Best Stool Softeners for Elderly: Top 6 Picks and Buying Guide
Written By Kobi Nathan, Pharm.D., M.Ed., CDP, BCGP, AGSF
Sleep Disorders
March 18, 2023
As people age, they may experience increased constipation and other digestive issues.

Finding the best stool softeners for elderly individuals can help alleviate these problems and improve overall digestive health.

This comprehensive guide will explore our top 6 recommendations for stool softeners, their benefits, and usage tips.

Keep reading to learn more about the most effective and safe stool softeners for managing constipation in the elderly.

Definition of constipation

Constipation is a common digestive issue that affects people of all ages but is particularly prevalent among elderly individuals.

It is characterized by infrequent bowel movements, difficulty passing stool, and sometimes abdominal discomfort.

Generally, having fewer than three bowel movements per week is considered constipation.

Various factors can cause episodic and chronic constipation, including a low-fiber diet, dehydration, lack of physical activity, certain medications, and age-related changes in the digestive system.

By understanding the causes and symptoms of constipation, seniors can take appropriate measures to address this condition and maintain optimal digestive health.

Please read my other article, which goes into great detail about managing constipation and offers precise dosage suggestions based on evidence-based medicine and my experience as a clinical pharmacist.

Alright, let’s shift our focus to the best stool softeners available for the treatment of constipation in older adults and jump right in:

1. Colace

Colace is one of the most popular stool softeners on the market. Its active ingredient, docusate sodium, works by drawing water into the stool, making it easier to pass and relieve constipation. Colace is gentle on the stomach and usually does not cause any negative effects.

It is safe to use and is recommended for occasional constipation.

That said, a warning about docusate – although it is one of the most common laxatives, it just does not work as well as the other types mentioned in this article.

The clinical and scientific evidence shows that it is not effective. According to the Canadian Agency for Drugs and Technologies in Health, the comprehensive review the agency conducted showed that:

“Docusate appears to be no more effective than placebo for increasing stool frequency or softening stool consistency. Furthermore, it does not appear to lessen symptoms associated with constipation (i.e. abdominal cramps) or affect the perceptions associated with completeness of or difficulties with stool evacuation.”

My advice – don’t buy it. I am not linking it for purchase here because, in my opinion, it is a complete waste of money. If your doctor prescribes it, respectfully bring up the Canadian statement I reference above.

2. Miralax

Miralax is another excellent option for seniors looking for a stool softener. This over-the-counter product comes in powder form, which can easily be mixed into any beverage. The active ingredient, polyethylene glycol 3350, is an osmotic laxative.

It helps to soften the stool and promote regular bowel movements.

Benefits of Miralax:

  • Easy to mix with beverages.
  • Effective stool softening.
  • Can be used daily for regularity.

3. Senna

For those who prefer a more natural approach, senna is an herbal laxative that can effectively treat constipation.

Senna contains compounds called sennosides, stimulating the intestines and promoting bowel movements.

While not technically a stool softener, senna can still be an effective solution for seniors struggling with constipation.

Benefits of Senna:

  • Natural herbal remedy.
  • Stimulates intestinal movement.
  • Available in tablet and tea form.

4. Phillips’ Milk of Magnesia

Phillips’ Milk of Magnesia has been a trusted constipation remedy for decades. Like polyethylene glycol, it is also an osmotic laxative.

Its main ingredient, magnesium hydroxide, works by drawing water into the colon, softening the stool, and easing its passage. This gentle liquid laxative is easy to swallow and can provide relief in as little as 30 minutes.

Benefits of Phillips’ Milk of Magnesia:

  • Fast-acting relief.
  • Easy-to-swallow liquid form.
  • Gentle on the digestive system.

5. Dulcolax Stool Softener

Bisacodyl is a stimulant laxative commonly used to provide short-term relief from constipation and facilitate bowel movements.

Like Senna, it works by stimulating the muscles in the intestines, promoting the movement of stool through the digestive tract.

Bisacodyl is available in various forms, including oral tablets and suppositories, and is typically recommended for occasional use when immediate relief is needed.

While bisacodyl is effective in addressing constipation, it is essential to use it as directed and not rely on it for the long-term management of chronic constipation, as overuse may lead to dependency and reduced bowel function.


6. Psyllium Fiber

Psyllium fiber is an excellent natural option for seniors looking to address constipation and improve their digestive health.

Derived from the husks of the Plantago ovata plant’s seeds, psyllium is a soluble fiber supplement that can absorb water, form a gel-like substance, and subsequently soften the stool, making it easier to pass.

In addition to its stool-softening properties, psyllium fiber offers numerous other health benefits, including supporting healthy cholesterol levels, regulating blood sugar, and promoting weight management.

Long-term use of psyllium fiber is perfectly acceptable and highly encouraged.

A personal endorsement – My gastroenterologist told me before my last colonoscopy that every person should drink dietary fiber daily to reduce the risk of colon cancer.

Benefits of Psyllium Fiber:

  • Natural constipation relief.
  • Supports healthy cholesterol levels.
  • Helps regulate blood sugar.
  • Promotes weight management.

How to Use Psyllium Fiber:

Psyllium fiber is available in various forms, including powder, capsules, and as an ingredient in fiber-enriched foods like cereals and snack bars.

To incorporate psyllium fiber into your diet, start with a small amount and gradually increase it over time to avoid gas and bloating.

Consuming plenty of water when taking psyllium fiber is crucial to ensure proper hydration and prevent the fiber from causing intestinal blockages.

As with any supplement, it’s always a good idea to consult a healthcare professional before incorporating psyllium fiber into your routine to determine the appropriate dosage and ensure compatibility with any existing medications or medical conditions.

What I recommend for my older patients struggling with constipation

In order:

  • I look for any medications that could be causing constipation and stop them after consulting with their doctor.
  • I identify and suggest a fiber-rich diet, hydration, and PRUNES! (this randomized study proved 50 grams of prunes twice daily was more effective than psyllium!).
  • I add an osmotic laxative such as Miralax.
  • If necessary, I add a stimulant, such as senna.
  • I will add a fiber supplement such as Metamucil. However, use it with caution in the elderly, as it can cause intestinal blockage if the older adult fails to drink enough water (expands and dries out).
  • It is okay and very common for an older adult to take an oral laxative indefinitely – there is no shame!
  • I tell my patients to GET MOVING! Movement and activity helps stimulate bowel evacuation. I repeat my mantra to them: “Move is Lube!”

Tips for Using Stool Softeners Safely and Effectively

When choosing and using stool softeners for elderly individuals, keeping safety and effectiveness in mind is essential.

Here are some tips to help ensure a positive experience with stool softeners:

1. Consult a healthcare professional

Before starting any new medication or supplement, consult a doctor or pharmacist to ensure the product is safe and appropriate for the individual’s needs.

2. Follow the recommended dosage

Always follow the recommended dosage on the product label or as advised by a healthcare professional. Overusing stool softeners can lead to dependence and other health issues.

3. Stay hydrated

Drinking plenty of water is crucial for maintaining healthy digestion and preventing constipation. Stool softeners work best when the individual is adequately hydrated.

4. Incorporate dietary fiber

Including fiber-rich foods can help promote regular bowel movements and prevent constipation. However, it is essential to increase fiber intake gradually to avoid gas and bloating.

5. Exercise regularly

Regular physical activity can help stimulate the digestive system and promote regular bowel movements. Engaging in gentle exercises like walking, swimming, or yoga can benefit seniors.


Several effective stool softeners are available to help alleviate constipation in elderly individuals.

Our top 6 recommendations include Colace, Miralax, Senna, Phillips’ Milk of Magnesia, Dulcolax Stool Softener, and Psyllium Fiber.

It is essential to consult a healthcare professional before using any stool softener and to follow proper usage guidelines to ensure safety and effectiveness.

By incorporating these products, proper hydration, a fiber-rich diet, and regular exercise, seniors can maintain healthy digestion and improve their overall quality of life.

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