Laxative in constipation

Magnesium hydroxide, an antacid with laxative properties (6 to 20 ml/p.o.), is used as an antacid, as a laxative in constipation, and in bowel evacuation before surgery. 

Lifestyle modifications should be employed prior to the use of laxatives in most instances of constipation. 

One of the main side-effects of opioid analgesics, such as codeine and tramadol, is constipation. Amitriptyline (tricyclic antidepressant) and orphenadrine tend to have antimuscarinic properties, resulting in side-effects such as constipation. Senna is a stimulant laxative indicated in constipation. 

Gelidium amansii (Lamx.) Qiong Zhi (isolated mucous substance) Agarose, agaropectin, taurine 33 A mild laxative in the treatment of chronic constipation. 

Senna was used as a laxative in the past and continues to be used for this purpose today. Senna is stated to possess cathartic properties (the leaf more than the fruit) and has been used traditionally for treating constipation (see Chapter 12). 

This acts very slowly, generally only after 12 to 24 h or longer, producing several soft stools. Larger doses (20 mg, 1/3 grain, or more) act as a hydragogue cathartic, but it is chiefly employed in small doses (5 to 10 mg, 1/10 or 1/6 grain) as a laxative in chronic constipation, often combined with aloes or calomel 0.3 to 0.5 g has been fatal. 

Drugs that are known to cause constipation should be avoided, or given with laxatives, in any patient who is encephalopathic or could become so, e.g. in acute liver failure and cirrhosis. Constipation prevents the clearance of toxic waste products in the bowel that can accumulate, cross the blood-brain barrier and cause (or worsen) encephalopathy. Examples of drugs to use with caution/avoid are ... 

Both patients and their carers should be advised to look out for early features of confusion, unstable gait and visual symptoms. In order to minimize patient discomfort, immediate measures should be taken to relieve these symptoms, for example using mild laxatives for constipation, ensuring adequate hydration and ensuring assistance is available when patients wish to be mobile. Some OTC drugs (e.g. antihistamines) have antimuscarinic effects. 

S. Three to be taken at bedtime. (An alterative and laxative, useful in constipation with deranged or deficient hepatic secretion.)... 

Dettmar PW, Sykes J. A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation. Curr Med Res Opin 1998 14(4) 227-33. 

For acute constipation in most age groups, a tap-water enema or glycerin suppository may be helpful. Occasional use of milk of magnesia or an anthraquinone laxative in low doses is justified as well. 

The German Commission E does not recommend that aloe be used for more than 1-2 wk when used as a laxative in self-treatment of constipation (Blumenthal, 1998). It should be used only after failure of dietary modification or a bulk-forming laxative. 

An Eclectic medical text notes that castor oil is "the most suitable laxative for constipation of pregnant women" (Felter and Lloyd 1898), and a more recent survey of gastroenterologists and obstetricians indicated that 26% of gastroenterologists and 38% of obstetricians would prescribe castor oil as a laxative to pregnant patients (Vinod et al. 2007). Other texts note that castor oil must be used with caution in pregnancy (Martindale and Reynolds 1996 Osol and Farrar 1955). 

In Chinese medicine, it is used as a nutritive, demulcent, emollient laxative, in cough due to luug dryuess, constipation, stomachache, sinusitis, oral ulcerations, scalds, and as a detoxicant for aconitine (hsu). 

There are various types of laxatives (see the Summary Drug Table Dm Used in the Management of Gastrointestinal Disorders). The action of each laxative is somewhat different, yet they produce the same result—the relief of constipation (Display 48-1). 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

LAXATIVES. The nurse records file results of administration on the patient s chart. If excessive bowel movements or severe prolonged diarrhea occur or if file laxative is ineffective, the nurse notifies file primary health care provider. If a laxative is ordered for constipation, the nurse encourages a liberal fluid intake and an increase in foods high in fiber to prevent a repeat of this problem. 

Avoid long-term use of these products unless use of tiie product has been recommended by the primary health care provider. Long-term use may result in tiie laxative habit, which is a dependence on a laxative to have a bowel movement. Constipation may also occur with overuse of these dru . Read and follow the directions on the label. 

DOSS itself is used as a laxative and cermumenolytic drug [71]. It is included in over-the-counter hematinic vitamin and mineral preparations to counteract the constipating effect of the iron contained in these products. In combination with anthrachinones, widespread use as catharic and emollient laxative is indicated [71-75]. 

Polyethylene glycol (PEG, MiraLax) is an osmotic laxative available only by prescription. It is useful in patients who are experiencing acute constipation and who have had inadequate response to more traditional agents. Principal adverse effects include upset stomach, bloating, cramping, and gas. 

Laxatives may provide appropriate relief when constipation occurs during the postpartum period, when not breastfeeding and in immobile patients. Patients who are not constipated but who need to avoid straining (e.g., patients with hemorrhoids, hernia, or myocardial infarction) may benefit from stool softeners or mild laxatives. 

Laxatives should not be given to children younger than 6 years of age unless prescribed by a physician. Because children may not be able to describe their symptoms well, they should be evaluated by a physician before being given a laxative. Treating secondary causes may resolve the constipation without the use of laxatives. As in adults, children benefit from a healthy balanced diet, adequate fluid, and regular exercise. 

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