Overview of laxatives
A person with constipation is faced with a difficult choice. The range of pharmacy products that help get rid of the problem is simply huge. However, you cannot rely on chance. All drugs have a different mechanism of action, have certain indications and contraindications for admission.
The main disadvantage of all drugs for constipation, without exception, is their symptomatic effect. They help to cope with stool retention, but do not eliminate the cause that provoked it. Therefore, constipation will return after a while.
It is necessary to resort to remedies for constipation with extreme caution. First, it is recommended to find out the reason for the stool retention. Most often, chronic constipation is a consequence of diseases of the digestive system. It is necessary to treat such disorders with a gastroenterologist. The doctor will find out their cause and prescribe specific medications.
If there is no time to visit a doctor, then you need to try to cope with constipation without medicines, following simple recommendations:
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Every morning, immediately after waking up, you need to drink 1 or 2 glasses of water at room temperature. This must be done half an hour before the first meal. You can drink plain or mineral water, but it is important that it is gas-free. This procedure allows you to cleanse the intestines and start metabolic processes in the body.
- To normalize the stool, you need to massage the abdomen. Improves the discharge of feces from coffee and honey.
- You need to eat right and lead an active lifestyle. The menu should contain cabbage, beets, prunes, apricots. In general, eating raw vegetables and fruits allows the intestines to contract more actively. This is an excellent prevention of constipation.
- It is useful to drink a glass of kefir before going to bed, but it must be fresh.
- Castor oil helps to quickly relieve constipation.
Constipation drugs can be osmotic or irritating, others are prebiotics. There are also filler preparations. When choosing a specific drug, you need to determine not only the mechanism of its action, but also take into account all possible indications and contraindications.
You need to ask the pharmacist how the drug works and what active substance it is based on. Before the first intake of the chosen remedy, you should read the instructions.
It is not recommended to use laxatives for a long time. If constipation persists, you need to consult a doctor and eliminate the causes that led to the violation of the stool.
When a person suffers from chronic constipation, it is recommended to take probiotic medications. They make the intestines work properly, while restoring the disturbed microflora.
If an immediate effect is needed, an enema must be given. Alternatively, use oil micro enema.
Content:
- Irritant constipation drugs
- Delayed Laxatives - Prebiotics
- Osmotic laxatives
- Fast acting laxative
- Intestinal fillers
- Herbal laxatives
Irritant constipation drugs
Irritant laxatives are used more often by people with stool problems. Their choice is huge. These drugs are taken in violation of intestinal motility, with its atony. Medicines from this group include: drops, suppositories, syrups, tablets. An example of such drugs is Sodium picosulfate, Bisacodyl, etc.
Many plants have a laxative effect, such as senna leaves, rhubarb root, buckthorn bark, castor oil. The effect after taking laxatives comes quickly. If you take the drug at night, the stool will happen in the morning.
How do irritant laxatives work? The ingredients in laxatives irritate the receptors in the colon. This causes the organ to contract. Therefore, after a few hours, a person has a chair.
Side effects. Doctors strongly recommend refraining from taking laxatives regularly. Otherwise, the receptors of the colon will be depleted and its tone will decrease. If you use laxatives for more than 10 days, then a person may develop intestinal atony, the nervous tissue undergoes degeneration, and the electrolyte balance is disturbed.
Laxatives contribute to the rapid development of addiction. The dose that helped to relieve constipation when initially taken will no longer have the desired effect. Therefore, it will have to be increased.
Irritant drugs can cause intense abdominal pain. It is difficult to withstand it, so many patients refuse such treatment.
Contraindications and indications for admission. You can take an irritating laxative, but only if constipation is a one-time occurrence. Chronic stool retention is a contraindication to this treatment.
It is forbidden to take drugs from this group to infants, women during pregnancy and lactation.
Other contraindications include:
- Peritonitis.
- Cystitis.
- Perforation of the digestive system.
- Inguinal hernia.
- Bowel obstruction.
- Bleeding (uterine, intestinal, stomach).
- Diseases of the peritoneal organs in the acute phase.
- Anal fissures and hemorrhoids.
- Acute proctitis.
- Abdominal pain, the cause of which is unknown.
Before using any laxative for the first time, you should consult a doctor.
Bisacodyl (Laxatin, Laxacodyl, Dulcolax, Bisacodyl, Pirilax, Laxbene, Stadalax)
These drugs are recommended to be taken when you need to prepare the intestines for examination. They can be used to treat constipation caused by surgery, as well as dieting and idiopathic stool retention.
Take the drug 1 tablet before bedtime. If the desired effect does not occur, then the dose is increased to 2 or 3 pieces. Children over six years of age are prescribed? tablet.
Side effects include:
- Flatulence and abdominal pain.
- Intestinal colic.
- Heaviness in the abdomen.
- The appearance of blood and mucus in the stool.
If the drug is taken uncontrollably and for a long time, dehydration, leaching of electrolytes from the body, and intestinal atony may develop.
pros
The advantage of the drug is that the intestines are cleaned efficiently. After taking the drug, you can undergo organ diagnostics, for example, a colonoscopy. The effect comes quickly, within 6 hours. Depending on the individual characteristics of the organism, stool can happen even after half an hour or an hour. It brings relief. In general, the drug acts softly and fully copes with the task. It can be used to treat young children.
Minuses
If you take Bisacodyl for a long time, a person will develop an addiction to it, which manifests itself in the form of intestinal atony. As a result, the natural urge to defecate may disappear altogether. Without another dose, you will not be able to go to the toilet. Also, taking the drug threatens to excrete useful substances from the body. If you use Bisacodyl uncontrollably, then the likelihood of developing acute intestinal inflammation increases. Moreover, it has many side effects that have been described above.
Sennosides A and B (Senade, Regulax, Herbion Laxana, Antrasennin, Tisasen, Ex-Lax, Senna chewable lozenges, Senna holly leaves, Senalex)
All of these drugs contain anthraglycosides, which are present in the leaves of the senna plant. Its laxative properties have been known for a long time. Taking drugs based on senna promotes the rapid elimination of feces. The person does not develop habituation. The effect occurs within 6-12 hours.
Drugs are taken to normalize the stool against the background of hemorrhoids, with weak intestinal motility, with organ atony and with spastic constipation. The dose depends on the selected drug. It is best to take it before bed.
Side effects and contraindications are the same as for Bisacodyl.
pros
Senna-based preparations are of plant origin, that is, the basis of laxatives is a natural component. Their use allows you to quickly deal with constipation. The effect occurs within a few hours. Addiction to the drug does not develop. Senna is a well-studied herb. Therefore, such a laxative is time-tested, and doctors are well aware of its strengths and weaknesses.
Minuses
Many patients complain of abdominal pain that precedes a bowel movement. In addition, the drug has many side effects. In case of an overdose, a person develops severe diarrhea.
Sodium picosulfate (Guttalax, Guttasil, Laxigal, Regulax Picosulfate, Slabicap, Slabilen)
These drugs help to increase intestinal motility, due to which it is emptied. When using them, the absorption of water and electrolytes decreases.
They take drugs based on sodium picosulfate for the same purposes as Bisacodyl. The effect occurs in 10-12 hours.
Side effects:
- Abdominal pain.
- Dehydration.
- Convulsions.
- Weakness.
- Diarrhea.
- Drop in blood pressure.
- Electrolyte imbalance.
pros
Preparations based on sodium picosulfate do not have a systemic effect on the body, they work exclusively in the intestines. The organ is cleaned efficiently. Most patients tolerate drugs in this group well. The dose can be adjusted depending on the actual need, that is, it can be reduced.
Minuses
With prolonged use or non-compliance with the dosage, dehydration develops, as well as an electrolyte imbalance. Compared to other irritating laxatives, the effect will take longer. The intestines will be cleansed only after 10 hours, not earlier. In addition, these products should not be taken by children under 4 years of age. The side effects can be quite serious.
Glycerol (suppositories Glycerin, Glycelax)
Glycerol is used in the form of suppositories. Their use allows you to lubricate the intestines, soften feces and facilitate its excretion. In addition, the drug stimulates organ peristalsis, irritates its mucous membrane.
Glycerol is prescribed for patients who do not have the ability to strain the peritoneum to empty the intestines. It is used by people after a heart attack, with hemorrhoids, anal fissures. Glycerol is often prescribed for pregnant and lactating women.
Contraindications to the use of candles:
- Intestinal neoplasms.
- Hypersensitivity to drug components.
- Acute phase of hemorrhoids or proctitis.
If a person has renal failure, then use candles with caution.
To cope with constipation, you need to inject 1 suppository into the rectum. The procedure is carried out 20 minutes after the morning meal.
Glycerol causes side effects such as: itching and burning in the injection area, allergic reactions. If you use suppositories for a long time, self-emptying of the intestines becomes difficult.
pros
The drug acts gently, its use does not cause abdominal pain. The candles are small, so it is convenient to insert them. Glycerol has few contraindications and side effects. This is one of the few remedies that can be used for people who are unable to strain the abdominal cavity to empty the intestines. Suppositories are used in pediatric practice. The effect occurs almost instantly, the feces leave the intestines after 5-10 minutes.
Minuses
With prolonged use of suppositories, intestinal contractility decreases, addiction develops. The use of candles can irritate the organ.
Delayed Laxatives - Prebiotics
Prebiotics are safe medications that can be used to relieve constipation in women during lactation and after childbirth. They are carbohydrates that the digestive organs are unable to absorb. Therefore, they enter the large intestine in their original form. There, prebiotics activate the growth of beneficial bacteria.
Prebiotics are represented by inulin, lactulose and fructooligosaccharides. They do not provide immediate relief from constipation, but they do not pose a health hazard. Their effects last longer than saline or irritant laxatives.
How do prebiotics work? Taking prebiotics stimulates the growth of beneficial bacteria in the intestines. The laxative effect is achieved through osmotic action and slight irritation of the intestinal wall. Fermentation of prebiotics causes them to produce organic acids that cause the muscles in the organ to contract. Lactulose is the most commonly used prebiotic. Taking it in a large dosage (45 ml) contributes to the fact that the stool will happen after 2 hours.
Side effects. The drugs have virtually no side effects. Taking them is associated with flatulence, but after three days, bloating disappears on its own. Constipation can be relieved with standard doses in about 2 days. The effect is delayed in time, since the lactulose must pass through the entire digestive system.
Indications, contraindications, merits. Prebiotics are used to treat acute and chronic constipation, with intestinal dysbiosis, accompanied by the absence of stool. The undoubted advantage of such drugs is their detoxification effect. They are prescribed for hepatic encephalopathy, as they remove nitrogen-containing substances from the body. Phosphorus and calcium are better absorbed due to prebiotics. These substances are detrimental to the pathogenic flora.
Lactulose (Normase, Portalac syrup, Duphalac, Goodluck, Lactulose Poly, Livolyuk-PB, Lactulose Stada, Romfalak)
Lactulose-based drugs act mildly, they are prescribed to patients with constipation, with encephalopathy, as well as to prepare the digestive system for diagnosis.
Lactulose removes ammonium ions from the body, allows for better absorption of calcium and phosphorus, stimulates the intestines to work actively. The stool becomes softer, feces swell, and more bile is produced. All this has a positive effect on the functioning of the digestive system.
Contraindications to the use of Lactulose are:
- Bowel obstruction.
- Hypersensitivity to drug components (lactulose and fructose).
- Diabetes. This contraindication is not absolute, but diabetics need to take drugs based on lactulose with caution.
The dose is determined on an individual basis. The appointment should be made by a doctor. Lactulose is recommended to be used for constipation in children, as a safe and effective drug.
pros
Lactulose acts mildly, does not irritate the intestinal walls. After taking it, the person does not develop diarrhea. A delayed effect can also be considered an advantage, not a disadvantage. The body does not experience stress, the feces come out easily. Lactulose is not addictive. It regulates the work of the intestines, after its cancellation, atony of the organ does not develop, its peristalsis does not suffer. Constipation disappears, and the physiological rhythm of the intestines is restored. The beneficial microflora is activated and better copes with harmful microbes. The drug can be used to treat children and pregnant women.
Minuses
The drug can cause bloating, which is accompanied by characteristic pain. The taste of Lactulose is not always pleasant, so children may refuse to take it. The drug has no other drawbacks.
Lactitol (Exportal, Importal N - powder for solution preparation)
Lactitol can be found in foods for diabetics. It acts as a sugar substitute. Doctors prescribe Lactitol to patients prone to constipation. Taking the drug allows you to make the feces softer, they swell and leave the intestines easier. Stool occurs one day after taking Lactitol. When it is possible to achieve a stable effect, the dose of Lactitol is gradually reduced.
Side effects after taking the drug are reduced to bloating and the appearance of a certain discomfort against this background.
pros
The drug not only allows you to cope with constipation, but also has an antitoxic effect, removing nitrogen-containing compounds from the body. Its reception has a positive effect on the intestinal microflora. Harmful microbes die, while beneficial flora, on the contrary, multiplies.
The drug acts exclusively at the level of the intestine, it does not have a systemic effect on the body. Lactitol is convenient to take as it can be mixed with almost any liquid, such as juice, coffee, or tea.
Lactitol can be used to treat constipation in children and people with diabetes.
Minuses
The effect does not come as quickly as we would like. Stool in a person happens only after a day. After the first intake of Lactitol, bowel movements will occur only after 2-3 days. The drug can cause increased gas production, which leads to abdominal discomfort. In case of overdose, vomiting may occur. During treatment, you need to drink a lot of water, which causes certain difficulties for some patients.
Osmotic laxatives
If a person has diseases of the digestive system and is pursued by chronic constipation, one should not try to cope with the problem with the help of osmotic laxatives. They are recommended to be taken only once, when stool retention is acute, or a person has poisoning (food or drug). Also, osmotic laxatives are prescribed for high-quality preparation of the intestine for diagnostic measures.
Drugs in this group do not cause intestinal atony, so some of them, for example, Forlax, can be taken in a course of up to 3 months. However, it must be borne in mind that they do not affect the cause of constipation, but simply eliminate it. Patients do not develop addiction to the drug.
How do osmotic laxatives work? After taking an osmotic laxative, fluid begins to accumulate in the intestines, water is removed from fat cells and blood plasma. This allows you to soften the stool and make it bigger. Emptying of the organ occurs against the background of increased osmotic pressure.
Side effects. The drugs of this group, with prolonged use, contribute to the elimination of salts from the body, disrupt its water-electrolyte balance. Therefore, with extreme caution, they should be prescribed to children and people with heart disease.
After taking osmotic laxatives, abdominal pain occurs, which can be quite intense.
Indications and contraindications. Osmotic laxatives are prescribed for alimentary poisoning, or for drug intoxication. They are also used to eliminate acute constipation. Polyethylene glycol is approved for the treatment of nursing and pregnant women.
Artificial Karlovy Vary salt
This drug is a substitute for geyser Karlovskaya salt and belongs to the saline laxative. Its reception contributes to the enhanced separation of bile. The drug is prescribed for alimentary poisoning, constipation and chronic cholecystitis. It is forbidden to take salt to patients with intestinal obstruction, as well as at high body temperature.
Side effects of taking Karlovska salt:
- Atony of the large intestine.
- Water and electrolyte imbalance.
- Diarrhea.
Salt is taken on an empty stomach. A teaspoon is given to children over 2 years old, the specified amount of the drug is diluted in half a glass of water. Adults are shown to take a tablespoon of salt, which is diluted in a glass of water. They start eating in 40 minutes.
pros
The drug not only helps to cope with constipation, but also improves the functioning of the gallbladder. Karlovskaya salt makes it easier to tolerate poisoning caused by the intake of expired products, alcoholic beverages, medicines, etc.
The drug has practically no side effects. It does not cause allergies. It can be used to treat children, but salt is contraindicated for pregnant and lactating women.
Minuses
Karlovskaya salt cannot be combined with other medicines, as it will reduce their effectiveness. It is forbidden to drink diuretics during treatment, since the likelihood of dehydration increases many times. Violation of storage conditions leads to a change in the properties of salt, as a result of which it can lose its quality. Therefore, the drug must be kept at a temperature of + 22-27 ° C.
Macrogol (Lavacol, Osmogel, Fortrans, Relaxan, Tranzipeg, Forlax, Forteza Rompharm)
Macrogol is often used as a laxative. It can be taken over a long period of time (up to 3 months). This will help to normalize bowel function. So that after the completion of the course there is no malfunction in the digestive system, a person will need to follow a diet, as well as play sports.
The drug is not absorbed into the bloodstream, it only works at the intestinal level. After taking it, patients do not experience abdominal discomfort, they do not increase gas production. Macrogol softens feces and facilitates bowel movements.
The drug does not lead to dehydration and does not interfere with metabolic processes. The effect develops within 1-2 days after the first dose. It is recommended to drink Macrogol with breakfast. The dosage is determined by the doctor.
pros
The drug allows you to qualitatively cleanse the intestines, completely remove all contents from it. This is especially true for people who are going to have an organ examination. You can take Macrogol for a long time. The drug acts only in the intestine and is not absorbed into the systemic circulation.
Minuses
Many patients report an unpleasant taste of the drug. To feel the laxative effect, you need to take a large amount of the drug. Most drugs based on Macrogol are prohibited for use by children, lactating and pregnant women.
Magnesium sulfate hyptahydrate (bitter salt, epsom salt, magnesia, epsom salt)
The drug is prescribed for biliary dyskinesia, for getting rid of constipation, for inflammation of the gallbladder, for preparation for a diagnostic examination of the intestine, for intoxication with heavy metal salts.
In addition to the laxative effect of magnesium sulfate has a choleretic effect on the body. One package of the drug is taken at the reception, which is diluted in 100 ml of water.
pros
Magnesium sulfate is an effective and fast-acting remedy for relieving constipation. It is widely used in medical practice. It liquefies even the hardest stones, does not cause inflammation of the intestines and the digestive tract in general.
Minuses
The drug is not prescribed to children under 15 years of age, patients with heart disease and disorders of the central nervous system. It removes constipation, but does not act on its cause. With the uncontrolled use of the drug, a person develops dehydration. If you take magnesium sulfate for more than 3 months, it will negatively affect the functioning of the kidneys and heart.
Fast acting laxative
Microlax is a micro enema that is used for rectal administration. The effect develops within 15 minutes after its setting. The stool becomes soft and leaves the intestines easily. One tube is enough to provide a laxative effect. Sodium citrate, which is part of the drug, acts as a peptizer. Sodium lauryl sulfoacetate has a thinning effect, and sorbitol attracts water to the intestines. Together, these substances contribute to the rapid cleansing of the organ from feces.
Microlax is prescribed to patients with constipation, as well as to cleanse the intestines before the upcoming examination. For children over 3 years old, 1 micro enema is recommended, which is introduced into the rectum.
pros
The drug acts very quickly, so it can be used to quickly relieve constipation. Enemas are allowed to be given to children. There are no side effects from the treatment.
Minuses
Not all patients find it convenient to give an enema to relieve constipation. Sometimes certain circumstances do not allow this. Some people experience discomfort from the procedure, indicate a burning sensation and other unpleasant sensations. In addition, Microlax does not affect the very cause of constipation; an enema simply eliminates this symptom. There were no other drawbacks of the drug.
Intestinal fillers
Intestinal fillers are substances that the digestive tract is unable to digest. They are not absorbed into the systemic circulation. The laxative effect is achieved by increasing feces in volume. Fillers can be represented by both modified saccharides and herbal remedies.
Some patients with chronic stool retention refuse to take these laxatives, as their effect does not always develop. There is also a high probability of flatulence, rumbling in the abdomen, and pain along the intestines.
Means related to intestinal fillers: agar-agar, flax and flavort seeds, wheat bran, sterculia, methylcellulose, psyllium husks (oval or ovoid).
How do intestinal fillers work? Fillers, regardless of their type, absorb water. The intestinal walls are stretched, so the organ seeks to get rid of excess fluid. Fecal masses come out together with water. However, with atony of the organ, these funds are ineffective. To develop a laxative effect, you need to drink as much water as possible (at least 2 liters per day).
Fillers are classified as mild agents that do not allow you to instantly cope with constipation. Depending on the drug chosen, the effect develops after 12 hours (when taking agar-agar) or in a day (when taking the seeds of the fleavor). Methylcellulose will allow you to cope with constipation only after 1-3 days.
- Side effects. When fillers are taken, the intestinal walls stretch, the organ fills with gas, and a strong rumbling may occur. For the full effect to develop, a person must drink a lot of water, which is not always possible. Various diseases of the urinary system and not only can become an obstacle for this.
- Contraindications. Pregnant women should not take constipation drugs, as this increases the likelihood of spontaneous abortion. Fillers are prohibited for persons with IBS, as well as bedridden patients, people with intestinal obstruction and diseases of the nervous system.
Herbal laxatives
Herbal laxatives, which are most often used to treat constipation, are the following:
- Buckthorn fruit, Buckthorn bark, syrup or extract, Ramnil, Zhostera fruit.
- Kafiol. This preparation contains senna leaves and fig fruits.
- Phytolax. It is a dietary supplement based on apricot fruits.
- Seaweed (kelp thallus). You can buy it in granules, tablets or in the form of an extract under the trademarks FitoTransit or Mamoklam Kelp thallus.
- The shell of oval plantain seeds is a part of such preparations as: Mucofalk, Naturolax, Fiberlex.
- Proctophytol. This herbal collection includes senna leaves, coriander fruits, licorice roots, alder buckthorn bark, common yarrow herb.
- Palm-shaped rhubarb roots, which are available in syrup, tablet and extract form.
- Licorice powder. It contains licorice root, senna leaves, fennel fruit (extract) and sulfur.
- Tincture of steel. The drug has not only a laxative effect, but also allows you to relieve inflammation and stop bleeding.
- Laxative collection No. 1. It contains yarrow herb, alder buckthorn bark, dioecious nettle leaves.
- Laxative collection No. 2. It contains buckthorn bark and fruits, senna leaf, anise fruits, licorice root.
Video: Life is great! A guide to choosing a laxative:
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
