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Laxatives.


Laxatives make feces pass more easily through the intestines. They are most commonly used to treat constipation, the difficult, infrequent passing of stools that are hard and dry.

However laxatives may be prescribed for other medical reasons. For example, they may be given to clear the intestine before a colonoscopy, in which an instrument for viewing the colon is passed through the anus. Laxatives may also be prescribed to counteract the constipating effect of narcotic drugs such as morphine or codeine.


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Types of Laxatives:

There are different types of laxatives depending on how they work. Bulk-forming agents, osmotic laxatives, fecal softeners and saline laxatives all make stools softer and easier to pass. Stimulant laxatives make the intestinal muscles move feces more rapidly. Most laxatives are taken orally, but some osmotic and stimulant laxatives may be administered as enemas or suppositories under certain circumstances.

Bulk-forming Agents - these preparations cause the feces to retain water to keep them soft and also add bulk to the feces, which stimulates intestinal muscle action. They are available as either granules or powders that are taken orally. It may take several days for these agents to have their full effect.

Bulk-forming agents are most often used to treat chronic constipation. For example, they may be prescribed in the treatment of irritable bowel syndrome or diverticulosis. You may also be given these laxatives to make passing stools easier after childbirth or following abdominal surgery.

Bulk-forming laxatives are the safest type for long-term use because their action is similar to the natural action of fiber in food. You should be sure to drink plenty of water when taking these laxatives because the bulky stools may otherwise eventually block the intestine. Side effects of bulk-forming laxatives may include excess intestinal gas and abdominal pain and bloating.

Osmotic Laxatives – These drugs work by preventing the body from removing water from feces. As a result, the feces stay soft but they do not increase in bulk as happens with bulk-forming laxatives. Osmotic laxatives are available only by prescription. The most commonly prescribed osmotic laxative is lactulose, which is a synthetic form of sugar that the body does not absorb. Lactulose can cause side effects such as intestinal gas, and abdominal cramps, which may gradually lessen with continued use. In elderly people, long-term use of lactulose can eventually cause dehydration and lead to a chemical imbalance in the blood.

Fecal Softeners – These laxatives act by softening feces. They also lubricate the fecal matter, enabling it to pass more easily through the intestine. Docusate can be taken orally as liquid or capsules, or used as an enema. Liquid paraffin (mineral oil) is a commonly used fecal softener that is taken orally. It is available over-the-counter, but you should not use this laxative regularly because it can cause anal irritation. Liquid paraffin can also prevent your body from absorbing certain vitamins, which may lead to nutritional deficiencies with long term usage.

Saline Laxatives – These drugs, which include magnesium citrate, other types of magnesium salts and phosphates, may be used for rapid bowel evacuation. Saline laxatives may be given as a liquid in single doses to clear the intestines before such procedures as colonoscopy, radiological investigation, or surgery on the lower digestive tract. They work by drawing water into the gut from the body and therefore may cause dehydration. You should be sure to drink plenty of water when taking these laxatives. Side effects include intestinal gas and abdominal bloating.

Stimulant Laxatives – These laxatives stimulate the intestinal muscles to contract more strongly resulting in more frequent bowel movements. Stimulant laxatives are sometimes used to clear the intestines quickly if other drugs have failed to work. You should not take them regularly because your body may come to depend on them to stimulate bowel movements. Side effects of these laxatives include abdominal cramps and diarrhea. Phenolphthalein may cause skin rashes and color the urine pink.

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