laxatives , laxatives , or predecessors are substances that loosen feces and improve bowel movements. They are used to treat and/or prevent constipation.
The laxatives vary about how they work and the side effects they may have. Certain laxatives, lubricants, and salts are used to evacuate the colon for intestinal and rectal examination, and may be supplemented with an enema under certain conditions. Simply high doses of laxatives can cause diarrhea.
Some laxatives incorporate more than one active ingredient. The laxatives may be oral or suppository in shape.
Video Laxative
Type
Bulk forming agent
Mass-forming laxatives, also known as coarse fibers, are substances, such as dietary fibers and hydrophilic agents in over-the-counter medicines, which add a lot of water into the dirt so that they can pass more easily through the intestine (the lower part of the gastrointestinal tract).
Properties
- Action site: small and large intestines
- Onset of action: 12-72 hours
- Examples: dietary fiber, Metamucil, Citrucel, FiberCon
Mass-forming agents generally have the softest effect among laxatives, making them ideal for long-term treatment of regular bowel movements.
Dietary fiber
Foods that help with laxation include fiber-rich foods. Food fibers include insoluble fiber and soluble fiber, such as:
- Fruits, like bananas, though this depends on maturity, kiwifruit, prunes, apples (with skin), pears (with skin), and raspberries
- Vegetables, such as broccoli, long beans, kale, spinach, cooked winter squash, cooked taro and poi, mature green peas, and baked potatoes (with skin)
- Whole grains
- Bran Products
- Nuts
- Nuts, such as nuts, peas, and lentils
Emollient agents (stool softeners)
Emollient laxatives, also known as stool softeners, are anionic surfactants that allow extra water and fat to be inserted in the stool, making it easier for them to move through the digestive tract.
Properties
- Action site: small and large intestines
- Onset of action: 12-72 hours
- Example: docusate (Colace, Diocto), Gibs-Eze
The emollient agent prevents constipation rather than treating long-term constipation.
Lubricant
Lubricant laxatives are substances that coat the stool with a slippery lipid and inhibit the absorption of water from the colon so that the feces more easily penetrate the large intestine. Lubricant laxatives also increase the weight of the stool and reduce intestinal transit time.
Property
- Action site: colon
- Action onset: 6-8 hours
- Example: mineral oil
Mineral oil is the only lubricant without a prescription. Mineral oil can lower the absorption of fat-soluble vitamins and some minerals.
Hyperosmotic Agents
Hyperosmotic laxatives are substances that cause the intestine to hold more water inside and create an osmotic effect that stimulates bowel movements.
Properties
- Action site: colon
- Onset of Action: 12-72 hours (oral) 0.25 - 1 hour (rectum)
- Examples: glycerin suppository (Hallens), sorbitol, lactulose, and PEG (Colyte, MiraLax)
Lactulose works with an osmotic effect, which retains water in the colon, lowers pH through bacterial fermentation to lactic acid, formic and acetic, and improves colon peristalsis. Lactulose is also indicated in systemic portal encephalopathy. The glycerine suppository works mostly with hyperosmotic action, but sodium stearate in the preparation also causes local irritation of the colon.
Solutions of polyethylene glycol and electrolytes (sodium chloride, sodium bicarbonate, potassium chloride, and sometimes sodium sulphate) are used for overall intestinal irrigation, a process designed to prepare the colon for surgery or colonoscopy and to treat certain types of poisoning. The brand names for this solution include GoLytely, GlycoLax, CoLyte, Miralax, Movicol, NuLytely, Suprep, and Fortrans. The sorbitol solution (SoftLax) has a similar effect.
Saline laxatives
Saline solution is an unabsorbable osmotic substance that attracts and retains water in the intestinal lumen, increasing intraluminal pressure that mechanically stimulates intestinal evacuation. Agents containing magnesium also cause cholecystokinin release, which increases bowel motility and fluid secretion. Salt laxatives can alter the patient's fluid and electrolyte balance.
Properties
- Action site: small and large intestines
- Onset of action: 0.5-3 hours (oral), 2-15 minutes (rectum) Example: sodium phosphate (and variant), magnesium citrate, magnesium hydroxide (milk magnesia), and magnesium sulfate (Epsom salt)
Stimulation agent
A stimulant laxative is a substance that acts on the intestinal mucosa or the nerve plexus, altering the secretion of water and electrolytes. They also stimulate peristaltic action and can be dangerous under certain circumstances.
Properties
- Action site: colon
- Onset of action: 6-10 hours
- Example: senna, bisacodyl
Long-term use of stimulant laxatives can create drug dependence by damaging the folds of the colonic dams, making the user less able to remove impurities through their own colon. A study of patients with chronic constipation found that 28% of chronic stimulant laxative users lost haustral folds for one year, while no control group did.
Miscellaneous
Castor oil is a glyceride that is hydrolyzed by pancreatic lipase to ricinoleic acid, which produces laxative action by an unknown mechanism.
Property
- Action site: colon
- Action onset: 2-6 hours
- Example: distant oil
Long-term use of castor oil can cause fluid loss, electrolytes, and nutrients.
Serotonin agonists
This is a motility stimulant that acts through the activation of 5-HT 4 receptors of the enteric nervous system in the gastrointestinal tract. However, some have been discontinued or restricted due to harmful cardiovascular side effects.
Tegaserod (brand name Zelnorm) was removed from the US and Canadian markets in 2007, due to a report of an increased risk of heart attack or stroke. It is still available for doctors to patients in emergency situations that are life-threatening or require hospitalization.
Prucalopride (brand name Resolor) is a drug currently approved for use in the European Union on October 15, 2009 and in Canada (brand name Resotran) on December 7, 2011. It has not been approved by the Food and Drug Administration for use in America. State, but is under development by Shire PLC.
Chloride channel activator
Lubiprostone is used in the management of chronic idiopathic constipation and irritable bowel syndrome. This causes the intestine to produce rich secretions of chloride-rich fluids that soften stools, promote motility, and promote spontaneous bowel movement (SBM).
Maps Laxative
Comparison of available agents
Effectiveness
For adults, randomized controlled trials found PG (MiraLax or GlycoLax) 17 grams once per day to be superior to tegaserod at 6 mg twice per day. A randomized controlled trial found a greater improvement of two sachet (26 grams) of PEG versus two sachets (20 grams) of lactulose. 17 grams per day PEG has been effective and safe in a randomized controlled trial for six months. Other randomized controlled trials found no difference between sorbitol and lactulose.
For children, PEG is found to be more effective than lactulose.
Problems with using
Harassment harassment
Some of the less significant adverse effects of laxative abuse include dehydration, hypotension, tachycardia, postural dizziness and syncope; However, laxative abuse can lead to a fatal acid-base and electrolyte imbalance. For example, severe hypokalemia has been associated with distal renal tubular acidosis due to laxative abuse. Metabolic alkalosis is the most common acid-base imbalance observed. Other significant side effects include rhabdomyolysis, steatorrhoea, inflammation and ulceration of the colonic mucosa, pancreatitis, renal failure, artificial diarrhea and other problems.
Although patients with eating disorders such as anorexia nervosa and bulimia nervosa often abuse laxatives in an attempt to lose weight, laxatives act to accelerate the transit of impurities through the colon, which occurs after absorption of nutrients in the small intestine. Thus, laxative abuse research has found that effects on body weight reflect temporary loss primarily from body water rather than energy loss (calories).
Laxative gut
Doctors warn against the chronic use of stimulant laxatives due to fears that chronic use may cause colon tissue to become obsolete over time and can not excrete impurities due to long-term overstimulation. A common finding in patients using stimulant laxatives is the brown pigment stored in the intestinal tissue, known as melanosis coli.
Historical and non-mainstream medical use
The laxatives, later called physicks or purgatives , are used extensively in pre-modern treatments to treat a variety of conditions that they now generally deem to be ineffective in modern evidence-based drugs. Likewise, laxatives (often called colon cleansing) continue to be promoted by alternative medicine practitioners for a variety of conditions, including unfamiliar conditions, such as slimy plaques.
See also
- ATC A06 code
- Bowel management
- Catharsis
- Food fiber
- Diuretics
- Enema
- Transanal irrigation
References
External links
Source of the article : Wikipedia
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