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Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubricant and saline laxatives are used to evacuate the colon or rectal and bowel examinations, and may be supplemented by enemas under certain circumstances. Sufficiently high doses of laxatives may cause diarrhea.

Some laxatives combine more than one active ingredient. Laxatives may be administered orally or rectally. But when misused or overused, they can cause problems, including chronic constipation. A healthy diet filled with fresh fruits, vegetables, and whole-grain products; regular exercise; and drinking at least eight cups of water daily can help prevent constipation in most people.

Types

There are different types of laxatives that come in pills, capsules, and liquids, suppositories and enemas. Each type of laxative has specific benefits and possible side effects. Though using a suppository or enema in the rectum is not as convenient (or pleasant) as swallowing a pill, these manually inserted (or squirted) laxatives often work much faster to relieve symptoms.

Common causes of constipation include diets low in fiber, side effects of medications such as narcotics, antidepressants, iron supplements, calcium channel blockers and other medications for high blood pressure, and certain types of antacids, prior surgeries, certain medical conditions including narrowing or blockage of the large intestine (colon), irritable bowel syndrome (IBS) or other colon disease, hormonal (endocrine) disturbances such as underactive thyroid and diabetes, and neurologic conditions.

The main classes of laxatives are Bulk-forming laxatives: They move through the body undigested, absorbing water and swelling to form stool. Stool softeners: They increase the amount of water absorbed by the stool to make it softer and easier to pass. Lubricant laxatives: These coat the surface of the stool and intestinal lining to keep in moisture, allowing for softer stools and easier passage. Osmotic-type laxatives: These help the colon retain more water, increasing the frequency of bowel movements. Saline laxatives: These draw water into the small intestine to encourage a bowel movement. Stimulant laxatives: They speed up the movement of the digestive system to induce a bowel movement.

Safety Use

When using a laxative to cure occasional constipation, remember these tips: If you need to use laxatives to be "regular," use fiber first. Drink fluids and stay well hydrated when using laxatives. Avoid regular use of stimulant laxatives. Some can limit your body's ability to absorb vitamin D and calcium. If your problem with constipation continues, see your doctor. Constipation may be a warning sign of a more serious problem such as colon cancer, diabetes, or hypothyroidism, among others.

Your doctor can evaluate your medical history, do a physical exam and lab tests, and determine the exact cause and solution for constipation. In infants with acute or recurrent constipation, glycerin suppositories or rectal stimulation with a lubricated rectal thermometer may be used to move hard stools. These methods should not be used often because they may cause irritation or tolerance.

Regards

Mary Wilson

Editorial office

Clinical Pharmacology and Toxicology

E-mail: pharmatoxicol@eclinicalsci.com