The short answer
- Before surgery: docusate is generally fine to continue until the day before; follow the hospital’s fasting rules for the day itself.
- Bowel surgery or colonoscopy: follow the specific preparation instructions instead.
- After surgery: for constipation from opioid painkillers, senna, bisacodyl or macrogol (Movicol, MiraLAX) are usually more effective than docusate alone.
What Colace does
Docusate (Colace in the US, Coloxyl in Australia, Dioctyl and Docusol in the UK) is a surfactant: it lets water mix into the stool to soften it. It doesn’t stimulate the bowel to push, which is why it’s described as gentle, and also why it often isn’t enough on its own. Reviews of the evidence have found little proof that docusate alone prevents or treats constipation in hospital patients. In Australia it’s often sold combined with senna (Coloxyl with Senna), which adds a stimulant effect.
Taking it before an operation
- Days before: continuing docusate is generally fine for most surgery. Tell the pre-admission team it’s on your list.
- The day of surgery: take only the medicines you’ve been told to take, with a sip of water. Stool softeners are usually not among them.
- Bowel surgery and colonoscopy: your preparation instructions replace your usual laxative routine.
- If you’re constipated before surgery, mention it: some surgeons prefer to start a stronger laxative beforehand, especially before joint replacement or spinal surgery where opioids will be needed.
The general rules on fasting and which medicines to stop are in the guide to medicines before and after surgery.
Preventing constipation after surgery
Anaesthetic drugs, opioid painkillers, less food and less movement all slow the bowel. Constipation after surgery is common and can be painful, especially after abdominal, hip, knee or spinal operations.
| Option |
Type |
Typical use after surgery |
| Senna (Senokot), bisacodyl (Dulcolax) |
Stimulant |
First choice for opioid-related constipation, often at night |
| Macrogol (Movicol, MiraLAX, OsmoLax) |
Osmotic |
Daily, alone or with senna |
| Docusate (Colace, Coloxyl) |
Softener |
Adds softening; weak alone |
| Lactulose |
Osmotic |
Alternative; can cause wind (see lactulose doses) |
| Glycerin or bisacodyl suppository |
Rectal |
If no bowel movement after 2–3 days |
Drink fluids, walk as soon as you’re allowed, eat fibre as your diet resumes, and reduce opioids as pain allows. Ask your surgical team before using laxatives after bowel surgery.
When to call the team
Contact your surgical team or seek urgent care if you have no bowel movement and no passing of wind, with a swollen, painful abdomen or vomiting. After abdominal surgery this can mean the bowel hasn’t restarted (ileus) or a blockage.
Frequently asked questions
Can I take Colace with Tylenol or ibuprofen?
Yes, docusate doesn’t interact with paracetamol (Tylenol) or ibuprofen.
How long does Colace take to work?
Usually 1–3 days. For quicker relief, a stimulant laxative works overnight and a suppository within an hour.
Is it OK to take Colace every day after surgery?
For a few weeks while on opioids, yes, usually alongside senna or macrogol. Stop when you’re off opioids and back to normal.
Sources and further reading
CanforaMedicine Guide
