minimizing the risk of constipation. Orange and grapefruit juices work as mild laxatives. Consuming two tablespoons of lemon juice with 8 ounces of hot water after awaking in the morning is a time-honored home remedy for constipation. Consuming lemon juice combined with olive oil, Epsom salt, and water is believed to relieve constipation in individuals without any digestion problem. Dissolve a tablespoon of Epsom salt in a cup of water. Add one teaspoon of lemon juice and a tablespoon of olive oil, and drink the mixture. It may take 1 to 15 hours to notice the result. 
7. Whole Foods
Eating whole foods could help in improving bowel movement. Whole foods such as whole grains, raw vegetables, beans, and raw and dried fruits are among the best dietary sources of fibers that add bulk to the stool. They are considered superior alternatives to pure wheat bran, which is known to irritate the intestinal linings and suppress absorption of nutrients from food. By eating two apples and two carrots daily you will get about 16 grams of dietary fiber. 
8. Magnesium Rich Foods
Constipation could be a symptom of magnesium deficiency. Magnesium works synergistically with calcium in aiding contraction and relaxation of the colon muscles that enable excretion of digestive wastes. Inadequate magnesium intake or a high calcium/magnesium ratio causes spasms in the colon, leading to constipation. The RDA for magnesium for adult males is 420 mg per day and for adult females, it is 320 mg per day. However, your body’s exact magnesium requirement could be higher if you are suffering from magnesium deficiency or experiencing rapid magnesium depletion due to stress or a health condition. Whole grains, beans, nuts, and seeds are the readily available sources of magnesium. Your magnesium intake should be proportional to your calcium consumption. Some of the best foods high in magnesium are almonds, cocoa, oatmeal, lentils, figs, dates, cowpeas, fish roe, celery, spinach, tomato, cornmeal, and wheat. 
The levels of lactobacilli and bifidobacteria in the colonic flora are believed to be lower than normal in individuals prone to constipation. Studies suggest that the levels of these beneficial bacteria in the gut return to normal after restoration of normal bowel movement. A small number of studies had revealed the beneficial effect of consuming fermented products in constipated individuals. In a study, consumption of 65 ml of beverage with a probiotic strain known as L. casei Shirota for four weeks helped in reducing gastrointestinal symptoms of chronic constipation. Another study revealed that consumption of fermented milk helped in relieving constipation in elderly people suffering from constipation due to reduced gut transit time. The beneficial effect persisted for four to six weeks after discontinuing intake of fermented milk. 
10. Coconut Water
Coconut water works as a natural laxative when consumed in large quantities. The laxative effect of coconut water is believed to be due to its high potassium content. Potassium helps in drawing out water from the colon into the fecal matter, thereby softening the hard stool. It is also known to play an important role in the contraction of the muscles of the intestinal wall. Prepare a powerful anti-constipation beverage by soaking a few prunes in a glass of hot water for 10 minutes. When the prunes become soft, put them in a blender and blend with coconut water. Drink the coconut water and prune mixture in the morning on empty stomach. 
The frequency of bowel movement varies from person to person. In some individuals bowel movement thrice a day is considered normal and in some excreting thrice a week is believed to be normal. If you have fewer bowel movements than your normal bowel movement pattern, you may take laxatives. However, instead of trying over-the-counter laxatives opt for natural food-based laxatives that are considered safe for health. In addition, add more fiber-rich foods to your diet, and drink enough water and exercise daily.