Laxatives Part 2

Stimulants

Peristalis also increases with the use of stimulant laxatives. Stimulant laxatives are effective at irritating the sensory nerve endings in the intestinal mucosa. Two of the most frequently used and abused over-the-counter stimulant laxatives are bisacodyl and phenolphthalein. Bidocodyl is often used to empty the bowel before diagnostic tests because it is minimally absorbed by the GI tract.

Castor oil is a very harsh laxative. I used it once and swore I would never do it again. Castor oil acts primarily on the small bowel and produces a watery stool within 2 to 6 hours. It is not recommended to be taken at bed time because the effects can start quickly and last through the night. It should also not be used if a person does not have quick and frequent access to a bathroom for the first 12 hours following consumption. Pregnant women should also not use caster oil because it stimulates uterine contractions and may cause spontaneous abortion. The prolonged use of castor oil can damage nerves and reduce intestinal muscular tone.

Bulk-forming

Bulk-forming laxatives come from natural fibrous foods and are not absorbable by the body. When taken they can help the body to absorb water into the intestines and they keep stool large and soft. This is important because dehydration can cause stool to become hard and compacted making elimination difficult. When consuming bulk-foming laxatives, defecation can occur within 8 to 24 hours. In some instances it can take several days before the stool will become soft and formed.

Powdered bulk-forming laxatives are very common and do not cause dependence. People with various gastrointestinal problems like diverticulosis, irritable bowel syndrome, ileostomy and colostomy can take bulk-forming laxatives without any complications. Most powdered bulk-forming laxatives come flavored and sugar-free. It is best to mix the powder in a glass of water or juice and drink it immediately. The powder will become thick and difficult to drink if it is not consumed quickly. It is important to increase fluid intake during the day because water is necessary to help loosen and soften stool.

Emollients

Emollients are surfactants that help to soften stool and lubricate the intestinal walls by lowering surface tension and helping water to accumulate in the intestine and stool. This is beneficial in preventing constipation and helps to decrease straining during defecation. Overstraining can cause hemmorhoids which are very painful will likely become aggravated by the passing of hard compacted stool.

Emollients are often prescribed to people after undergoing surgery, experiencing a heart attack or before other drugs are used to treat fecal impaction. Some examples of stool softeners are docusate calcium (Surfak), docusate potassium (Dialose), docusate socium (Colace), and docusate sodium with casanthranol (Peri-Colace).

Mineral is a lubricant that can help increase water retention in the stool. However, side effects include nausea, vomiting, diarrhea, and abdominal cramping. Children, the elderly, or patients with serious medical conditions should not use mineral oil.

Emollients should not be taken by anyone with appendicitis, ulcerative colitis, and inflammation of the intestines, pregnancy, spastic colon or bowel obstruction.

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