Colace – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Docusate sodium belongs to the family of medications known as stool softeners. It is used to treat and prevent occasional constipation due to hard stools. Docusate sodium works by increasing the amount of water in the stool, making stools softer and easier to pass. It usually starts to work within 1 to 3 days, but it may take up to 5 days to work.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Capsules

Each capsule contains docusate sodium USP 100 mg. Nonmedicinal ingredients: gelatin, glycerin, PEG-400, propylene glycol, sorbitol, titanium dioxide, D & C Red No. 33, FD&C Red No. 40 and FD&C Yellow No. 6.

Drops

Each mL of solution contains docusate sodium USP 10 mg (1%). Nonmedicinal ingredients: purified water, propylene glycol, poloxamer 188, polyethylene glycol 400, methylparaben, propylparaben, sodium citrate dihydrate, vanillin, citric acid, and D&C Red No. 33.

Syrup

Each 5 mL of syrup contains docusate sodium USP 20 mg. Nonmedicinal ingredients: purified water, poloxamer 188, citric acid, sodium citrate dihydrate, sucrose, alcohol, polyethylene glycol 400, methylparaben, propylparaben, peppermint oil, menthol crystals, FD&C Red No.  40, D&C Red No. 33, and natural orange terpeneless flavour.

How should I use this medication?

For adults and children older than 12 years, the recommended dose ranges from 100 mg to 200 mg daily.

For children 6 to 12 years old, the recommended dose is 40 mg to 120 mg daily.

For children 3 to 6 years old, the recommended dose is 20 mg to 60 mg daily.

For children under 3 years of age, your doctor will recommend the appropriate dose.

Children under 6 years of age should not be given this medication unless recommended by a doctor.

Swallow the capsules whole with water or fruit juice. The syrup or drops should be given in 120 mL (about ½ cup) of milk or fruit juice, or in infant formula to mask the bitter taste of the medication. Use an oral syringe or dropper to measure each dose of the syrup or drops.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature; protect it from light, moisture, and freezing; and keep it out of the reach of children.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under “What form(s) does this medication come in?”

Do not dispose of medications in wastewater (e. g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Docusate sodium should not be taken by anyone who:

• is allergic to docusate or to any of the ingredients of the medication
• has abdominal pain, nausea, fever, or vomiting

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• diarrhea
• skin rash
• stomach or intestinal cramping
• throat irritation (if using liquid forms)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breastfeeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Diabetes: Liquid forms of the medication (especially syrup) may contain large amounts of sugar.

General: If you experience a sudden change in your bowel movements that lasts for 2 weeks or more, do not take this medication without first talking to your doctor. If you take docusate sodium for one week and it does not seem to help with your constipation or if rectal bleeding occurs, stop taking this medication and contact your doctor.

Medical conditions: Docusate sodium is not recommended for people who have appendicitis, symptoms of appendicitis (e.g., nausea, vomiting, abdominal pain), bleeding from the rectum, undiagnosed bleeding, congestive heart failure, high blood pressure, fecal impaction, or intestinal obstruction.

Overuse and prolonged use: Overusing or using docusate sodium for long periods of time may cause your bowels to become dependent on the medication. Unless recommended by your doctor, do not use this medication for longer than one week.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor.

Breast-feeding: It is not known if docusate sodium passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Laxatives such as docusate sodium should not be given to children under 6 years of age unless recommended by a doctor.

What other drugs could interact with this medication?

There may be an interaction between docusate sodium and any of the following:

In general, stool softeners should not be taken within 2 hours of other medications, since they may reduce the effectiveness of those medications. Talk with your doctor or pharmacist to verify that this is the case with the medications that you are taking.

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Colace

Things We Do for No Reason: Prescribing Docusate for Constipation in Hospitalized Adults

The “Things We Do for No Reason” (TWDFNR) series reviews practices that have become common parts of hospital care but which may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent “black and white” conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.

Click here for the Choosing Wisely website.

CASE PRESENTATION

An 80-year-old woman with no significant past medical history presents with a mechanical fall. X-rays are notable for a right hip fracture. She is treated with morphine for analgesia and evaluated by orthopedic surgery for surgical repair. The hospitalist recognizes that this patient is at high risk for constipation and orders docusate for prevention of constipation.

BACKGROUND

Constipation is a highly prevalent problem in all practice settings, especially in the hospital, affecting two out of five hospitalized patients.¹ Multiple factors in the inpatient setting contribute to constipation, including decreased mobility, medical comorbidities, postsurgical ileus, anesthetics, and medications such as opioid analgesics. Furthermore, the inpatient population is aging in parallel with the general population and constipation is more common in the elderly, likely owing to a combination of decreased muscle mass and impaired function of autonomic nerves.² Consequently, inpatient providers frequently treat constipation or try to prevent it using stool softeners or laxatives.

One of the most commonly prescribed agents, regardless of medical specialty, is docusate, also known as dioctyl sulfosuccinate or by its brand name, Colace. A study from McGill University Health Centre in Montreal, Canada reported that docusate was the most frequently prescribed laxative, accounting for 64% of laxative medication doses, with associated costs approaching $60,000 per year.³ Direct drug costs accounted for a quarter of the expenses, and the remaining three quarters were estimated labor costs for administration. Medical and surgical admissions shared similar proportions of usage, with an average of 10 doses of docusate per admission across 17,064 admissions. Furthermore, half of the patients were prescribed docusate upon discharge. The authors extrapolated their data to suggest that total healthcare spending in North America on docusate products likely exceeds $100,000,000 yearly. A second study from Toronto found that 15% of all hospitalized patients are prescribed at least one dose of docusate, and that one-third of all new inpatient prescriptions are continued at discharge. ⁴

WHY YOU THINK DOCUSATE MIGHT BE HELPFUL FOR CONSTIPATION

Docusate is thought to act as a detergent to retain water in the stool, thereby acting as a stool softener to facilitate stool passage. Physicians have prescribed docusate for decades, and attendings have passed down the practice of prescribing docusate for constipation to medical trainees for generations. The initial docusate studies showed promise, as it softened the stool by increasing its water content and made it easier to pass through the intestines.⁵ One of the earliest human studies compared docusate to an unspecified placebo in 35 elderly patients with chronic atonic constipation and found a decreased need for enemas.⁶ Some other observational studies also reported a decreased need for manual disimpactions and enemas in elderly populations.^7,8 One randomized, controlled trial from 1968 showed an increased frequency of bowel movements compared to placebo, but it excluded half of the enrolled patients because they had a positive placebo response. ⁹ Since those early studies from the 1950s and 1960s, docusate remains widely accepted as an effective stool softener with positive endorsements from hospital formularies and order sets and patient information sheets such as the JAMA Patient Page.¹⁰ Furthermore, the World Health Organization lists docusate as an “essential medicine,” reinforcing the notion that it is effective.¹¹

WHY THERE IS NO REASON TO PRESCRIBE DOCUSATE FOR CONSTIPATION

Despite common practice, the efficacy of docusate as a stool softener has not been borne out by rigorous scientific data. On the contrary, multiple randomized controlled trials have failed to show any significant efficacy of this drug over placebo (Table).

The initial trial in 1976 studied 34 elderly patients on a general medical ward for prophylaxis of constipation.¹² They randomized patients to 100 mg twice daily of docusate sodium versus a control group that did not receive any type of laxative. The number of bowel movements and their character served as the measured outcomes. The study demonstrated no statistically significant differences in the frequency and character of bowel movements between the docusate and placebo groups. Even at that time, the authors questioned whether docusate had any efficacy at all: “[w]hether the drug actually offers anything beyond a placebo effect in preventing constipation is in doubt.”

Another trial in 1978 studied 46 elderly, institutionalized patients with chronic functional constipation.¹³ All patients underwent a two-week placebo period followed by a three-week treatment period with three arms of randomization: docusate sodium 100 mg daily, docusate sodium 100 mg twice daily, or docusate calcium 240 mg daily. Patients received enemas or suppositories if required. All three arms showed an increase in the average number of natural bowel movements when compared to each patient’s own placebo period, but only the arm with docusate calcium reached statistical significance (P < . 02). According to the authors, none of the therapies appeared to have a significant effect on stool consistency. The authors hypothesized that the higher dose given to the docusate calcium arm may have been the reason for the apparent efficacy in this cohort. As such, studies with higher doses of docusate calcium would be reasonable.

A third study in 1985 compared docusate sodium 100 mg three times daily versus placebo in six healthy patients with ileostomies and six healthy volunteers.¹⁴ Therapy with docusate “had no effect on stool weight, stool frequency, stool water, or mean transit time.”

Another study in 1991 evaluated 15 elderly nursing home residents with a randomized, double-blind crossover design.¹⁵ Subjects received 240 mg twice daily of docusate calcium versus placebo for three weeks and then crossed over to other arm after a two-week wash-out period. The investigators found no difference in the number of bowel movements per week or in the need for additional laxatives between the two study periods. There were also no differences in the patients’ subjective experience of constipation or discomfort with defecation.

Larger studies were subsequently initiated in more recent years. In 1998, a randomized controlled trial in 170 subjects with chronic idiopathic constipation compared psyllium 5.1 g twice daily and docusate sodium 100 mg twice daily with a corresponding placebo in each arm for a treatment duration of two weeks after a two-week placebo baseline period.¹⁶ Psyllium was found to increase stool water content and stool water weight over the baseline period, while docusate essentially had no effect on stool water content or water weight. Furthermore, by treatment week 2, psyllium demonstrated an increase in the frequency of bowel movements, whereas docusate did not. It should be noted that this study was funded by Procter & Gamble, which manufactures Metamucil, a popular brand of psyllium.

Lastly, the most recent randomized controlled trial was published in 2013. It included 74 hospice patients in Canada, comparing docusate 200 mg and sennosides twice daily versus placebo and sennosides for 10 days. The study found no difference in stool frequency, volume, or consistency between docusate and placebo.¹⁷

A number of systematic reviews have studied the literature on bowel regimens and have noted the paucity of high-quality data supporting the efficacy of docusate, despite its widespread use.^18-22 With these weak data, multiple authors have advocated for removing docusate from hospital formularies and using hospitalizations as an opportunity to deprescribe this medication to reduce polypharmacy. ^3,4,23

Although docusate is considered a benign therapy, there is certainly potential for harm to the patient and detrimental effects on the healthcare system. Patients commonly complain about the unpleasant taste and lingering aftertaste, which may lead to decreased oral intake and worsening nutritional status.²³ Furthermore, docusate may impact the absorption and effectiveness of other proven treatments. ²³ Perhaps the most important harm is that providers needlessly wait for docusate to fail before prescribing effective therapies for constipation. This process negatively impacts patient satisfaction and potentially increases healthcare costs if hospital length of stay is increased. Another important consideration is that patients may refuse truly necessary medications due to the excessive pill burden.

Costs to the healthcare system are increased needlessly when medications that do not improve outcomes are prescribed. Although the individual pill cost is low, the widespread use and the associated pharmacy and nursing resources required for administration create an estimated cost for docusate over $100,000,000 per year for North America alone.³ The staff time required for administration may prevent healthcare personnel from engaging in other more valuable tasks. Additionally, every medication order creates an opportunity for medical error. Lastly, bacteria were recently found contaminating the liquid formulation, which carries its own obvious implications if patients develop iatrogenic infections. ²⁴

WHAT YOU SHOULD DO INSTEAD

Instead of using docusate, prescribe agents with established efficacy. In 2006, a systematic review published in the American Journal of Gastroenterology graded the evidence behind different therapies for chronic constipation.²¹ They found good evidence (Grade A) to support the use of polyethylene glycol (PEG), while psyllium and lactulose had moderate evidence (Grade B) to support their use. All other currently available agents that were reviewed had poor evidence to support their use. A more recent study in people prescribed opioids similarly found evidence to support the use of polyethylene glycol, lactulose, and sennosides.²⁵ Lastly, the 2016 guidelines from the American Society of Colon and Rectal Surgeons do not mention docusate, though they comment on the paucity of data on stool softeners. Their recommendations for laxative therapy are similar to those of the previously discussed reviews.²⁶ Ultimately, the choice of therapy, pharmacological and nonpharmacological, should be individualized for each patient based on the clinical context and cause of constipation. Nonpharmacologic treatments include dietary modification, mobilization, chewing gum, and biofeedback. If pharmacotherapy is required, use laxatives with the strongest evidence.

RECOMMENDATIONS

• In patients with constipation or at risk for constipation, use laxatives with proven efficacy (such as polyethylene glycol, lactulose, psyllium, or sennosides) for treatment or prophylaxis of constipation instead of using docusate.
• Discuss de-prescription for patients using docusate prior to admission.
• Remove docusate from your hospital formulary.

CONCLUSION

Docusate is commonly used for the treatment and prevention of constipation in hospitalized patients, with significant associated costs. This common practice continues despite little evidence supporting its efficacy and many trials failing to show benefits over placebo. Decreased utilization of ineffective therapies such as docusate is recommended. Returning to the case presentation, the hospitalist should start the patient on alternative therapies, instead of docusate, such as polyethylene glycol, lactulose, psyllium, or sennosides, which have better evidence supporting their use.

Do you think this is a low-value practice? Is this truly a “Thing We Do for No Reason?” Share what you do in your practice and join in the conversation online by retweeting it on Twitter (#TWDFNR) and liking it on Facebook. We invite you to propose ideas for other “Things We Do for No Reason” topics by emailing [email protected].

Disclosures

All authors deny any relevant conflict of interest with the attached manuscript.

Does Colace (docusate) Work For Constipation? No! ~ Pallimed

by Bob Arnold (@rabob)

(This is the first post from the Pallimed Writers Group, a growing group of nearly 20 clinicians who are reviewing landmark studies and important current research. This study was highlighted in the GeriPal Top 25 articles in HPM.- Ed.)

Randomized, Double-Blind, Placebo-Controlled Trial of Oral Docusate in the Management of Constipation in Hospice Patients. Tarumi et al. Journal of Pain and Symptom Management, 2013: 45(1), 2-13.

Palliative care fellows may wonder about their attendings fixation on bowel movements. It may be because we do not ask medical students to disimpact patients any more or because, given the lack of ambulatory care many residents do, they do not see it as a big deal (Constipation a GREAT topic for those of us who like puns and dad jokes).

For patients, however, constipation is a topic they think about many times a day. It is very common (39-70% prevalence) in patients with cancer or other serious illness, particularly in elderly patients. The prevalence goes up to 80% in patients on opiates and for many of my patients, the bloating, nausea and discomfort associated with opiates are worse than the pain we are treating.

At the hospital where I work, Colace (docusate) is often used as the first treatment of constipation and/or as the drug of choice to prevent constipation. This has been despite a lack of evidence (JPSM 2000:19:130-6). I was thrilled to see this RCT of docusate and sennosides vs placebo and sennosides looking at whether docusate improved stool frequency, volume, and consistency. They found no difference in any of these variables.

Let’s take a closer look using the JAMA Users’ Guides to the Medical Literature:

1) Are the results valid?
     a. Was the assignment of patients to treatment randomized? Yes
     b. Were all patients who entered the trial properly accounted for and attributed for at the conclusion? Yes (and I wish I would have gotten more information.) Of the 1426 patients who were screened, only 305 met the study criteria and 80 consented. More data about why so many patients did not meet the study criteria or how the 26% who consented differed from non-consenters would be nice. Once we got to the 80 patients, the information and follow up is great (although only 73% completed the ten-day study.)
     c. Were patients, clinicians and study personnel ‘blind’ to treatment? Yes (although I would like it better if they asked patients if they got the placebo or the active drug to make sure the blinding worked. )
     d. Were the groups similar at the start of the trial? Yes; moreover, their OME, and use of other drugs were similar enough to be comfortable with the groups equivalency. It might have been nice to know how physically active both groups were and if they were from the same hospices, but now I am being a pain in the ass.
     e. Aside from the Experimental Intervention, Were the Groups Treated Equally? Yes.

2) What Are the Results?
     a. How Large Was the Treatment Effect? This was impressive. They looked at bowel movements every which way and found NO DIFFERENCE. They looked at frequency, volume, difficulty of defecation, and symptoms of constipation. There were differences in consistency (thankfully no pictures) but this was not consistent.
     b. How Precise Was the Estimate of the Treatment Effect? I have no worries about this. I might have chosen constipation symptoms as the primary outcome (and this would have required a different sample size). Given the consistency (UGH) of the findings, this does not seem to be a problem.

3) Will the Results Help Me in Caring for My Patients?
     a. Can the Results Be Applied to My Patient Care? This patient population is sicker and has more cancer than my patients. The patients were all recruited from an in-patient hospice unit where the median LOS was 16 days and 97% died during their stay. Moreover, the study population changed in the middle of the project (from requiring the patient be on opiates and have cancer) which should always make a reviewer nervous. This is going to be biggest question for many of you (although there is no reason to think that non-cancer, less sick patients will have different findings).
     b. Were All Clinically Important Outcomes Considered? Yes. I think this is a strength of the study.
     c. Are the Likely Treatment Benefits Worth the Potential Harm and Costs? Someone might say – who gives a shit? Docusate is cheap as stink (in my hospital taking it off the formulary would save less than 1000 dollars a year). And the pill does not taste as nasty as the liquid formulation (see GeriPal’s excellent laxative taste test) and is just one pill (not even that if it is given as a combination with senna).
      I still hate docusate because clinicians think they are doing something when they are not. In my hospitals, the house staff think when they are giving docusate for patients on opiates they are doing something and thus DO NOT USE ANOTHER (EFFECTIVE) LAXATIVE. This study is worth reading and quoting so people start off using the right drugs rather than letting patients get constipating and then chasing their tail.

Let’s get things moving!

Robert Arnold MD is a palliative care doctor at the University of Pittsburgh and a co-founder of VitalTalk. He loves both high and low brow comedy (The Good Place and Nanette), pop culture (the National Enquirer and Pop Culture Happy hour) and music of all kinds (not opera tho!)

Pregnancy constipation: Are stool softeners safe?

Is it safe to take stool softeners to treat pregnancy constipation?

Answer From Yvonne Butler Tobah, M. D.

Stool softeners are generally considered safe during pregnancy.

Pregnancy constipation, defined as having fewer than three bowel movements a week, can be uncomfortable. Stool softeners, such as Colace, moisten the stool and make it easier to pass. These products are unlikely to harm a developing baby because their active ingredient is only minimally absorbed by the body. Check with your health care provider, however, before taking any medication — including stool softeners and other types of laxatives — to treat pregnancy constipation.

Keep in mind that pregnancy constipation can often be prevented with lifestyle changes. For example:

• Drink plenty of fluids. Water is a good choice. Prune juice also can help.
• Include physical activity in your daily routine. Being active can help prevent pregnancy constipation.
• Include more fiber in your diet. Choose high-fiber foods, such as fruits, vegetables, beans and whole grains. With your health care provider’s OK, consider a fiber supplement, such as Metamucil.

If you take iron supplements, mention the constipation to your health care provider. Although iron is an important nutrient during pregnancy, too much iron can contribute to pregnancy constipation. You might have to take a stool softener if you are taking an iron supplement.

With

Yvonne Butler Tobah, M.D.

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Show references

1. Constipation. National Institute of Diabetes and Digestive Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/all-content. Accessed April 5, 2017.
2. Frequently asked questions. Women’s health FAQ120. Problems of the digestive system. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq120.pdf?dmc=1&ts=20131213T1128542208. Accessed April 5, 2017.
3. Briggs GG, et al. Docusate sodium. In: Drugs in Pregnancy & Lactation. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins. 2015. http://www.ovid.com/site/index.jsp. Accessed April 21, 2017.
4. AskMayoExpert. Constipation: Treatment in pregnancy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
5. Iron. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 5, 2017.
6. Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. April 7, 2017.

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How Long Does It Take For Colace To Work

How Long Does It Take For Colace To Work

How long does Peri Colace take to act?

It is best to take this medicine in the evening or before bedtime. PeriColace should have a bowel movement within 6-12 hours. Do not use this medicine for more than 7 consecutive days unless your doctor tells you to.

And how long does it take Colace to take effect?

12 to 72 hoursHow much more Peri Colace can I take?

Usual daily dose: Adults and children from 12 years: from 2 to 4 tablets per day Children from 6 to 12 years: from 1 to 2 tablets per day Children from 2 to 6 years: up to 1 tablet per day Children under 2 years : consult a doctor.

Considering how long does it take to use a stool softener?

Osmotic laxatives, including magnesium citrate and magnesium hydroxide, can produce a bowel movement in 30 minutes to 6 hours. Others can take 24 to 48 hours to take effect. Stimulant laxatives like Dulcolax and Senna can last anywhere from 6 to 12 hours. Stool softeners such as docusate can take 24 to 48 hours to complete.

Is it okay to take a stool softener every day?

Over-the-counter stool softeners work for most people. While they are intended only for short-term relief from constipation, there is probably nothing wrong with using a laxative every day. For many people, changing their diet can be an effective way to relieve constipation.

Can I take 2 Colace at the same time?

You should have a bowel movement within one to three days of the first dose. Colace can be taken regularly for softer stools, but it is important never to take double the amount of the drug.

Does Colace help against gas?

Colace checked for irritable bowel syndrome (IBSC) constipation Works well for me. I take 2 a day It really helps me with gas and constipation.

Which is better Colace or MiraLAX?

Colace is a laxative. It helps to draw water into the stool itself to make it softer and lighter. It does not stimulate bowel movements like many laxatives do. MiraLAX is used for the short-term treatment of constipation and for the long-term treatment of chronic constipation.

Are Colace and Dulcolax the same thing?

Colace (docusate) and dulcolax (bisacodyl) are effective medicines for the treatment of constipation. Although they can both be prescribed or bought over the counter, they differ in how they work. Colace is an emollient laxative while Dulcolax is a stimulant laxative.

What is a fast acting stool softener?

Stool softeners such as Colace and Surfak. Lubricating laxatives such as mineral oil (Liquid Petrolatum) Stimulant laxatives are the fastest, such as Aloe, Cascara (Natures Remedy), compounds of Senna (ExLax, Senokot), Bisacodyl (Dulcolax, Correctol) and castor oil.

Does stool softener work if you are already constipated?

Fabric Softener Fabric Softener (also known as a laxative)

What is the best laxative?

• Best overall result: MiraLAX laxative powder.
• Best Budget: Phillips Milk of Magnesia.
• Ideal for after childbirth: the Colace chair becomes softer.
• Ideal for seniors: Phillips saddles soften liquid gels.
• Ideal for constipation: Colace 2 in 1 stool softener and stimulating laxative.
• Best AllNatural: PruneLax Cirulex Regular Natural Laxative Tablets.

What if you stay constipated for too long?

Don’t let constipation get out of hand for too long. Left untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition in which part of the intestine leaks out of the ■■■■ due to excessive tension.

How can I make sure I follow him right away?

Quick Ways To Clean Your Jaw

How To Handle Hard Stools?

Home Remedies

Do Laxatives Help You Lose Weight?

Laxatives Can Help You Soak In The Water

Can I Take Laxatives In The Morning?

A stool softener is usually taken in the evening before bedtime. Make sure you follow the instructions on the package and stick to the exact recommended dose. If you choose to use a capsule or tablet, drink an 8-ounce glass of water while taking the medicine.

What Makes Stool Instantly Soft?

Eat More Fiber

Is MiraLax Addictive?

Polyethylene glycol 3350 can be addictive. Taking MiraLax too often or for too long can become dependent on laxatives. People who have or may have an intestinal obstruction (intestinal obstruction) should not take MiraLax.

How do you escape after the operation?

You should also plan on taking a stool softener such as docusate (Colace) after the operation. A fiber-containing laxative such as flea seeds (Metamucil) may also help. Before surgery, buy a laxative or laxative so that you have it on hand when you get home.

What food do you throw away right away?

14 Healthy Foods To Help You With The Onset

What Happens If You Take Too Much Dulcolax Laxative?

How Long Does It Take For Colace To Work

​Laxatives or Stool Softeners For Constipation

There’s nothing worse than that bloated, tight feeling in your gut when you just can’t poop. And when you’re struggling to relieve yourself, you’ll pretty much try anything to get your system running smoothly again.

So chances are, you’ve considered a laxative to speed things up. But what’s the difference between a stimulant laxative, and a stool softener, which is also marketed to help you go? What’s really the best fix for constipation?

Using a stimulant laxative or a stool softener every once and awhile isn’t a big deal, as long as you’re not depending on them regularly. But which one should you choose to cure your constipation when it does hit?

The right choice depends on whether you’re having a one-time or chronic problem, says gastroenterologist Will Bulsiewicz, MD. If pooping isn’t generally an issue for you and you just need some help for the moment, a stimulant laxative like bisacodyl (Dulcolax) or senna (Sennokot) will do. These work by speeding up and strengthening your colon’s contractions, which aids in pushing your waste out.

You don’t want to use these too often, though, or they could lose their effectiveness. That can create a laxative dependence, leading you to need higher and higher doses in order to poop.

Herbal home remedies for constipation like aloe, cascara, and Smooth Move tea can have the same effect, says Dr. Bulesiewicz.

Stool softeners like docusate (Colace) work by reducing the hardness of stools, which should make them easier to pass. Problem is, they won’t do much if you’re already constipated, since they take three of four days to kick in, he adds. But they can help treat chronic constipation.

If you’re using laxatives more than once a month, Dr. Bulsiewicz recommends talking to a doctor about longer-term solutions like stool softeners. Another remedy might be to take fiber supplements, which adds bulk to your stool to help you go, and an osmotic laxative—which draws water into your intestines to help stool pass easier— like polyethylene glycol (Miralax) or milk of magnesia.

In rare cases, your constipation might not respond to any medication. This could point toward pelvic floor dyssynergia, a condition that stops your anal canal and pelvic muscles from relaxing, says Dr. Bulesiewicz. If you have this condition, you may feel like you have to keep pooping even if you already went, or like you didn’t fully poop when you did go. Treating this often requires physical therapy.

How to Tell If Your Poop is Normal:

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Instead of relying on meds to help you go, though, work on preventing constipation in the first place. The easiest way to do so? Make sure to consume plenty of water and fiber. Exercise can help too, says Bulsiewicz. “When you move, your colon will move as well.”

Related: 5 Ways to Make Yourself Poop

Another trick: Try sitting on the toilet at the same time every day for five minutes. If you can’t poop, just leave. “Having a routine establishes a rhythm that your body can follow,” says Bulsiewicz. “After a few days, your body will amazingly start to recognize what you’re trying to accomplish and ramp up to help accommodate your goal. ”

Suzannah Weiss
Suzannah Weiss is a freelance writer and editor whose work has appeared in New York Magazine, The Washington Post, Playboy and more.

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Safe Medications to use When Pregnant

Allergies Colds Nasal Congestion	Benadry l (Diphenhydramine), Claritin, Claritin-D or Z yrtec ( cetirizine) Sudafed (pseudoephedrine) = DO NOT USE DURING FIRST 12 WEEKS OF PREGNANCY OR BREASTFEEDING	A void aggravating factors, Ocean Spray (Saline), Vicks (Metholatum), Vaporizer/Humidifier,
Back Pain	Tylenol (Acetaminophen)	Heat or Cold, massage, acupuncture, Chiropractor, maternity belt for back support, shoes with arch support, limits on lifting, sleep on side with pillow between legs, back stretches
Bloating Gas	Gas-X (Simethicone)	Avoid gas causing foods
Constipation	Stool Softener such as Colace (Docusate) Fiber: Senokot, Dulcolax, Metamucil, Fibercon, Citrucel, Konsyl Milk of Magnesia Fleets Enema Glycerin suppository	Increase fluid intake (64 to 96 oz per day), Prunes or prune juice daily, Increase diet fiber (fruits & Veggies), Regular exercise
Cough	Robitussin DM, Vicks 44 (Dextromethorpan)
Diarrhea	Imodium AD, Kaopectate **NO PEPTO-BISMOL**	Usually best to let it run its course, clear liquid diet for 24 to 48 hrs, Gatorade, BRAT Diet (bananas, rice, applesauce, toast)
Fever 100. 4*F	Tylenol (Acetaminophen)	Cool Compresses, increase fluid intake
Gas Pains:	Gas-X – Chew 1-2 tablets after meals and at bedtime or as needed. Maximum 6 in 24 hours. Mylicon-80 – 1 tablet after meals and at bedtime or as needed. Maximum 6 in 24 hours.
Headache	Tylenol (Acetaminophen)	Increase fluids, Rest, Stress reduction, massage, acupuncture, Chiropractor, Wann compress with lavender oil
Heartburn Indigestion	Rolaids – Chew 1-2 tablets every hour. Maximum of 24 tablets in 24 hours. Tums – Chew 1-2 tablets every hour. Maximum of 16 tablets in 24 hours. Maalox – 2-4 teaspoons 4 times per day. Best taken 20 minutes to 1 hour after meals and at bedtime. Zantac and Pepcid AC– Can be taken twice daily as needed	Frequent small meals, decrease fat intake, Wait to lie down after eating at least 30 min. Pineapple (fresh or frozen), Raw almonds, Papaya tablets, 1 Tablespoon of Apple Cider Vinegar with a chaser of one glass water
Hemorrhoids	Preparation H, Anusol HC, Tucks Pads Stool softeners (Docusate (Colace)) Mothers Love (Rhoid Balm)	A void constipation and staining, Increase Fiber & Fluids, Sitz baths, Ice packs,
Insomnia	Benadryl (Diphenhydramine) Tylenol PM (Acetaminophen & Diphenhydramine) Unisom (Doxylamine Succinate)	Warm baths, passion flower (tea), essential oil (Lavender), deep breathing, daily exercise and avoid caffeine
Leg Cramps	Calcium 1000mg at bedtime, Magnesium lactate or Citrate 5mmol in AM & mmol in PM	Avoid pointing toes, t1ex foot and elevate when cramping, increase fluids, hot shower or warm bath
Ligament pain	Tylenol (acetaminophen)	Maternity belt
Nausea & Vomiting	Unisom (Doxylamine Succinate) – Yi tab in AM and 1 tab in PM, Vitamin B6 50mg 3 times a day Tums Rolaids	Peppermint or Ginger tea or candy, sip ginger ale, Sea Bands (acupressure), Acupuncture, Toast or crackers before getting out of bed
Nosebleeds:	Saline Nasal Spray – Squeeze twice in each nostril as needed
Sore Throat	Tylenol (Acetaminophen), throat lozenges	Warm saline gargles, increase fluid
Swelling	Vitamin B6 50-100 mg per day	Lemon juice, watermelon, strawberries, cucumber, increase water intake, swimming Decrease salt intake, compression stockings
Yeast Infection:	Monistat 7, Mycelex 7, or Gyne-Lotrimin – 1 applicatorful in the vagina at bedtime. You can also spread some on the outside if needed. **DO NOT USE THESE MEDICATIONS BEFORE 13 WEEKS.**

90,000 “On the grows” in 13 minutes. Summary of Kolas’s novel

: A young teacher who has worked for several years in rural schools is fired from his post because of revolutionary activities. He connects his future life with the cause of the revolution.

Book 1. In the Polessye wilderness

A young teacher Andrei Petrovich Lobanovich, who recently graduated from a teacher’s seminary, is assigned to the remote Polessye village of Telshino. He quickly realizes that the “rural intelligentsia” is only capable of drinking, playing cards and dragging along the “panenkas”.Andrey does not find among them either a friend or a like-minded person. The exception is a young priest who helps local peasants.

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Lobanovic goes to work, trying not to be limited to the school curriculum. He wants to “awaken a“ critical thought ”in his students, so that they“ approach everything consciously, ”which he sees as the guarantee of a new life for the people.

Lobanovich visits his neighbor, the scoundrel Pan Barankevich, who considers himself the offspring of an old Lithuanian family and speaks the Belarusian language.Podlovchiy is married for the second time. Andrey likes the eldest daughter of the scoundrel Yadvisya, a slender, dark-skinned girl of about sixteen.

Lobanovich works with younger groups, prepares older students for the upcoming exams and finds high satisfaction in his work. Sometimes Andrei thinks that “he is not an important teacher at all,” and he decides to visit his friend and mentor Tursevich. Having stayed with him, Andrei realizes that he will not be able to stay in Telshshin for a long time, even for the sake of Yadvisi. He dreams of traveling to Belarus, while Tursevich is thinking about entering a teacher’s institute.Lobanovich believes that the institute kills all living things in the teacher’s soul that are still left after the seminary, and makes him a “dry kashchei-official”.

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Returning, Lobanovic understands that Jadvisya is interested in him. Andrei is not ready for marriage, “he was attracted by the unknown expanses of human life, free, creative work.” Love for him is an obstacle on the way, however, life is not dear to him without Yadvisi.

Soon the scoundrel’s daughters leave for a visit, and Andrei decides to throw Yadvis out of his head and “get closer to the people.”He organizes conversations with the peasants, but cannot find an approach to them. Andrey feels himself sinking into a quiet and warm swamp.

The return of Yadvisi pleases Andrei, but he cannot explain himself to her – he is stopped by timidity and caution. In the spring, Lobanovic hints to Yadvis that she means a lot to him. Sometimes a girl runs into the teacher’s apartment when he is not at home. One day Andrey finds her there and breaks the kiss. Since then, her name sounds like music to him.

After Easter Lobanovich learns that Yadvisya is leaving somewhere.Andrey is taking his senior students to exams. Returning, his beloved Lobanovich no longer catches. Where and why Yadvisya left, he does not know. Now nothing keeps him here. Having handed over the school to the village headman, Lobanovich leaves.

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Book 2. In the depths of Polesye

Part 1. In his native land

Andrey comes home for the summer, in the small village of Mikutichi near Neman. There he meets a seminary friend and fellow countryman Ales Sadovich, who is also dissatisfied with the first year of work.Like Lobanovich, Sadovich wants to find something new, meaningful in his life.

The Lobanovich family rents a small farm. Andrei’s father died long ago, and Uncle Martin runs the farm, trying to feed Andrei’s mother, two younger brothers and a sister. The land on the farm is lean, the rent is constantly increasing, and the Lobanovich family lives in poverty.

Lobanovich tries to join the family, but his mother and uncle consider him a “scientist” and protect him. Andrei tries to tell Uncle Martin how to increase the yield of the land, but he prefers to do business the old fashioned way. It is in Mikutichi that Lobanovich notices the disunity of the peasants, their unwillingness to learn something new.

Andrei often meets Sadovich, and one day he finds another friend, Janka Tukala, with him. Having become friends over the summer, the friends decide to correspond more often. At the end of summer, Andrei was assigned to the village of Vygony, near Pinsk.

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Part 2. In a new place

Andrey is the first in Vygoni who meets the clerk Amos Adamovich Botyanovsky, who arouses antipathy in him.Lobanovich is pleased with both the neat building of the school and his apartment, spacious and renovated. Andrei visits Father Nikolai, a rather pleasant man.

This time Andrey is not limited to lessons. He meets Aksyon Kale, a peasant from Vysoky. This intelligent man of about thirty cannot read and write, but due to his craving for justice, the local authorities consider him a dangerous person. Andrey undertakes to teach him to read and write.

Andrey’s outlook changes when he finds on the school porch a brochure revealing “the role of political organizations, on whose banners a ruthless, merciless struggle against tsarism was written.”Andrey is discussing the brochure with Kahl.

Sexton Botyanovsky considers Andrei a democrat and troublemaker and spies on him. Soon Lobanovich meets the teacher Olga Viktorovna Androsova from a neighboring village. Andrey finds a like-minded person in it. Botyanovsky spreads the news throughout the village, hoping to undermine the teacher’s reputation, but the Vygonovites see in this meeting only a love affair.

Now Andrey perceives all political events in a different light. Instead of instilling in children ideas that strengthen the current political system, Lobanovich limits himself to pure knowledge.Only with Kal Lobanovich talks about politics and destroys his faith in the tsar-protector. Soon a group of peasants begins to gather at Andrey’s place, to whom he reads proclamations and leaflets.

A new clerk, Matei Duleba, who previously worked as a teacher, appears in Vysokoe. Soon he informs Andrei that rumors are already circulating about his evening conversations with the peasants. Matei sympathizes with the teacher and asks to quit “this dark job”, knowing that she can lead to prison. But Andrey can no longer stop.

In January 1904, the war with Japan begins, which ends with the Portsmouth Peace Treaty, humiliating for the Russian Empire.Lobanovich, who has been living in Vygoni for two years, feels the expectation of something big and important among the people. He is disappointed with the defeat of Russia in the war, Olga is glad about it. She believes that an unnecessary war dealt a strong blow to the autocracy. Androsova, already a member of the underground organization, takes Andrey to a meeting of the underground cell of the Socialist-Revolutionaries and Narodnaya Volya.

Soon a “formidable wave of peasant uprisings” passed through Russia. Aksyon gathers a peasant gathering and calls for and burn the estate of the local landowner, but Andrei convinces the rebels to write a petition to the landowner with threats and demand to return their lawful lands. Having received the petition, the pan goes to Pinsk and raises his superiors to their feet.

A few days later, a “gigantic general strike” begins in the country, because “the concessions made by the tsar did not satisfy the insurgent people.” Lobanovich hopes for the victory of the revolution, but the strike is brutally suppressed. Andrei notices that, in addition to the clerk, policemen and people of the landowner are watching him. They try to arrest Aksyon, but he hides. Andrei is arrested and taken under escort to Pinsk.

Book 3.On the rostans

Part 1. Verkhan

Andrey gets out of an unpleasant case, which threatened with hard labor, thanks to a peasant petition. The authorities decided that with this document the teacher saved the man’s estate from ruin. Andrey is lowered and transferred to the opposite edge of Belarus, to the village of Verkhan. This time he shares responsibilities with another teacher. Lobanovich gets the older groups.

Unlike Polesie schools, one third of Lobanovich’s pupils are girls. Having chosen the strongest among the senior students, Lobanovich begins to prepare them for exams.

Andrei does not favor the rural intelligentsia, but he still pays a visit to the local priest, Father Vladimir Malevich. The priest’s house resembles a landowner’s estate, and the priest himself cohabits with a young housekeeper.

Lobanovich tries to go beyond the school curriculum and “to induce the inquisitive mind of his pupils.” Among the girls, the most capable is Lida Muravskaya, the daughter of a widow who lived on a farm near Verkhany. Not only classmates, but also the teacher himself are staring at the beautiful Lida.

In the spring of 1906, the first State Duma was created in Russia. Lobanovich places high hopes on it, believing that the Duma will limit the power of the emperor, but nothing comes of this, and soon the Duma ceases to exist.

Pupils of Lobanovich successfully pass the exams. During the holidays, Andrei stays in Verkhany. A partner introduces him to the widow Antonina Mikhailovna Muravskaya, after which the teacher often appears at the farm – preparing Lida to enter the teacher’s seminary.

Lobanovich plans to create an organization of rural teachers. He writes about his idea in allegorical terms to Sadovich. From the reply letter, Andrei learns that Yanka Tukala and several other seminary friends are living with Sadovich. Friends appoint “May Day” for the beginning of June. Meanwhile, Andrey likes Lida more and more, and the girl is drawn to the teacher. Once Lobanovich kisses her, repents greatly and decides that this will not happen again.

Soon Tursevich comes to visit Andrey.He is going to enter the teacher’s university and is diligently preparing for the exams. Tursevich does not support Andrei’s rebellious sentiments.

Lobanovich goes to the May Day in Mikutichi. Friends establish a revolutionary teachers’ union and draw up a decree describing their future revolutionary activities. When almost all the teachers disperse, a local police officer bursts into the apartment and grabs the signed protocol. A crowd of peasants gathers near the school, ready to protect the youth. Frightened by the crowd, the sergeant retires without arresting anyone.

The signatory teachers are now in danger. The main instigators decide to go to America. Lobanovich returns to Verkhan with a heavy heart. Tursevich is afraid for his future and leaves. Some time later, Andrei receives a package with a dismissal order.

At his father Vladimir Lobanovich meets the chief of the fighting Socialist-Revolutionary squad, whom the priest hides from the authorities. He advises Andrei to contact the party of revolutionaries.By becoming a member, the former teacher will receive help and work. For the first time, Andrei thinks about which game to choose.

Before leaving, Lobanovich comes in to say goodbye to Lida, but she meets him coldly – she does not need a homeless and unemployed Lobanovich.

Part 2. At the crossroads

After staying in Mikutichi, Lobanovich settles with his older brother Vladimir, an employee in the Radziwill forestry. Andrey goes to the nearest place for mail, where he meets Yanka Tukala. He informs Lobanovich that all the dismissed teachers are being watched.Yanka himself is also unemployed, becoming a frequent guest of Andrey.

Friends hide all forbidden literature in a deep forest under a rotten log. They believe that they cannot avoid interrogation, and prepare for it: they compose their own version of events and often rehearse it.

The peasants from the surrounding villages learn that a teacher lives in Smolyarna, and ask Vladimir “to talk with his brother, whether he will undertake to teach their lads.” A handicraft school opens at the forester’s estate. Andrei and Yanka cannot decide which political party is better.

Lobanovich receives a letter from Lida. The girl did not enter the city girls’ school, because the disgraced teacher prepared her for the exams. Now Lida is going to take courses for telegraph operators. Lobanovich understands that “their roads will not converge.”

Yanka brings Andriy a leaflet written by teachers of the Minsk province who are protesting against the illegal dismissal of their colleagues and are going to boycott the vacated positions. The title of the flyer is handwritten.

Soon Yanka learns that “a secret meeting of representatives of various revolutionary underground organizations was appointed in Minsk,” where the dismissed teachers are also invited.At the meeting, friends become even more entangled in political currents. Lobanovich meets Nikita Andreevich Vlasyuk, one of the founders of the first Belarusian newspaper. He offers Andrey to work in a newspaper.

In the spring, Lobanovic and Tukala move to Mikutichi, where the dismissed teachers flock. Friends inform them of the version invented for interrogation, and teachers accept this method of protection.

At the beginning of summer, Andrei receives a letter from Vlasyuk with an invitation to work and a vague promise to study at the University of Krakow.In the Vilna edition of the newspaper Lobanovich is assigned a closet. The newspaper brings almost no income, so Andrey works for food. Vlasyuk is only listed as an editor, and the founders of the newspaper are pro-Western. Studying in Krakow is an empty promise, a bait for newspaper employees. To feed himself, Lobanovich works as a tutor.

One night a bailiff comes to the editorial office and orders Andrey to leave Vilna within three days. Lobanovich takes the story to the main newspaper of the city “Vilensky Vestnik”, and in return receives a correspondent ticket.This small victory for Lobanovich does not help. The founders give Andrey a letter of recommendation to the Minsk lawyer Semipalov.

The lawyer is not at home. In “Minsk Voice” Andrei sees an article where “the participants of the teachers’ meeting in Mikutichi defamed in every way.” Andrei goes to the editorial office, and, introducing himself as a correspondent for Vilensky Vestnik, tells his version, after which Andrei’s article is published in Minsk Voice with a refutation and Kudesnik’s signature.

Andrei and Yanka spend the rest of the summer “in Uncle Martin’s spacious threshing floor” helping with the housework.In August Lobanovich has to appear in Minsk to testify. The interrogation proceeds in a strange way: the captain gives Lobanovich a sheet of paper, orders him to write down his version of events and releases Andrey. Only at home, Andrei realizes that during the interrogation they took a handwriting sample from him, wishing to accuse the protesting teachers of writing the leaflet.

Thanks to Kudesnik’s article, the Vilna Court of Justice exempts all teachers from court, with the exception of Lobanovich. He is being tried under a “convict” article. Semipalov’s lawyer argues that Andrei did not write the leaflet.This does not help – Andrei is displeasing to the authorities. In a crudely fabricated case, he receives three years of fortress.

In the cell, Lobanovich meets the silent Petersburg worker, the Bolshevik Alexander Golubovich. One day, Lida comes to prison, who has become a beauty. She is marrying the assistant to the station master, but is not happy about this, and as if she wants Andrei to stop her. But he is silent. Tukala has not been announced. Andrei does not believe that his bosom friend disappeared without a trace, and after his release he is going to find him.The advice of the St. Petersburg worker becomes the basis of Lobanovich’s activities in “further wanderings along new roads.”

Reviews

Olga

Review added: 02/23/2021

We stayed in the sanatorium from February 1 to February 11, 2021. We were treated for the first time. In previous years, they visited the sanatoriums of the Kurgan and Novosibirsk regions, Altai Territory. Arriving in Kolos, we realized that there was nothing to look for somewhere. Nearby, at home, there is everything and high quality. But let’s take a look at everything in order, starting with the purchase of a voucher for the action in the city office.Pre-phoned. Call center operators answered all my many questions very thoroughly, after which the purchase of a voucher did not take more than 10 minutes. I was glad that the native Kolos sets the task “to provide comfort for guests in everything. ” And we really felt it from the doorway. Natalya Nikolaevna, the administrator of the accommodation service, not only placed (without making us wait for the necessary minutes before check-in), but also carefully talked about the design of the sanatorium-resort card, helped us with moving around the territory.The cleaning service and all auxiliary (locksmith, carpenter, security guards, etc.) solved problems at the first request, and unnoticed by us. I would also like to note the professionalism of the medical staff and the separately attending physician Svetlana Aleksandrovna, who not only qualified the treatment, but also monitored its results before our departure home: by appointing my husband an EKG both at registration and at discharge and showing us positive results of the analysis in dynamics during the stay in the sanatorium.Not a single doctor, in any of the sanatoriums we visited, was so professional in treating his angina pectoris !!! And it became obvious to us that professionals work here with a capital letter! I would like to say a special thank you for the exercise therapy classes. This is the first time I missed a single one either! And what a set of exercises! It does not tire, does not strain, but at the same time it involves all muscle groups. Despite all the difficulties and workload in the ozone therapy room, Oksana also managed to carry out the procedures with high quality and always tried to find a convenient time for us to visit the office.I was also pleased with the service of the coordinators: they did what in other sanatoriums the patients do themselves in a coordinated, clear, prompt manner (they run around the rooms, sign up for procedures, make a schedule of their visits). And here everything is in one window in 5 minutes. Just super! Despite the fact that on the first day the spa card was issued before 12 noon, not a single procedure was lost, everything prescribed by the doctor on the same day began to be received! All the staff of the sanatorium, from the guards to the doctor, treated us like family for the entire period of their stay.And many thanks to everyone for that. We really felt warmth, care, friendliness !!! I would also like to note the work of the management of the sanatorium, which managed to create a wonderful team and focus it on high-quality work on the principle “the client (read the patient of the sanatorium) is always right” forgotten since Soviet times! Thank you for your care, warmth and comfortable stay, quality treatment. We realized that we don’t need to go and look for anything in the neighboring regions, we have the BEST SANATORIUM !!! Everything is relative! We look forward to seeing you again next year.

90,000 Minsk exhibition “The Artist and the City” is being held online – Rossiyskaya Gazeta

Malevich’s heirs gathered at Yakub Kolas

The exhibition “The Artist and the City”, taking place in Minsk for the ninth time, is now working in virtual reality. Anyone can walk along Yakub Kolas Square to the accompaniment of birdsong and city noises. The exhibition is dedicated to the 100th anniversary of the creative association UNOVIS, created in Vitebsk by the father of Suprematism, Russian artist Kazimir Malevich – another connecting thread of Russian and Belarusian culture.

“The Artist and the City” – a project of the Memorial Museum-Workshop of Zaire Azgur in Minsk. The place for the exhibition was not chosen by chance: the monument to Yakub Kolas and his literary heroes was created by this outstanding Soviet sculptor. Over the summer, about two million people manage to visit the art open-air. The project gravitates towards technical innovations and extraordinary innovative solutions – film screenings and even quiet concerts are held right on the square, when musicians perform live, and the audience listens to them in special headphones.The coronavirus pandemic prompted the authors of the idea to go into virtual reality: you can take a walk in the center of Minsk and join the work of contemporary Belarusian artists on the specially created website higminsk.by.

In virtual reality, the viewer gets the opportunity to go to Yakub Kolas Square, take a look at its surroundings, wander between stands with reproductions of works by artists. This is how the exposition will look in the real world when it takes its place in the park near the monument to the Belarusian classic. In the meantime, when you click on the reproduction, we are presented with a high-quality image with all the accompanying information in three languages, and the voice of the online guide, the popular young art critic Nikita Monich, also sounds. The works of Belarusian authors will move to the real world as soon as the epidemiological situation allows.

This year, on the occasion of the anniversary of UNOVIS, the Vitebsk Center for Contemporary Art became a partner of the exhibition.

– The idea of ​​organizing an exhibition dedicated to the 100th anniversary of UNOVIS and the collaboration with the Vitebsk Center for Contemporary Art is a historically justified, long-awaited step, says Oksana Bogdanova, director of the Zaira Azgur museum-workshop.- Yes, Zaire Azgur did not belong to the bloc of the left radical avant-garde art. But he was born in the Vitebsk province and his creative biography is associated with the phenomenon of the Vitebsk art school. In 1921-1922 he studied at the school of drawing and painting with Yudel Pen, through whose workshop Marc Chagall, Osip Tsadkin passed, and in 1922-1923 – at the State Artistic and Practical Institute (reorganized Vitebsk People’s Art School, discovered by Marc Chagall).

The exhibition will come home to every art lover – it doesn’t matter if you are in Belarus or in Russia

The project “The Artist and the City” uses 32 works by 16 Vitebsk artists – in particular, representatives of the “Kvadrat” association, who consider themselves the heirs of Kazimir Malevich and revolutionaries -suprematists: Alexander Maley – the founder of the association, Nikolai Dundin, Viktor Shilko, Alexander Dosuzhev, Alexander Slepov and Valery Chukin.

The project “The Artist and the City” after a month or two in Minsk usually went to the regions – to Vitebsk or Brest.

Do you want to know more about the Union State? Subscribe to our news on social networks.

Burger King actively grows with R-Keeper 7

Another new restaurant of the international franchise Burger King opened its doors yesterday in the capital of our Motherland. The restaurant is located in the center of Minsk along Yakub Kolas street, 28/1.

Congratulations to our partners with the opening of another restaurant! Since the opening of the first restaurant to this day, Burger King has been working with the professional system R-Keeper 7, which simplifies the daily work of the restaurant employees and provides great opportunities for the management of the chain management.

“R-Keeper” is a solution consisting of various modules that automate many business processes of the establishment.

“R-Keeper Manager” : The brain of a restaurant.It helps to conveniently set up a cash register to work with a flow of guests, work quickly with menus and prices, form flexible schedules of discounts and special offers, manage staff access to cash transactions, and provide timely reports on the restaurant’s operation of any complexity.

“R-Keeper” module “Cashier” allows you to quickly and efficiently serve guests, take into account the individual wishes of guests, control the actions of staff and is also a tool for additional sales

“R-Keeper VDU module” : Automation of cook and dispensing stations. In the “VDU” system, the dishes entered into the order are immediately displayed on the screen, which is especially convenient for fast food outlets, when order fulfillment should take a minimum of time. And also send information about the readiness of orders to the queue screen.

The module “Web-monitoring” is used in the “R-Keeper” system for remote control of the restaurant in real time. Allows the owners and managers of the establishment, from anywhere in the world, to remotely receive information about the sales and loading of the restaurant online.

Module “R-Keeper Self-service kiosk” : kiosk software that allows guests to independently place an order on a stand-alone terminal and pay by credit card.

All of the above software runs on professional POS equipment. And the service of the ITCAFE.BY company ensures the uninterrupted operation of restaurants 24 hours a day, 7 days a week throughout Belarus.

Harnessing the Power of Positive Thinking

Man’s worst enemies would not wish him

of those troubles that can bring him

own thoughts

(Eastern proverb)

The doctor has three remedies in the fight

with a disease – a word, a plant, a knife.

Avicenna

How our thoughts affect health

In one of the Parisian hospitals, at her own peril and risk, referring to the head physician, the young psychologist Emilie Kei made her patients to repeat out loud or mentally 10 times the phrase “Every day I feel better and better” three times a day aloud or mentally. And to repeat this not mechanically, but as brightly as possible.

Within a month, the patients of this doctor became the main source of conversations of the medical staff of the hospital, and then of the whole of France.It is surprising, but true: seriously ill patients recovered within a month, and in some patients the need for surgery even disappeared.

That is, the guess of the great scientist of antiquity Paracelsus, who argued that faith works miracles, was confirmed.

Our health depends a lot on our thinking!

It has been proven that there is a direct connection between the mental and physical state of people.

One of the most important psychological laws says: the verbal expression of love, sympathy and admiration enhances the vital energy of the person to whom it is addressed.And evil and unkind words reduce the energy of the listener.

The total number of diseases associated with bad thoughts continues to grow steadily. To resist them, one must follow the advice of the ancient sages – to enjoy life, no matter how hard it is!

So, health, life and destiny of a person directly depend on his thoughts: Thinking about good – expect good. Thinking about the bad – the bad and you get it.

Positive thinking man – the basis of intelligent, conscious activity, the basis of well-being, health and prosperity.

Whereas negative thoughts or so-called stereotypical thinking make many people suffer, be unlucky and unhappy.

There are several main types of stereotyped or negative thinking that distort the perception of the world and lead to negative thoughts. In turn, negative thoughts lead to appropriate feelings and emotions, and as a result, to inappropriate behavior.

Here are some examples of stereotyped thinking:

1. Polar thinking , according to the principle: “All or nothing.”Typical for adolescents and people with an anxious personality type. Thinking like this leads to passive behavior, poor health, and severe depression.
2. Thoughts as negative prediction . People predict the events of their future, extremely negatively. They do not take into account other possible outcomes, they can become depressed and suffer even before something bad (they invented) happens in reality.
3. Thinking that devalues ​​something positive. People see only negative in themselves and their deeds, forgetting and not noticing their positive experience, past successes and achievements. This kind of thinking can lead to emotional distress and inaction.
4. Distorted thinking based on emotional reasoning. Unconditional belief in the truth of any statement, ignoring the possibility of proving the opposite statement.
5. Stereotyped labeling . Giving yourself or others negative characteristics, excluding positive evidence. This kind of thinking leads to the destruction of relationships.
6. Minimizing Thinking . A person evaluates himself, others or a situation, exaggerating the negative, or downplaying the positive. This does not provide an opportunity to reveal their abilities and opportunities to achieve success.
7. Selective thinking . Taking into account only negative aspects: failures, defeats, without considering all events, including positive ones.Such people have many failures in life.
8. Mind Reading. The conviction that a person can really do this, excluding other possibilities. In communication, such people talk to themselves, as it were, without waiting for the answer of the interlocutor. (like, he asked himself – he answered, and got angry at his own answer …).
   These people have problems in communication and in personal relationships, and as a result – loneliness.
9. Over-generalization. Generalizing negative conclusions that go beyond the specific situation: “All men or women are bad, and the whole world is not good.”Such people repeat their failures in similar situations.
10. Personalization. The person considers himself the reason for the negative behavior of other people, ignoring the real reasons for their behavior. People with this mindset think that their mistakes and miscalculations are the focus of others. This can lead to neuroses and phobias.
11. Ownership. The belief that in a certain situation it is necessary to behave in a certain way.If this does not happen, it is perceived as a failure and causes suffering.
12. Tunnel Thinking. In this case, the person focuses his attention only on the negative aspects of a particular situation. He does not notice (ignores) that there are positive moments, solutions and exits.

If you find yourself in one or more types of stereotypical thinking, leading to negative or obsessive thoughts, bad mood, well-being and behavioral disturbances, then you should think about changing your thinking and beliefs.

The following exercise will help you change your thinking

1. Choose a quiet, calm place so that no one bothers you, sit comfortably, and ask yourself, “What would I like to have in my life, but do not have it yet?” Take a piece of paper and make a list of your wishes.
2. Then ask yourself the following question: “What do I have that I would not want to have?” Take a new piece of paper and make a list of what you would like to give up.
3. Compare both of these lists. Which one grabs your attention the most? If the “Don’t want, but have” list ranks first in terms of size and relevance, then this exercise will become even more important to you.
4. Re-read everything you “don’t want but have” and come up with a positive phrase that has the same meaning but calls something you “don’t have but want”. For example, if you do not want, but are overweight, then what you want, but do not have, is a slender figure.Replace each “I do not want, but I have” with “I want, but I do not have.”
5. Write down all the changed phrases in a single list of your wishes and keep them in mind. Reinforce positive thoughts regularly and you will achieve your goals.

How to implement this in practice? Sometimes our thoughts are very arbitrary, and no amount of willpower is able to rid us of unwanted thoughts. In such cases, seek help from your imagination. Remember that imagination is stronger than will, i.e.because it is rooted in the unconscious. Our unconscious is like a child – nothing can be taken away from it, it can only be replaced. Do not try to fight negative thoughts coming to you with an effort of will. Just replace them with positive ones by replacing the corresponding images.

How positive thinking helps in recovery

By mastering the energy of positive thinking, a person has the opportunity to connect the body’s natural ability to heal itself to the treatment process.

Each of us has a personal experience of recovering from the flu, colds, bruises, cuts, or anything else that our body once did a great job with. You can use this experience to free yourself from any other ailment, including psychosomatic diseases (diseases of the body, in the development of which psychological factors play a significant role).

Remember that if you have ever felt your possibilities, then you have acquired them forever.

Stress Management by S.A. Igumnov gives the following algorithm for self-healing with the help of positive thinking.

1. Imagine the process of your recovery in the past, feel it in a concise form. In just a minute, survive the entire illness from the very beginning until complete recovery. Try to make it bright, colorful, lively.
2. Now take yourself, the present one, sick of what you want to get rid of, to the place where you saw your quick healing. Create a “movie” in which you also quickly recover from your current illness.Make this “movie” absolutely similar to the previous one: the same size, brightness, color, speed of movement, the same location. Feel the process of your recovery as clearly as possible. Despite the fact that you yourself create this life experience, your body will perceive it as something quite real, and will treat your current illness, no matter how serious it may be, as something from which you can quickly and completely recover.

With the help of this technology, you define the current ailment as a disease from which the body already knows how to free itself.From this moment on, he will begin to receive subconscious signals for change every second, and you will feel yourself recovering. This technology will be a good addition to the main treatment you are taking.

Used literature:

Belarusian military newspaper For the glory of the Motherland, “Do not think about the bad, you will get sick.”

Psychoanalyst Matveev “Stereotypical thinking, negative thoughts of a person that interfere with life.”

S.A. Igumnov Stress management: modern psychological and drug approaches: – Mn.: I.P. Kolas, 2004.-76s.

Louise Hay, The Healing Power Within Us.

Prepared by psychologist I.D. Chernykh,

medical and psychological department

Electrodes with low diffusible hydrogen content

Low Diffusible Hydrogen Electrodes: History and Recommendations
Authors: Lincoln Electric Welding School Instructor Joseph Kolasa and Joseph Marlin, Welding Electrode Manager

Advances in metallurgy led to the development of stick electrodes for arc welding, which were first used for welding in shipyards during the First World War. As more and more sophisticated work procedures have been adopted in the shop and in the field, many welding industries have a need for reliable electrodes that can provide low diffusible hydrogen content in the weld metal.

As a result, a separate category of “low hydrogen” welding electrodes has appeared on the market. These versatile electrodes have become the preferred choice for a variety of applications and quickly gained widespread acceptance in industry.They are ideal for applications where base metal is susceptible to cracking, where thick sections are expected to be welded, or where the base metal has a high alloy content such as high carbon and low alloy steels.

Properties of electrodes
Low hydrogen electrodes can have increased deposition rate or fast solidification (for welding in difficult spatial positions) and can provide reliable connections, meet the requirements of X-ray inspection, and high toughness and fluidity.

Some hydrogens with low diffusible hydrogen content in the weld metal have a -1 suffix in the AWS classification.This suffix means that this electrode meets the requirements for increased strength characteristics.

Consumables can also have an additional diffusible hydrogen content identifier. This identifier can be h5, H8 and h26. “H” and the corresponding number represent milliliters of diffusible hydrogen per 100 grams of weld metal. For example, identifier h5 means 4 ml of diffusible hydrogen per 100 grams of weld metal.

The identifier “R” indicates that the electrode has a moisture resistant coating.To obtain such an identifier, the electrodes are exposed to 27 ° C at 80% relative humidity for 9 hours after being removed from the package or re-baked. The moisture content after this procedure should not exceed 0.4% by weight. Even a small excess of this threshold can lead to the appearance of porosity and other defects.

Although electrodes with a low hydrogen diffusivity in the weld metal are best suited for reverse polarity DC welding (especially with a diameter of 0.4 mm or less), they are also suitable for AC welding.What’s more, some EXX18 series electrodes, such as Lincoln Electric’s Excalibur® 7018, are specifically designed for AC welding.

Most common electrodes
Low diffusible hydrogen electrodes are the most common type of welding consumable in industries such as energy, general manufacturing, shipbuilding, difficult-to-weld steels, positional welding and piping (ASME uplift).

In particular, the most popular E7018 electrodes have some features that set them apart from all other series. They are well suited for welding in difficult positions other than downhill welding and have a high iron powder content for a stable and quiet arc with low spatter, medium penetration and high deposition rates. E7018 forms a lot of slag that can be easily removed.

This class of electrodes is also well suited for welding joints in high carbon or low alloy steels with high mechanical properties.The versatility of the E7018 electrodes makes them a good choice for many applications.

Welding technique and common problems
The success of using E7018 electrodes with X-ray inspection requirements and ensuring a low diffusible hydrogen content in the weld metal depends largely on the welding technique. The most common defects are pore formation and cracking.

It is also important to remember that the electrodes have to be changed frequently. Each electrode is only enough for a certain length of the connection, after which the work will have to be interrupted. Remember that incorrect re-ignition of the arc can lead to various problems.

One of the most common is an electrode that is too vertical, leading to a peak or lengthening of the arc. Many welders start welding too high and run the electrode over the crater. To avoid this, when reigniting, position the electrode at a height of 6-12 mm from the work piece or the previous seam.

Imagine you have a 20 cm plate and a 7 cm seam. Many welders would place an arc at the end of the previous seam and then run an electrode into the edge of the plate.Instead, to make the connection as smooth as possible, it is best to start 6-12 mm before the crater. The electrode should be directed directly into the joint at an angle of no more than 5-10 degrees.

Sometimes it is necessary to interrupt welding with an unused electrode and then resume work. It is likely that the tip of the electrode will have time to harden and the coating will become hard and brittle. Most operators then insert the electrode into the electrode holder and hit the surface like a hammer. This is not necessary, because this can break off part of the electrode coating, which will affect the formation of slag and can lead to displacement and cracking of the weld metal.

Instead, disconnect the electrode and rub it firmly against the surface of the welding table. Don’t knock them. It is necessary that, after friction, the electrode core protrudes at the tip – this will make it possible to establish good electrical contact and provide good gas protection.

In addition, to prevent the accumulation of moisture after opening the package, the electrodes must be stored under suitable conditions. Electrodes with low diffusible hydrogen content in the weld metal can be baked to remove moisture.Contact the electrode manufacturer for recommended parameters for this procedure.

Thus, in order to ensure high quality WDS, especially with the use of electrodes with a reduced content of diffusible hydrogen in the deposited metal, it is necessary to know the appropriate welding technique. Understanding how these electrodes work and learning high quality welding techniques will pay off completely with reliable welds and no porosity issues.

Major breakdowns in hydrophores (pumping stations)

Water supply stations are very widespread.
In almost every house there are stations that pump water, but sometimes break down. We will consider breakdowns in hydrophores, when the pump stopped pumping water, when the pump often turns on, when water flows from the pump, and we will touch on the topic of choosing a pumping station for a residential building.
1. When the water station starts to turn on and off frequently when water is turned on. Here the problem is related to the accumulator, which is a tank, and inside the tank there is a membrane and compressed air. What’s happening?

• diaphragm rupture.
  When it bursts, water fills the entire tank and the required pressure on which the relay is triggered is created very quickly. Because the amount of water that is needed for a given pressure builds up quickly as the tank is full. And the station starts to work with short-term switching on and off. In order to check whether the membrane is whole or not whole, you do not need to unscrew the flange. It is enough just to push on the nipple of the air supply. And from there the air should be puffed out when the membrane is intact.If water poured out of the nipple, then you need to change the membrane. The tank is easy to disassemble. We unscrew the bolts and remove the flange, take out the membrane. The inside of the tank must be well dried so that the water (remaining) does not destroy the inside of the tank. We insert a new membrane, making sure that the membrane fits well around the entire circumference of the flange attachment. We attach the flange and tighten the bolts.
• Air leaking from the tank.
  If there are leaks or cracks at the seam or at the flange connection.Either the air comes out at the place of air pumping through the nipple (you can replace the nipple). Or the tank is rusted. Or a crack in the weld. It turns out that the pressure in the tank drops and the station starts to turn on and off frequently. In this case, replace the tank.

2. The pump has stopped pumping water, but the engine is running.
depressurization. This means that there is air leakage at the connections where there is a check valve (compression sleeve). These places need to be examined carefully. It happens that the check valve bursts and the pump starts pumping air instead of water.It happens that the polyethylene pipe is not tightly squeezed in the seat and air is sucked in the compression sleeve. If the pipe is scratched and air is passing through it, sanitary silicone can be used to seal it. Wait 30 minutes for drying before use. Make sure there is water in the well.
3. Mechanical wear of pump parts.
there is an impeller inside, which can fail due to the presence of sand in the water. The impeller is erased.when the drilling was done, the mesh on the pipe was incorrectly selected. as sand can be of different sizes and shapes. in this case, it is advisable to put a filter (only an oblique sedimentary filter is allowed) at the pump inlet. However, such a filter will not protect against fine sand.
4. The pump has stopped pumping water, but the engine will not start.
the relay has failed, which turns off the pump when the required pressure is created. and when the pressure drops, the spring raises the contacts and the electric motor turns on.If the station is in the basement, then this spring rusts and bursts. if the engine does not smell like burnt plastic, then you need to pay attention to the relay.

5. The pump does not stop.
can be adjusted, the pressure at which the pump is turned off. When adjusting, REMEMBER that the terminals may be energized.

6. Water flows in the pump between the motor and the pumping part.

Periodically, the station can be turned on and the pump pumps up water that was lost. So the matter is in the oil seal, which is leaking.