There are several types of laxatives, listed below. Some laxatives combine more than one type of active ingredient to produce a combination of the effects mentioned. Laxatives may be oral or in suppository form.
Constipation with no known organic cause, i.e. no medical explanation, exhibits gender differences in prevalence: females are more often affected than males.
Also known as bulking agents or roughage, these include dietary fibre. Bulk-producing agents cause the stool to be bulkier and to retain more water, as well as forming an emollient gel, making it easier for peristaltic action to move it along. They should be taken with plenty of water. Bulk-producing agents have the gentlest of effects among laxatives and can be taken just for maintaining regular bowel movements.
==Hydrating agents (osmotics)== These cause the intestines to hold more water within, softening the stool. There are two principal types, saline and hyperosmotic.
Saline laxatives attract and retain water in the intestinal lumen, increasing intraluminal pressure and thus softening the stool. They will also cause the release of cholecystokinin, which stimulates the digestion of fat and protein. Saline laxatives may alter a patient's fluid and electrolyte balance.
Lactulose works by the osmotic effect, which retains water in the colon, lowering the pH through bacerial fermentation to lactic, formic and acetic acid, and increasing colonic peristalsis. Lactulose is also indicated in Portal-systemic encephalopathy. Glycerin suppositories work mostly by hyperosmotic action, but also the sodium stearate in the preparation causes local irritation to the colon.
Solutions of polyethylene glycol and electrolytes (sodium chloride, sodium bicarbonate, potassium chloride, and sometimes sodium sulfate) are used for whole bowel irrigation, a process designed to prepare the bowel for surgery or colonoscopy and to treat certain types of poisoning. Brand names for these solutions include GoLytely, GlycoLax, CoLyte, Miralax, NuLytely, and others.
For children, PEG was found to be more effective than lactulose.
{| class="wikitable sortable" border="1" |+Common Stimulant Laxatives |- ! Preparation(s) !! Type !! Site of Action !! Onset of Action |- | Cascara (casanthranol)|| Anthraquinone || colon || 36–8 hours |- | Buckthorn || Anthraquinone || colon || 36–8 hours |- | Senna extract (senokot) || Anthraquinone || colon || 36–8 hours |- | Aloe vera (aloin) || Anthraquinone || colon || 58–10 hours |- | Phenolphthalein || Diphenylmethane || colon || 48 hours |- | Dulcolax (bisacodyl) (PO) || Diphenylmethane || colon || 66–12 hours |- | Dulcolax (bisacodyl) (suppository) || Diphenylmethane || colon || 160 minutes |- | Microlax || enema || rectum and colon || 015–60 minutes |- | Castor Oil || ricinoleic acid || small intestine || 22–6 hours |}
Zelnorm (market name for Tegaserod) was discontinued from marketing on March 30, 2007 but is still available for prescription under tight controls.
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