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A must-read on laxatives:

Beneficial or disadvantageous?

Constipation in children

Laxatives: Good or bad?
Bulk-forming laxatives, stool surfactant agents

In response to constipation, there are pharmacologic interventions formulated which can help ease the difficulty associated with defecation. However, a bulk of these medications otherwise called laxatives are self-prescribed – and surprisingly, a vast majority of the population using it can actually do without it!

Laxatives should be used only when the condition experienced by an individual fails to respond to all the natural remedies for constipation. Most of the time constipation is relieved by adequate to increased fluid intake, increased fiber ingestion, prompt response to the feeling of defecation (as early as its onset), as well as by regular exercise. Before a specific laxative should be used, an individual should at first make sure he or she undergoes a thorough medical evaluation in order to avoid the adverse effects that may accompany the ingestion of the drug.

There are many types of laxatives, and these are being classified according to their mechanism of action. A significant number of laxatives, though, work via a combination of mechanisms. In order to understand these clearly, let us tackle these one by one.

One type of laxative is the bulk-forming laxative. Increasing the weight of stools will enable faster transit through the gastrointestinal tract, and therefore, alleviate constipation. This type of laxative is composed of hydrophilic and indigestible colloids that work through water absorption, therefore forming a bulky as well as emollient substance that is capable of distending the colon. Colon distention will then cause signals to travel towards the brain and in effect, the brain is stimulated to promote peristaltic movement. Laxatives of this type are usually prepared from synthetic fibers such as polycarbophil, or natural plant products such as psyllium and methylcellulose. However, some adverse effects include bloating and gas production within the colon, due to the presence of bacteria in the colon that are capable of digesting these plant products.

Another type of laxative works through softening the stools; hence the name stool surfactant agents. These laxatives work by allowing water and lipids to penetrate the stools thoroughly, therefore lubricating the colonic mucosa. Administered either orally or rectally, these laxatives include that of docusate or glycerin suppositories; these are commonly administered in hospitalized patients. Mineral oil is also a laxative of this type, and it commonly administered in children and debilitated patients, working through lubricating the feces and slowing down water absorption from stools. However, this has to be carried out carefully since aspiration of this substance into the respiratory tract can cause pneumonitis. Aside from that, when used beyond the prescribed period, malnutrition can ensue due to the impaired absorption of fat-soluble vitamins such as Vitamin A, D, E, and K.

Laxatives: Good or bad?
Osmotic, stimulant laxatives, anthraquinone derivatives

Osmotic laxatives are also an option: these are compounds that increase the fluidity of the feces since these are soluble and yet non-absorbable compounds. Also used in the treatment of short-term constipation are non-absorbable sugars or salts, such as magnesium oxide, sorbitol, or lactulose. However, magnesium oxide should not be used for a long time especially in patients with kidney problems since it imposes the risk for hypermagnesemia. Sorbitol as well as lactulose may also result to belching or cramps. Increased doses of these osmotically active agents can promote purgation or the rapid evacuation, approximately within one to three hours. Most commonly used in this aspect are magnesium citrate and sodium phosphate. However, care has to be employed in its administration, since this may lead to volume depletion within the blood vessels, and well as disturbances in electrolyte balance.

Stimulant laxatives are also commonly employed in the problem of constipation. This works through a quite vague mechanism, targeting mainly the nervous system and consequently colonic electrolyte and fluid secretion. However, there are speculations that this can induce dependency. This is particularly helpful though in bedridden patients, since it can be used for prolonged periods.

Anthraquinone derivatives are also commonly employed as laxatives, and among its examples are aloe, cascara, and senna. However, prolonged use may induce pigmentation inside the colon, a condition known medically as “melanosis coli”. But there are recent concerns regarding its potential to be carcinogenic, so it is not used liberally nowadays.

Now that you know the basics behind the laxatives that you can easily access at the pharmacy nearest to you, what is now your judgment? Constipation can be relieved through laxatives, but the use of these substances may come with a price. Beware of using these substances liberally, if you happen to do so right now. Sometimes a visit to a physician can be of more help than self-medication!

In to swimbi.com