Colace 2-In-1 Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This product is used to treat constipation. It contains 2 medications: sennosides and docusate. Sennosides are known as stimulant laxatives. They work by keeping water in the intestines, which helps to cause movement of the intestines. Docusate is known as a stool softener. It helps increase the amount of water in the stool, making it softer and easier to pass.

How to use Colace 2-In-1

Take this medication by mouth with a full glass of water (8 ounces/240 milliliters) as directed by your doctor. If you are self-treating, follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.

Dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this drug more often than directed. Do not take this medication for more than 7 days unless directed by your doctor. Serious side effects may occur with overuse of this medication (see also Side Effects section).

It may take 6 to 12 hours before this medication causes a bowel movement. Tell your doctor if your condition lasts or gets worse, or if bleeding from the rectum occurs. If you think you may have a serious medical problem, get medical help right away.

Side Effects

Stomach/abdominal pain or cramping, nausea, diarrhea, or weakness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

This medication may cause your urine to turn reddish-brown. This effect is harmless and will disappear when the medication is stopped.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: nausea/vomiting/diarrhea that doesn’t stop, muscle cramps/weakness, irregular heartbeat, dizziness, decreased urination, mental/mood changes (such as confusion).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this product, tell your doctor or pharmacist if you are allergic to senna, sennosides, or docusate; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: appendicitis or symptoms of appendicitis (such as nausea/vomiting, sudden or unexplained stomach/abdominal pain), a sudden change in bowel habits that lasts for longer than 2 weeks, bleeding from the rectum, intestinal blockage.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant before using this medication. Using it for long periods during pregnancy is not recommended. Consult your doctor for more details.

This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: mineral oil.

Does Colace 2-In-1 interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: nausea/vomiting/diarrhea that doesn’t stop, severe stomach/abdominal pain or cramping.

Keep all medical and lab appointments.

Lifestyle changes that may prevent or relieve constipation include exercising, drinking enough water, and eating a proper diet with fiber-rich foods such as bran, fresh fruits/vegetables. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

If your doctor has directed you to take this medication on a regular schedule and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Colace 2-In-1 8.6 mg-50 mg tablet

Color: redShape: roundImprint: P 054

This medicine is a red, round, tablet imprinted with “P 054”.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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Colace (Docusate Oral/Rectal) – Side Effects, Interactions, Uses, Dosage, Warnings

uses

What is Colace (Docusate Oral/Rectal) used for?

• Constipation

warnings

What is the most important information I should know about Colace (Docusate Oral/Rectal)?

You should not use docusate if you are allergic to it.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

• stomach pain;
• nausea;
• vomiting; or
• a sudden change in bowel habits that lasts over 2 weeks.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

Side Effects

What are the side effects of Colace (Docusate Oral/Rectal)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using docusate and call your doctor at once if:

• you have rectal bleeding;
• no bowel movement occurs after using a laxative;
• you need to use a stool softener for more than 1 week; or
• rash occurs.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Colace (Docusate Oral/Rectal) if I’m pregnant or breastfeeding?

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Interactions

What drugs and food should I avoid while taking Colace (Docusate Oral/Rectal)?

Avoid using mineral oil, unless told to do so by a doctor.

Dosage Guidelines & Tips

How to take Colace (Docusate Oral/Rectal)?

Use Colace (Docusate Oral/Rectal) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Colace (Docusate Oral/Rectal)?

Since docusate is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

Overdose Signs

What happens if I overdose on Colace (Docusate Oral/Rectal)?

If you think you or someone else may have overdosed on: Colace (Docusate Oral/Rectal),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Colace (Docusate Oral/Rectal), call 911

911

What to Expect

The liquid and capsule forms of docusate typically take about one to two days to work. Docusate enemas usually take effect within 20 minutes.

It’s best to use this medicine only for short periods of time. Let your doctor know if you’re still constipated after one week.

Secondary Uses

Your doctor may recommend docusate for other uses. For example, it’s sometimes given to empty the bowels before an X-ray of the stomach.

Images

P51

Color: orange

Shape: oval

Imprint: P51

SCU1

Color: red

Shape: oval

Imprint: SCU1

L486

Color: red/white

Shape: oval

Imprint: L486

top 12 rating according to KP

Constipation (which is what doctors officially call constipation) indicates problems in the gastrointestinal tract. If the process becomes chronic, then this is already a serious cause for concern. Obviously: it’s time to see a doctor, because the problem cannot be solved by auxiliary drugs alone.

Treatment of chronic constipation should be complex. It is necessary to change the lifestyle – increase physical activity, reconsider the nature of nutrition, accustom yourself to the optimal water regime, and, of course, choose medications together with the doctor.

To combat constipation, a number of drugs are used that help soften the intestinal contents and increase its volume, increase peristalsis and facilitate the process of defecation. Our top 12 best laxatives for colon cleansing combines remedies with different mechanisms of action. The rating includes syrups, tablets, capsules and powders for oral solution preparation. The drugs in the rating are divided into groups according to the active substance.

Top 12 ranking according to KP

Important! Any drugs and dietary supplements have side effects and contraindications. Our list is an overview and does not serve as a guide to action. Before using any drug, consult your doctor.

Lactulose products

Lactulose is a synthetic disaccharide that is not absorbed in the intestines, but serves as food for beneficial bacteria living there. These bacteria break down lactulose into lactic, formic and acetic acids, as a result, the contents of the intestine “acidify” and begin to attract water. This increases the osmotic pressure, the stool becomes softer, and the peristalsis of the colon increases ¹ . All this contributes to the gentle cleansing of the intestines.

But it is important to know that lactulose has a very low level of evidence.

Duphalac

Lactulose syrup at a dosage of 667 mg/ml is packaged in individual sachets. Each sachet contains 15 ml of the drug, in total there are 10 sachets in the package. But the manufacturer also offers other forms of release: bottles containing 200, 500 and 1000 ml of syrup. These packages come with a measuring cup.

The preparation is a viscous liquid which may be colorless, yellowish or yellow-brown. It has no smell, and the taste is slightly sweet due to the presence of sugars in the composition. “Duphalac” is indicated for use in constipation, hepatic encephalopathy and for softening stools for medical purposes. It is allowed to use during pregnancy and lactation, as well as in childhood.

Contraindications : galactosemia, galactose and fructose intolerance, individual hypersensitivity to the components, obstruction of the gastrointestinal tract, perforation of the digestive tract or the threat of its occurrence. A complete list of contraindications is in the instructions.

Pros and cons

is suitable for children, pregnant and lactating women.

high price in the segment.

Portalak

Lactulose clear viscous syrup is supplied in 500 ml vials. The syrup has a neutral smell and a sweetish taste. The active ingredient lactulose is an osmotic laxative that increases the volume of fluid in the intestines, helps soften the stool and improve peristalsis. The drug is used in the treatment of chronic constipation, for the treatment and prevention of hepatic encephalopathy, and for diseases that require relief from defecation.

Contraindications : intestinal obstruction, hypersensitivity to lactulose, suspected appendicitis, acute inflammation in the abdominal cavity, rectal bleeding not associated with hemorrhoids, glucose-galactose malabsorption and others. Use during pregnancy and lactation is possible only with the permission of a doctor.

Pros and cons

reasonable price; large bottle.

extensive list of contraindications; in the reviews there are complaints about too sweet taste.

Lactulose

Lactulose syrup appears as a viscous, clear liquid that varies in color from colorless to yellowish brown. Sometimes crystals are visible in the liquid, which dissolve when heated. Release form – individual sachets, which contain 15 ml of syrup. The drug can be used for the prevention and treatment of hepatic encephalopathy, chronic constipation and other diseases and conditions in which defecation is difficult.

Among contraindications indicated intestinal obstruction, individual intolerance to lactulose, suspicion of appendicitis, acute inflammatory diseases of the abdominal cavity, intolerance to galactose and fructose, lactase deficiency and others. Use in pregnant and lactating women is allowed only after consulting a doctor.

Pros and cons

convenient packaging; you can take with you, reasonable price.

many contraindications; may not be available for sale.

Macrogol Laxatives

Macrogol 4000 is an osmotic laxative that increases the water content of the intestinal lumen and thereby increases the volume and softens its contents. Macrogol is not absorbed into the blood and is excreted from the body unchanged. Due to this, preparations with macrogol practically do not have side effects ² .

Like lactulose, macrogol has a very low level of evidence.

Forlax

Macrogol laxative is intended for use in adults and children over 8 years of age and appears as a white powder with a slight citrus scent. The characteristic aroma of the preparation is given by orange and grapefruit oil and concentrated orange juice. A solution for oral administration is prepared from the powder. “Forlax” is used for the symptomatic treatment of constipation, and it is allowed for pregnant and lactating women.

The list of contraindications for includes: individual intolerance to components, total or partial intestinal obstruction or suspected of it, abdominal pain of unknown origin, toxic megacolon, Crohn’s disease and other serious inflammatory bowel diseases, perforation or risk of perforation of the gastrointestinal tract.

Pros and cons

pleasant smell; convenient packaging; availability in pharmacies.

tastes too sweet according to some users.

Lavacol

This drug is a white or off-white powder for oral solution. The composition includes macrogol and electrolytes, including sodium and potassium. Macrogol increases the volume of fluid in the intestines and facilitates defecation, while electrolytes maintain the composition of the blood plasma. The drug can be used for the symptomatic treatment of constipation and bowel cleansing before surgery and endoscopy.

Contraindications : general serious condition of the patient, individual sensitivity to the components, obstruction and obstruction of the gastrointestinal tract, malignant tumors of the colon, perforation of the gastrointestinal tract or the risk of its occurrence, toxic colitis or toxic megacolon and others. Pregnant and lactating women can use the drug after consulting a doctor.

Pros and cons

reasonable price; retail availability.

many contraindications.

Macrogol Lekas ​​

Macrogol laxative is a white powder that is used as an oral solution. The finished solution has a neutral smell and a sweetish taste. Indications for the use of the drug: symptomatic treatment of constipation and bowel cleansing before surgical and diagnostic interventions on the colon.

The contraindication list for includes idiosyncrasy, gastrointestinal obstruction, severe heart failure, dehydration, gastric ulcers, tumors or other conditions involving the colon mucosa, inflammatory bowel disease, and toxic megacolon associated with spastic stenosis. The entire list of contraindications is indicated in the instructions. Use during pregnancy and lactation – only with the permission of a doctor.

Pros and cons

inexpensive drug; convenient packaging.

many contraindications.

Laxatives with hay and sodium picosulfate

These drugs have a stimulating effect on the colonic mucosa, increasing the amount of water and electrolytes in the intestinal lumen. This activates peristalsis and accelerates the passage of feces from the lower gastrointestinal tract ³ . Please note that these drugs are not suitable for long-term use.

Picosulfate has moderate evidence and senna has low evidence.

Guttalax

Sodium picosulfate is available as oral drops. A 30 ml vial contains a clear, colorless or slightly yellowish viscous liquid. The drug is dosed in drops that can be mixed with water or taken in pure form.

“Guttalax” is intended for the treatment of constipation of various origins, including against the background of intestinal atony and hypotension, dysbacteriosis, after taking medications. It can be used for diseases of the gallbladder and irritable bowel syndrome, which are accompanied by constipation.

Contraindications : obstructive bowel disease, intestinal obstruction, intolerance to drug components, severe dehydration, abdominal pain with nausea and vomiting, acute inflammatory bowel disease and others.

Pros and cons

handy dispenser; economical consumption.

a large list of contraindications and possible side effects.

Senade

Herbal laxative contains dry extract of senna leaves. The active substance is able to irritate the receptors of the large intestine and thereby enhance its peristalsis. Tablets are recommended for constipation associated with atony and weak intestinal motility, as well as for regulating stool in certain diseases: hemorrhoids, proctitis, anal fissures.

Suitable for adults and children over 6 years of age, use with caution during pregnancy and lactation.

Contraindications : spastic constipation, abdominal pain of unknown origin, intestinal obstruction, peritonitis, strangulated hernia, cystitis, gastrointestinal and uterine bleeding, hypersensitivity to components, water and electrolyte imbalance.

Pros and cons

inexpensive drug; herbal ingredients.

long-term use may cause flatulence and abdominal pain.

Regulax Picosulfate

As the name implies, the drops contain sodium picosulfate, a laxative that has a stimulating effect on the colonic mucosa and causes the accumulation of water and electrolytes in it.

The drug facilitates defecation and is used to treat constipation associated with medication, intestinal atony and hypotension, and some diseases: diseases of the gallbladder and biliary tract, irritable bowel syndrome.

Contraindications : acute inflammatory bowel disease, severe dehydration, acute abdominal disease or severe abdominal pain, intestinal obstruction, intolerance to components and fructose.

Pros and cons

neutral odor and taste; convenient dosing.

waste packaging.

Laxatives with psyllium

Psyllium is the seed coat of psyllium ovata or Plantago ovata. This shell consists of almost 80% soluble fiber, which, when it enters the intestines, attracts moisture, swells and acquires the consistency of a gel. Due to this, the volume of intestinal contents increases, and it freely leaves the body in a natural way. In addition, psyllium serves as food for beneficial intestinal microflora and helps to avoid dysbacteriosis ⁴ .

Drink plenty of water while taking psyllium medications. It is worth noting that psyllium has a low level of evidence.

Phytomucil Norm

This dietary supplement contains 2 active ingredients – psyllium husk and plum fruit pulp. Soluble psyllium fiber helps form soft stools and aids in bowel cleansing. Homemade plum fruits contain insoluble dietary fiber – they stimulate the mucous membrane of the colon and improve its peristalsis.

BAA is produced in the form of granules, which are packaged in individual sachets of 5 g. The bioadditive is indicated for use as an additional source of fiber and flavonoids for constipation, irritable bowel syndrome with a predominance of constipation, hemorrhoids, rectal fissures.

Among the contraindications for are individual intolerance, acute inflammatory diseases and obstruction of the gastrointestinal tract, children under 3 years of age. The dietary supplement is approved for use in pregnant and lactating women.

Pros and cons

2 active ingredients; can be for children from 3 years old, women during pregnancy and lactation.

high price in the segment; small package size.

Psyllium

Dietary supplement in the form of capsules contains psyllium husks in the amount of 750 mg. The dietary supplement serves as a source of soluble and insoluble dietary fiber, which increases stool volume and stimulates intestinal contractility. Also, Psyllium can be an additional source of dietary fiber for people who suffer from constipation and follow a diet low in fiber.

Contraindications : individual intolerance, pregnancy and lactation, age under 18 years.

Pros and cons

high content of psyllium in 1 capsule.

small package.

Psyllium Husks Fiber

A dietary supplement from a popular brand is available in the form of capsules, each containing 500 mg of psyllium. The dietary supplement is intended to improve intestinal motility, as it helps to increase the volume of intestinal contents and make it softer. After entering the digestive tract, the dietary fibers of psyllium “swell” – the manufacturer reports that this allows you to create a feeling of satiety and reduce the number of absorbed calories.

BAA is not recommended to be taken during pregnancy and lactation, as well as in case of individual intolerance and under the age of 18 years.

Pros and cons

well-known manufacturer; big package.

is sometimes out of stock.

How to choose a laxative for colon cleansing

– Of course, anyone can choose a laxative for themselves – after all, prescriptions are not required for them. But it is better to entrust this to a specialist, – emphasizes gastroenterologist Liliya Sagdutdinova . – Only a doctor, taking into account his education and experience, can choose the most effective medicine for a particular patient from a number of good drugs.

If you dare to solve the problem yourself, it is very important to first study the list of contraindications indicated in the instructions. Ignoring this is fraught with serious consequences.

What if the laxative doesn’t help?

– For patients who do not respond well to laxatives, a prokinetic 5-HT4 agonist is recommended. In general, to avoid problems with constipation, you need to move more (at least walk – at least 60 minutes a day), drink more water (30 ml per 1 kg of body weight), and add foods consisting of insoluble dietary fiber to the diet – for example, wheat bran, our expert adds.

Photo: market.yandex.ru, KP

Sources:

1. Clinical aspects of the use of lactulose in the practice of a gastroenterologist. I. G. Fedorov, L. Yu. Ilchenko, S. D. Kosyura, M. A. Chichkina.
   https://cyberleninka.ru/article/n/klinicheskie-aspekty-primeneniya-laktulozy-v-praktike-gastroenterologa/viewer
2. Evaluation of the efficacy of macrogol in chronic functional constipation. S. D. Kosyura, Z. R. Shcherbova. Medical business. 2018 year. https://cyberleninka.ru/article/n/otsenka-effektivnosti-makrogola-pri-chronicheskom-funktsionalnom-zapore/viewer
3. Possibilities of using sodium picosulfate in the pharmacotherapy of constipation in functional bowel disorders. 2019 year. V. N. Drozdov, K. I. Karnoukh, S. Yu. Serebrova, I. A. Komissarenko, A. K. Starodubtsev v-farmakoterapii-zaporov-pri-funktsionalnyh-rasstroystvah-kishechnika
4. Impaired bowel function in patients with metabolic syndrome. I. A. Komissarenko, S. V. Levchenko. 2022 https://cyberleninka.ru/article/n/narushenie-funktsii-kishechnika-u-patsientov-s-metabolicheskim-sindromom/viewer
5. Chang L et al. American Gastroenterological Association-American College of Gastroenterology clinical practice guideline: Pharmacological management of chronic idiopathic constipation. Gastroenterology 2023 Jun; 164:1086

Laxatives for constipation | Microlax

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Laxatives for constipation

Contents

• Stimulant laxatives
• Bulking agents
• Emollients
• Microclysters

Stool retention is common in both sexes and in all age groups ² . According to various sources, from 2 to 27% of the population ¹ suffer from it, and there is a trend towards an increase in the prevalence of constipation among young people ² . There are no exact statistics in Russia, because not everyone reports such a delicate problem to the doctor ¹ .

Constipation can be a symptom of a specific medical condition. If, after examination, no changes in the intestines or other organs can be found, constipation is considered a primary violation ¹⁶ .

To restore the regularity of the stool, you need to change the diet, drink enough fluids and increase physical activity ⁴ .

If these methods fail, laxatives are used as symptomatic treatment ² .

They are prescribed to cleanse the intestines, removing from it dense stools that are difficult to pass.

Also, laxatives help restore regular and painless stools, make them soft and prevent the occurrence of “fecal blockage” ^1,3,11 .

Laxatives with different mechanisms of action are presented on the pharmaceutical market today. But for convenience they are divided into 3 large groups ^{1, 3} :

• Stimulating;
• Increasing the volume of intestinal contents;
• Stool softeners.

Each group is suitable for a specific problem that has led to constipation ³ . We will deal with all this diversity in the article.

Stimulant laxatives

Peristalsis stimulants (intestinal contractions) – irritants that act on the nerve endings in the intestinal mucosa ^3,4,5,6,7 .

Drugs with an irritating effect may affect different parts of the digestive tract ^3,4,5 :

• small intestine – area of ​​action of castor oil and laxative resins;
• Colon activity is increased by senna, buckthorn, rhubarb, sulfur, sodium picosulfate and diphenylmethane derivatives.

They also produce drugs that are converted to their active form by intestinal enzymes, so they “work” in both the small and large intestines ^3,4,5,6 .

It is important to remember that the abuse of stimulant laxatives can cause side effects:

Diarrhea with cramping pain in the abdomen. Due to diarrhea, the body loses the potassium, sodium and chloride ions it needs.

With their deficiency, general weakness worries, and due to an imbalance of ions, there is a possibility of arrhythmias and a decrease in blood pressure ^5.16

The “lazy bowel” phenomenon “Lazy” refers to the large intestine, which has turned into an enlarged tube that has lost its tone. Without taking large doses of laxatives, it is not able to contract and move feces. This often happens if the drug accumulates in the colon mucosa and its nerve plexuses, and then destroys the smooth muscles that push the feces ^1,5,16

The “lazy bowel” syndrome is manifested by the progression of constipation, which is difficult to correct ^2.5 . Due to rapid tolerance ⁷ peristalsis stimulants are not recommended for more than 14 days ^5.16 .

Bulking agents

Bulk laxatives retain water, swell and stretch the intestinal walls with increased volume. Excessive stretching triggers peristalsis and bowel movement is accelerated ¹⁷ .

This group of drugs includes ^3.16 :

• dietary fiber;
• osmotic laxatives – macrogol, lactulose, salts.

The listed drugs are difficult to digest, and some are not digested at all, so they are practically not absorbed through the mucous into the blood ¹⁷ .

Dietary fiber

Dietary fiber (fiber) is found in bran, seaweed, psyllium and flax husks ¹⁴ . They are also found in vegetables and fruits. Fiber is able to swell in the intestinal lumen, increasing the mass of feces, which mechanically irritates the intestinal wall ^3.7 . But the effect is manifested immediately, and after 10 days, sometimes the result has to wait up to 3 weeks ⁶ .

To get a laxative effect when using dietary fiber, do not forget to drink enough water ³ – 1.5-2 liters per day ¹⁷ , because to increase the volume of feces, fiber must absorb a lot of liquid ^3.7 .

When choosing between wheat bran and psyllium, be aware that wheat bran can cause flatulence ^7.16 . Therefore, the elderly are advised to use psyllium seeds, which are better tolerated ¹⁶ .

Macrogol

Products based on polyethylene glycol (macrogol) are poorly absorbed substances ^{6. 9} . Due to this property, they are able to retain fluid in the intestinal lumen ^7.9 .

Macrogol does not cause dehydration, but only slows down the absorption of water ¹⁴ . After taking a laxative, the stool becomes thinner, its consistency improves, and the frequency of bowel movements increases ⁷ .

The disadvantage of macrogol is a rather slowly developing effect and intestinal hypotension ¹ , and the main side effect is potentiation of fecal incontinence ⁷ . According to the instructions, the recommended duration of macrogol intake is up to 14 days ⁸ .

Saline laxatives

Concentrated salts – magnesium sulfate, sodium sulfate, Karlovy Vary salt ^{8, 9} – act at the level of the small intestine and increase the osmotic pressure in it ¹⁷ . On the one hand, this attracts liquid into the intestinal lumen ^1,4,5,6,7 , and on the other hand, it retains water in it ^{7. 8} .

Under the influence of salts, the feces become liquid, as in diarrhea, and are easily excreted ^,8,17 .

But it is precisely because of severe diarrhea that saline laxatives are not suitable for long-term use. With the constant release of loose stools, water and ion imbalances may occur ¹⁷ . Also, these drugs are not recommended for people with kidney and heart diseases, because salts can be absorbed into the bloodstream in a minimal amount and retain water in the body ¹⁴ . When using Karlovy Vary salt, its unpleasant taste can become a problem for patients ⁸ .

Lactulose

Lactulose does not have a direct laxative effect, but with the help of beneficial bacteria. Using it as food ^{10, 13} , bifidobacteria and lactobacilli living in the intestines secrete substances that act like osmotic laxatives ^7,10,13,17 . But at the same time, severe diarrhea does not occur, because lactulose “works” exclusively in the large intestine ^{15. 17} .

The laxative effect of lactulose develops gradually:

with a single dose after 24-48 hours;

systemically – after 2-4 hours ¹⁵

Since lactulose is not digested, it is practically not absorbed and has no systemic side effects ¹⁵ . Sometimes, with an incorrectly selected dose against the background of the use of the drug, bloating may disturb ^15.17 .

Emollients

These constipation medicines include glycerin, almond oil, liquid paraffin, sodium docusate ^2,7,8 . They contribute to the impregnation of stool with water, increasing the volume of intestinal contents and softening its consistency. In addition, stool softeners lubricate the intestinal mucosa. Currently, drugs in this group have a limited set of indications due to side effects (loss of fat-soluble vitamins) ^6.7 .

Watch in our video which laxative to choose for constipation: tablets, syrup or microclysters

Microclysters

For emergency bowel relief from hard stools, laxatives in the form of microclysters can be used ¹² . This form includes drugs with a combined mechanism of action, that is, working “together”. They calpeptize (break down dense masses), increase its volume and make it soft ^2.11 .

Microenemas are also used to correct constipation associated with lazy bowel syndrome ² .

Micro enema MICROLAX ^® acts locally and has a mild laxative effect due to the presence in its composition ¹¹ :

• sodium citrate , which displaces bound water from the fecal lump;
• sodium lauryl sulfoacetate which loosens stools;
• sorbitol , which increases the flow of water into the intestinal lumen.

Using MICROLAX ^® is easy, no special knowledge or training is required ¹¹ . The tube with a tip contains the necessary single dose of the drug, and the micro enema format facilitates the use of a laxative drug, including in the “fecal plug” or preparation for the study of the rectum ¹¹ .

MICROLAX ^® is approved for use in adults and children from birth ¹¹ . It acts only on the feces, softens them and facilitates bowel movements ¹¹ . At the same time, the drug is not addictive and does not affect the function of other parts of the gastrointestinal tract.

Remember that laxatives do not eliminate the cause of constipation, they only reduce unpleasant symptoms. Their independent, prolonged or uncontrolled intake may aggravate the course of the causative disease, if stool retention is one of its manifestations ² .

All laxatives should be taken only after consulting a doctor. To get rid of constipation comfortably and effectively, be sure to be examined by a general practitioner or gastroenterologist. Only a specialist will be able to take into account all contraindications, the risk of side effects and prescribe medications so that they are not addictive.

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Dealing with constipation requires patience and a holistic approach. Lifestyle changes, dietary modifications, and physical activity can help restore stool regularity ² . It is important to follow the recommendations of a specialist, and if necessary, use laxatives prescribed by a doctor.

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

Literature

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