Laxative products are available in a wide array of dosage forms, most of them for oral use. This variety probably yields the most benefits for pediatric and geriatric patients. Many of the dosage forms enhance patient acceptability and perhaps make laxative use more pleasant. However, laxatives available as chewing gum, wafers, effervescent granules, and chocolate tablets may not be thought of as drug products; therefore, they are more likely to be misused and abused. Enemas and suppositories are popular nonoral dosage forms used for laxative administration. Routine use oflaxative enemas includes preparing patients for surgery, child delivery, and gastrointestinal radiologic or endoscopic examinations, as well as for treating certain cases of constipation. The enema fluid determines the mechanism by which evacuation is produced. Tap water and normal saline create hulk through an osmotic volume effect; vegetable oils lubricate, soften, and facilitate the passage of hardened fecal matter: and the irritant action of soapsuds produces defecation. However, prolonged rectal irritation may occur after Read more [...]

Children A number of factors can alter a child's bowel habits, including unavailable toilet facilities; emotional distress; febrile illness: chronic medical conditions (e.g., cystic fibrosis and hypothyroidism); family conflict: dietary changes (e.g.. switching from human to cow's milk); or a change in daily routine or environment. Some children are poor or picky eaters, which may contribute to the development of constipation due to inadequate bulk and fluids in the diet. Constipation associated with an organic or pathologic etiology is uncommon in children." Bowel movement patterns vary widely in children; therefore constipation can be a complex problem that is often difficult to detect and manage. Selected Laxative Products Trade Name Primary Ingredients Bulk-Forming Laxatives Citrucel Powder Methylcellulose 2 g/tsp Citrucel Sugar Free Powder Methylcellulose 2 g/tsp FiberCon Tablets Calcium polycarbophil 625 mg Maltsupex Liquid Barley malt extract 750 mg/tsp Metamucil Fiber Wafer Psyllium hydrophilic mucilloid 3.4 g/2 wafers Metamucil Read more [...]

The ideal laxative would (1) be nonirritating and nontoxic, (2) act on only the descending and sigmoid colon, and (3) produce a normally formed stool within a few hours, after which its action would cease and normal bowel activity would resume. Because no currently available laxative precisely meets these criteria, proper selection of a laxative depends on the etiology of the constipation. Agents used to treat constipation have been classified according to their chemical structure and site, intensity, or mechanism of action. The most meaningful classification is by mechanism of action, including bulk-forming, emollient, lubricant, saline, hyperosmotic and stimulant agents. None of these laxative agents should be taken for more than 1 week without consulting a primary care provider. Bulk-Forming Agents Most bulk-forming laxatives are derived from natural sources such as agar. plantago (psyllium) seed, kelp (alginates) and plant gums (e.g.. tragacanth, chondrus, karaya [Sterculia]). Guar gum is a natural product found in the bean cluster plant (Cyamopsis tetragonolobus); it is most useful today Read more [...]

A treatment for constipation is especially relevant for consumers that suffer on a regular basis or cannot bear attendant symptoms. For the overall health it is important to have a regular bowel movement. If a healthy diet, lots of exercise and common "cures" such as prunes and fluids require several days to take effect and sometimes don't work at all, it might be necessary to take a laxative to restore regularity. It sometimes might be necessary to visit the doctor to diagnose the cause of constipation. Diagnosis If warning signs exist, the doctor should be consulted. Numerous hormonal disturbances, metabolic disorders and various drugs can cause constipation. Metabolic disorders include diabetes mellitus, an under-active thyroid, reduced potassium or increased calcium levels in the blood. Drugs that can cause constipation include antihypertensive agents, cardiac drugs, iron tablets, antidepressants, hypnotics and diuretics. If these causes can all be ruled out, so-called functional disturbances of spontaneous intestinal motility are generally responsible in 80 to 90 percent of cases. Read more [...]

Monroe Community Hospital "Effects of Dietary Fiber - LiquaFiber™ - on Replacing Bowel Medications and Psyllium Fiber use in Long Term Care Residents" This clinical trial was performed at Monroe Community Hospital in Rochester, New York. Monroe Community Hospital is a 560-bed long-term care facility that has a unique patient mix. The facility has residents of all ages, from children as small as infants to the elderly. The facility boasts one of the finest Alzheimer's units in the country and has a high speed transitional care unit that offers wonders in a variety of therapies. This study began on March 1st and ran until April 20th . Problem Like most long- term care facilities MCH faces the everyday problems associated with constipation and bowel management. One of the contributing factors is the difficulty of patients obtaining the Recommended Daily Allowance of fiber. The products available require large amounts of liquid to be ingested which is very difficult for residence to consume on a consistent basis. The patients are afflicted with taste fatigue and refuse the treatment, hence Read more [...]

CSA – Cheboygan Surgical Associates Definition Small, hard stools. Bowel movements (B.M.'s) may be infrequent and passing them may be difficult, painful or impossible. You may also have bloating or cramping. • Mild Constipation: no bowel movements for 1-2 days longer than usual • Moderate Constipation: no bowel movements for 2-3 days longer than usual • Severe Constipation: no bowel movements for 4-5 days longer than usual Causes Disease, side effects of treatment, decreased activity, lack of liquid in the diet and emotional stress can all cause constipation. Constipation is also caused by medications, such as: Darvocet Duragesic Patch Norco Tylenol #3 & #4 Darvon Kytril Percocet Tylox Demerol Lortab Percodan Vicodin Dilaudid Morphine Sulphate Roxanol Zofran Duramorph M.S. Contin Roxicet Prevention If possible, try to increase the amount of liquids you drink. Make some dietary changes, such as increasing fruits, vegetables and bran, and decrease starchy foods such as white bread, cakes and cheese. Many people find hot Read more [...]

Constipation is defined as the difficulty of passing stools, incomplete passage, or infrequent passage of hard stools. It can be further defined as having less than three stools per week for women and five for men despite a high residual diet, or a period greater than 3 d without a bowel movement. It can be caused by gastrointestinal disorders, metabolic and endocrine disorders, pregnancy, neurogenic and psychogenic problems, or it could be drug induced. Laxative Mechanisms of Action Laxatives promote bowel evacuation by decreasing water and electrolyte absorption, increasing intraluminal osmolarity, or increasing hydrostatic pressure in the gut. Chronic use of laxatives, particularly stimulants, may lead to laxative dependency. Laxative dependency, in turn, may result in fluid and electrolyte imbalances, steatorrhea, osteomalacia, and vitamin and mineral deficiencies. Known as laxative abuse syndrome (LAS), it is difficult to diagnose. Laxative abuse syndrome is often seen in women with anorexia nervosa, depression, and personality disorders and also in elderly patients with quasimedical concerns Read more [...]

Drug Nomenclature Molecular formula: C12H10Mg3O14 =451.1 CAS: 3344-18-1 ATC code: A06AD19; A12CC04; B05CB03 Read code: y01SE Pharmacopoeias. In Europe and US. European Pharmacopoeia, 6th ed. (Magnesium Citrate, Anhydrous). A white or almost white, fine, slightly hygroscopic powder. Soluble in water practically insoluble in alcohol. It dissolves in dilute hydrochloric acid. Store in non-metallic, airtight containers. The United States Pharmacopeia 31, 2008 (Magnesium Citrate). A 5% suspension in water has a pH of 5.0 to 9.0. Store in airtight containers. Profile Magnesium citrate is an osmotic laxative used as a bowel evacuant before investigational procedures or surgery of the colon. Dosages have ranged from about 11 to 25 g of magnesium citrate. In the UK, an aqueous solution containing magnesium citrate is prepared from a sachet (Citramag) containing about 11.6 g of magnesium carbonate and about 17.8 g of anhydrous citric acid by mixing with 200 mL of hot water. After the solution has cooled, one dose (the contents of one sachet) is taken by mouth at 8 a.m. the day before Read more [...]

(British Approved Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: DA-1773; LA-391; Nátrium-pikoszulfát; Natrii Picosulfas; Natrii Picosulfas Monohydricus; Natrio pikosulfatas; Natriumpikosulfaatti; Natriumpikosulfat; Picosulfato de sodio; Picosulphol; Pikosíran sodný monohydrát; Sodium Picosulphate BAN: Sodium Picosulfate INN: Sodium Picosulfate [rINN (en)] INN: Picosulfato de sodio [rINN (es)] INN: Picosulfate de Sodium [rINN (fr)] INN: Natrii Picosulfas [rINN (la)] INN: Натрия Пикосульфат [rINN (ru)] Chemical name: Disodium 4,4´-(2-pyridylmethylene)di(phenyl sulphate) Molecular formula: C18H13NNa2O8S2,H2O =499.4 CAS: 10040-45-6 ATC code: A06AB08 Read code: y01Ru; y07d4 Pharmacopoeias. In Europe and Japan. European Pharmacopoeia, 6th ed. (Sodium Picosulfate). A white or almost white, crystalline powder. Freely soluble in water slightly soluble in alcohol. Adverse Effects and Precautions As for Bisacodyl. Bowel evacuation. Sodium picosulfate with magnesium Read more [...]

Bisacodyl is a diphenylmethane stimulant laxative used for the treatment of constipation and for bowel evacuation before investiga-tional procedures or surgery. Preparations UK: Biolax; Dulcolax; Entrolax US: Alophen; Bisa-Lax; Correctol; Doxidan; Dulcolax; Evac-Q-Tabs; Ex-Lax Ultra; Feen-A-Mint; Fleet Bisacodyl; Fleet Laxative; Gentlax; Modane Drug Approvals (British Approved Name, rINN) International Nonproprietary Names (INNs) in main languages (French, Latin, and Spanish): Bisacodilo; Bisacodylum; Bisakodil; Bisakodilis; Bisakodyl; Bisakodyyli; Biszakodil. BAN: Bisacodyl INN: Bisacodyl [rINN (en)] INN: Bisacodilo [rINN (es)] INN: Bisacodyl [rINN (fr)] INN: Bisacodylum [rINN (la)] INN: Бисакодил [rINN (ru)] Chemical name: 4,4´-(2-Pyridylmethylene)di(phenyl acetate) Molecular formula: C22H19NO4 =361.4 CAS: 603-50-9 (bisacodyl); 1336-29-4 (bisacodyl tannex) ATC code: A06AB02; A06AG02 Read code: y01RZ Pharmacopoeias. In China, Europe, Japan, and US. European Pharmacopoeia, 6th ed. (Bisacodyl). A white or almost white crystalline powder. Practically insoluble Read more [...]