$Unique_ID{BRK00832}
$Pretitle{}
$Title{How Do Laxatives Work and Which Ones Are Safe to Use?}
$Subject{laxatives laxative safety medication medications colon constipation
parasite excretion parasites elimination poisons empty bowel classifications
stimulant saline emollient hyperosmolar bulk forming}
$Volume{R-12}
$Log{}

Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


How Do Laxatives Work and Which Ones Are Safe to Use?


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QUESTION:  It is hard to find good information about laxatives, but when you
need them they are important.  Would you please discuss them in you column,
and tell us how they work, and which ones are safe to use?

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ANSWER:  There are more than 100 different kinds of laxatives available in the
United States as over-the-counter medications.  The purpose of a laxative is
to relieve common constipation, prevent straining when defecating in the
postoperative or cardiovascular patient, accelerate the excretion of
parasites, speed up the elimination of poisons taken either accidentally or
intentionally, or to help empty the bowel before radiologic or colonoscopic
tests are performed on a patient.  That's an impressive list of good reasons
to use laxatives.
     Unfortunately, many people abuse them, mistakenly believing that because
they are over-the-counter preparations, they are harmless.  Indeed, American
spend close to $400 million a year on laxatives.
     There are five different classifications for laxatives.  They are:
stimulant, saline, emollient, hyperosmolar, and bulk forming laxatives.  They
all work by influencing fecal consistency and accelerating the passage of
feces through the colon to help eliminate the stool from the rectum.
     Stimulant laxatives, such as castor oil, impair water absorption in the
ileum (the lowest portion of the small intestine) and in turn speeds the
passage of feces.  Five to seven percent of users develop a pink to deep
purple rash, which may persist for years after use of the drug is
discontinued.  Some people are allergic to stimulant laxatives and may
experience complications ranging from skin lesions to gastric irritations to
death.  Stimulant laxatives should be used for no longer than a week at a
time.
     Saline laxatives include such products as magnesium salts, enemas, and
rectal suppositories containing sodium.  The contents of the suppositories
react to form carbon dioxide and produce the urge to defecate.  Up to a fifth
of the magnesium from the saline laxative may be absorbed and a patient with
kidney problems should use with caution for side effects may be pronounced and
dangerous.
     Emollient laxatives, such as mineral oil, soften the stool, and increase
mucous production.  Mineral oil decreases the body's ability to absorb such
important nutrients as Vitamin A, D and K, and may also impair absorption of
medications, including oral contraceptives.
     Hyperosmolar laxatives, such as polyethylene glycol and glycerin, are
mainly used to clean out the bowel before some type of medical testing.  They
may cause side effects, including bloating, nausea, vomiting or local
irritation.
     Bulk forming laxatives absorb water and increase the bulk of the stool.
People using them should drink at least 8 ounces of water with each dose.
Patients with problems of the esophagus, small intestine or colon may develop
obstructions when using bulk laxatives.
     Clearly, laxatives are not harmless medications.  Package directions
should be followed to the letter, and you might want to consult your doctor
for a recommendation as to which product is best for you.
     Pregnant or breast-feeding women should definitely speak to their doctors
before using a laxative.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.