Painful, difficult bowel movements; feeling gassy or bloated; hard, dry stools or excessive straining to have a bowel movement. 
It's important to remember that a normal rhythm does not have to involve a daily bowel movement. Constipation is diagnosed when a patient has fewer than three bowel movements a week, and/or stools are hard and dry.

There are many causes of constipation.
A diet without enough fresh fruit, vegetables and whole grains, and a lifestyle without enough exercise are two common factors. But a number of other causes are possible as well, for example:

• Certain diseases
• Certain medications
• Hormonal changes; pregnancy
• Recovery from surgery
• Low mobility due to illness or old age

Some people have one bowel movement a day, some people have more than one, and other people have just three or four a week – all of these rhythms may be normal. 
But if you have fewer than three bowel movements a week, or if having a bowel movement involves excessive straining and/or pain, you may be suffering from constipation and should see your doctor.

Women certainly report having constipation three times more frequently than men. It may be partly that women are more aware of their health and more willing to talk about it than men. 
Nevertheless, there are certainly some physical factors that affect digestion, e.g. hormonal changes during pregnancy and in menopause.

The active ingredient in laevolac is lactulose, a disaccharide (double sugar) of the sugars galactose and fructose.The bond between the two parts is not split in the small intestine, so lactulose reaches the colon undigested.
There it is used as an energy source by health-promoting bacteria such as lactic acid bacilli and bifidobacteria, stimulating their growth.This increases the bulk of the stool, and when the colon is full, it becomes more mobile. Also, since these bacteria degrade lactulose mainly to lactic acid, the content of the intestine becomes acidified which increases water retention in the colon.This makes the faeces softer.

The use of laevolac may be considered during pregnancy. Long experience and clinical studies have shown no evidence of undesirable or damaging effects during pregnancy. However, you should consult your doctor before taking any laxative, including laevolac, when you are pregnant.

Lactulose is indicated and approved to treat constipation in children including babies and toddlers. However, the approval status of laevolac may not be the same in all countries world-wide. Please consult your paediatrician or pharmacist before giving your baby any medication.

If you are taking any medication, you should tell your doctor about it before he/she prescribes any laxative. In general, laevolac has good compatibility with other medicines, but your doctor should decide what is best for you.

Yes. laevolac is only digested in the colon whereas the absorption of contraceptive hormones takes place in the small intestine. Hence, interactions of oral contraceptives when taking lactulose are not to be expected. However, sever episodes of diarrhoea may occur when laxatives are taken at high dosages. This may lessen the effectiveness of the 'pill'. In these cases additional or back-up forms of contraception are recommended.

Like every medicine, laevolac sometimes has side effects. Flatulence or abdominal pain may occur during the first few days of treatment. As a rule it disappears after a couple of days. Please consult your doctor if the symptoms are persistent.

For some people constipation is an occasional problem, while for others it is a chronic condition. laevolac should normally have a significant effect within a few days. Due to its gentle mode of action and its demonstrated safety profile, laevolac can also be used long-term. However, please consult your doctor if constipation persists, or if you suffer from painful cramps or any unexpected bleeding.

Prebiotics are food components or carbohydrates which stimulate growth of beneficial bacteria in the colon. These substances are used as an energy source mainly by bifidobacteria and lactic acid bacilli. Scientific literature demonstrates that lactulose, the active ingredient in laevolac, is a recognised prebiotic. Therefore laevolac helps to activate natural mechanisms to restore the microbial balance and function of the colon.

If you get any side effects talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in this leaflet. By reporting side effects you can help provide more information on the safety of this medicine.

Please report side effects to your doctor, pharmacist, the national health authority, or send the filled form to the following address:

FRESENIUS KABI AUSTRIA GmbH
Estermannstraße 17
4020 Linz
Austria
E-mail: international.linz@fresenius-kabi.at