Constipation lubricants

Ricinoleic acid (18 1 with an hydroxyl group on Cl2) from Ricims communis, the castor oil plant. Castor oil, containing 90% of ricinoleic acid, is poorly digested (because of the hydroxyl group) and acts as a lubricant and a slight irritant to the intestines, hence its use to relieve constipation. 

Tian Men Dong is sweet, bitter and very cold, and enters the Lung and Kidney meridians. It can strongly nourish the Lung-Yin and the Kidney-Yin and reduce heat. It is particularly used in severe and chronic conditions of Yin deficiency of these organs. Moreover, since it is quite cold and bitter and it can lubricate the intestines and soft stool, it is suitable for use when there is constipation. However, it should be avoided in conditions of weakness of Spleen-Qi and loose stool. 

Psyllium seeds are tasteless and odourless, and their peculiar action on the intestines renders them of particular value in sluggishness and atony of this organ. Swelling into a demulcent, jelly-like mass, which gently lubricates and stimulates the bowels, the seeds do not gripe, and their action is certain. Probably nothing better than Psyllium seeds can be given to most people for constipation, and they are eminently suited to children. The adult dose varies between two and four teaspoonfuls after meals, children proportionately with their age. 

Dry mouth can be managed with increased intake of fluids, oral lubricants (Xerolube), ice chips, or use of sugarless chewing gum or hard candy. Constipation can be treated with increases in exercise, fluid, and dietary fiber intake. 

Therapeutically, mineral oil has been used in the treatment of constipation, as it acts as a lubricant and stool softener when taken orally. Daily doses of up to 45 mL have been administered orally, while doses of up to 120 mL have been used as an enema. However, excessive dosage of mineral oil, either orally or rectally, can result in anal seepage and irritation and its oral use as a laxative is not considered desirable. 

Therapeutically, poloxamer 188 is administered orally as a wetting agent and stool lubricant in the treatment of constipation it is usually used in combination with a laxative such as danthron. Poloxamers may also be used therapeutically as wetting agents in eye-drop formulations, in the treatment of kidney stones, and as skin-wound cleansers. 

Dong quai purportedly "lubricates" the intestine, relieving constipation (Johns, 1996). It has also been used to treat dysentery (Huang, 1993). 

Mineral oil, a lubricant, is indicated in constipation or preparation for bowel studies or surgery. 

Emollients (surfactants) are stool softeners (surface-acting drugs) and lubricants used to prevent constipation and decrease straining during defecation by lowering surface tension and promoting water accumulation in the intestine and stool. 

Getting daily exercise, increasing fluid intake, eating a high-fiber diet, and using a stool softener that lubricates the stool lead to regular bowel movements, which, in turn, prevent constipation. 

Figure 106,2. Opioid-induced bowel dysfunction (OBD). Opioids increase intestinal fluid absorption, inhibit intestinal secretions and peristalsis, and block propulsive movements in the colon. Constipation and other symptoms associated with OBD occur in 15-90% of cancer patients and may be more distressful and debilitating than pain. Tolerance rarely develops to these symptoms and traditional therapy including stimulants, lubricants, arxf bulk laxatives may not be effective.

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