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Stool softener docusate sodium: Docusate Sodium Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Docusate Sodium – an overview

Case scenario.

At 94 years, Evelyn retained a regal demeanor, sitting in her chair holding court with four generations of offspring attending to her, although she did not allow much to be done for her. With end-stage heart disease as an admitting diagnosis, along with osteoarthritis, cataracts, and hearing loss, life had become a challenge. She insisted on doing almost everything herself, despite exerting high levels of energy expenditure. An initial physical therapy visit offered recommendations to make the environment safer and easier to move around, and adjust her equipment for improved comfort and efficiency. Monthly visits were scheduled to reassess her safety and mobility, and to instruct various caregivers in different ways to assist as Evelyn’s condition became more fragile. Begrudgingly she allowed more help with bathing, dressing, and other tasks.

Because sitting was her primary position of comfort both day and night, skin integrity and pressure relief concerns were addressed. Adapting her chair to an optimal height with the fabrication of a platform underneath the entire chair elevated the seat height while maintaining the other comfort features and eliminated the instability of multiple cushions. She enjoyed doing some exercises while she sat, if someone did them along with her, and the family was more than willing to comply. Her family’s concerns about potential falls were discussed repeatedly and at length in the context of physical limitations, quite variable patient willingness to have assistance or use devices, and Evelyn’s right to self-determination. Evelyn was under hospice care for 8 months, long enough to celebrate her 95th birthday. Just a week later, her daughter found her in her chair one morning, having expired peacefully during the night.

Traditional physical therapy might have been offered on a very short-term basis to achieve a specific short-term goal and then the patient would have been discharged as she did not have rehabilitation potential. However, under hospice, supportive, palliative care can be provided, easing the transition to dependency and facilitating a safe and comfortable patient-directed death.

Correctol Stool Softener – 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?

Correctol Stool Softener is no longer being manufactured for sale in Canada. For brands that may still be available, search under docusate sodium. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

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/Correctol-Stool-Softener

Colace Capsules (docusate sodium) dose, indications, adverse effects, interactions.

.. from PDR.net

CLASSES

Enemas for Constipation
Softeners, Emollients

DESCRIPTION

Anionic surfactant used to treat constipation
Available as calcium salt or as the sodium salt; no apparent clinical difference between the two salts
At recommended doses, exhibits little stimulatory actions and thus not considered a laxative; stool softening effects apparent after 1—3 days of therapy

COMMON BRAND NAMES

Colace, Colace Clear, Correctol, D.O.S., DC, Diocto, Doc-Q-Lace, Docu Liquid, DocuLace, Docusoft S, DocuSol, DOK, DOK Extra Strength, Dulcolax, Enemeez, Genasoft, Kao-Tin, Kaopectate Liqui-Gels, Phillips Stool Softener, Silace, Stool Softener, Stool Softner DC, Sur-Q-Lax, Surfak, Uni-Ease

HOW SUPPLIED

Colace/Colace Clear/Correctol/D. O.S./DC/Doc-Q-Lace/DocuLace/Docusate/Docusate Calcium/Docusate Sodium/Docusoft S/DOK/DOK Extra Strength/Dulcolax/Genasoft/Kaopectate Liqui-Gels/Kao-Tin/Phillips Stool Softener/Stool Softener/Stool Softner DC/Surfak/Sur-Q-Lax/Uni-Ease Oral Cap: 50mg, 100mg, 240mg, 250mg
Colace/Diocto/Doc-Q-Lace/Docusate/Docusate Sodium/Silace Oral Syrup: 15mL, 60mg
Colace/Diocto/Docu Liquid/Docusate/Docusate Sodium/Fleet/Silace Oral Liq: 1mL, 5mL, 10mg, 50mg
Diocto/Docu Liquid/Docusate/Docusate Sodium/Fleet Oral Sol: 5mL, 15mL, 50mg
Docusate/Docusate Sodium Oral Susp: 5mL, 50mg
Docusate/Docusate Sodium/DocuSol/Enemeez/VACUANT Rectal Enema: 100mg, 283mg
Docusate/Docusate Sodium/DOK/Stool Softener Oral Tab: 100mg

DOSAGE & INDICATIONS

For the prevention or treatment of constipation.

Oral dosage (oral liquid-filled capsules, soft-gels, or tablets containing docusate sodium)

Adults, Adolescents, and Children 12 years and older

50 to 300 mg/day PO given in single or divided doses.

Children 2 to 11 years

50 to 150 mg/day PO given in single or divided doses.

Oral dosage (capsules containing docusate calcium)

Adults, Adolescents, and Children 12 years and older

240 mg/day PO.

Oral dosage (oral solution containing 10 mg/mL docusate sodium)

Adults, Adolescents, and Children 12 years and older

50 to 200 mg/day PO given in single or divided doses. Up to 500 mg/day PO in divided doses recommended per treatment guidelines for idiopathic childhood constipation.

Children 2 to 11 years

25 to 100 mg/day PO given in single or divided doses. Per treatment guidelines for idiopathic childhood constipation, 12.5 to 25 mg PO 3 times daily has been recommended.

Infants and Children 6 months to 1 year†

12.5 mg PO 3 times daily, recommended per treatment guidelines for idiopathic childhood constipation. In clinical practice, 10 to 40 mg/day PO given in single or divided doses has also been used effectively. Use only under medical supervision.

Oral dosage (oral syrup containing 60 mg/15 mL docusate sodium)

Adults, Adolescents, and Children 12 years and older

60 to 360 mg/day (15 to 90 mL/day) PO given in single or divided doses.

Children 2 to 11 years

60 to 150 mg/day (15 to 37.5 mL/day) PO given in single or divided doses.

Rectal dosage (283 mg enema; e.g., Enemeez)

Adults, Adolescents, and Children 12 years and older

1 to 3 rectal enemas daily as needed. A bowel movement is generally produced within 2 to 15 minutes of administration. Do not use product for longer than 1 week unless under the supervision of a physician.

Children 2 to 11 years

1 enema (283 mg) per rectum daily as needed; only use after consultation with a physician. A bowel movement is generally produced within 2 to 15 minutes of administration. Do not use product for longer than 1 week unless under the supervision of a physician.

Rectal dosage (283 mg enema; e.g., Docusol)

Adults, Adolescents, and Children 12 years and older

1 to 3 rectal enemas daily as needed. A bowel movement is generally produced within 2 to 15 minutes of administration. Do not use product for longer than 1 week unless under the supervision of a physician.

Rectal dosage (100 mg enema; e.g., Docusol Kids)

Children 2 to 11 years

1 enema (100 mg) per rectum daily as needed. A bowel movement is generally produced within 2 to 15 minutes of administration. Do not use product for longer than 1 week unless under the supervision of a physician.

Rectal dosage (oral solution)

Adults

50 to 100 mg PR of docusate liquid in saline or water as a retention enema.

Oral dosage (oral solution containing 50 mg/15 mL docusate sodium)

Children 2 to 11 years

50 to 150 mg/day (15 to 45 mL/day) PO given in single or divided doses.

MAXIMUM DOSAGE

NOTE: Do not exceed recommended dosage limits for the specific product; specific OTC products, for example, may specify slightly different recommendations from other products on the product label.

Adults

240 mg/day PO for docusate calcium; 360 mg/day PO for docusate sodium; 849 mg/day (three 283 mg enemas) PR docusate sodium.

Geriatric

240 mg/day PO for docusate calcium; 360 mg/day PO for docusate sodium; 849 mg/day (three 283 mg enemas) PR docusate sodium.

Adolescents

240 mg/day PO for docusate calcium; 360 mg/day PO for docusate sodium; 849 mg/day (three 283 mg enemas) PR docusate sodium.

Children

>= 12 years: 240 mg/day PO for docusate calcium; 360 mg/day PO for docusate sodium; 849 mg/day (three 283 mg enemas) PR docusate sodium.
2 to 11 years: 150 mg/day PO for docusate sodium; 283 mg/day PR for docusate sodium.
< 2 years of age: Safety and efficacy have not been established; however, 40 mg/day PO of docusate sodium has been used.

Infants

Safety and efficacy have not been established; however, 40 mg/day PO of docusate sodium has been used.

DOSING CONSIDERATIONS

Hepatic Impairment

Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

Renal Impairment

Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

ADMINISTRATION

Oral Administration

Oral Solid Formulations

Give tablets or soft-gel capsules with full glass of water.

Oral Liquid Formulations

Oral solution: Measure the dose to be administered using a calibrated measuring device to ensure accurate dosing. Solution should be mixed with 6–8 ounces of milk, fruit juice, or infant formula to mask the bitter taste and prevent throat irritation.

Rectal Administration

Rectal mini enema: The patient should lay on their left side with top knee bent and arms resting comfortably. Alternatively, the patient may kneel, then lower their head and chest forward until left side of the face is resting on a surface with arms folded comfortably. Open tube by twisting off and removing tip. Moisten the shaft of the tube with water or a few drops of the medication. Applying lubricant to the anal area is recommended before inserting enema. With steady pressure, carefully insert the tube shaft into the rectum. Squeeze tube to empty contents and keep the tube squeezed until completely removed from the rectum. Discard empty tube.

STORAGE

Generic:
– Store at room temperature (between 59 to 86 degrees F)
Colace:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Colace Clear:
– Store at room temperature (between 59 to 86 degrees F)
Correctol:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
D.O.S.:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
DC:
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Diocto:
– Store at room temperature (between 59 to 86 degrees F)
Doc-Q-Lace:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Docu Liquid:
– Store at room temperature (between 59 to 86 degrees F)
DocuLace:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Docusoft S:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
DocuSol:
– Store at room temperature (between 59 to 86 degrees F)
DOK:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
DOK Extra Strength:
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Dulcolax:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Enemeez:
– Protect from freezing
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Genasoft:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Kaopectate Liqui-Gels:
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Kao-Tin :
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Phillips Stool Softener:
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Silace:
– Protect from freezing
– Store at room temperature (between 59 to 86 degrees F)
Stool Softener :
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
Stool Softner DC :
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Sulfolax:
– Protect from moisture
– Store at room temperature (between 59 to 86 degrees F)
Surfak:
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Sur-Q-Lax :
– Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F
Uni-Ease :
– Store at 77 degrees F; excursions permitted to 59-86 degrees F
VACUANT:
– Protect from freezing
– Store at 77 degrees F; excursions permitted to 59-86 degrees F

CONTRAINDICATIONS / PRECAUTIONS

General Information

There are few absolute contraindications to the use of docusate; do not use docusate in patients with a known hypersensitivity to the drug or any of the product components.

Abdominal pain, GI bleeding, vomiting

Before self-treatment with a docusate laxative, patients should be advised to consult their health care professional if they notice a sudden change in bowel habits that persists for two weeks. Patients should not use this product for a period >= 1 week without health care provider consultation. Patients should not use this product if they are experiencing abdominal pain, nausea, and/or vomiting. In addition, if the product fails to produce a bowel movement after use or if rectal GI bleeding occurs, patients should be instructed to discontinue use of laxative and consult their physician as this may indicate a serious condition. If a patient is using a rectal formulation, the patient should be encouraged to follow proper administration techniques; forcing the enema may result in injury and damage to the rectum. For patients with impaired rectal function, including loss of sensation, occasional rectal examinations are warranted.

Pregnancy

Docusate salts are generally considered to be low risk in pregnancy, due to their lack of systemic absorption and lack of adverse effects on hydration and nutritional status of the pregnant mother. No reports linking the use of docusate salts to congenital defects in humans have been published and epidemiologic data do not support an association between the drug and congenital defects. Docusate salts are sometimes found within the formulations of prescription prenatal vitamins to help prevent constipation from iron or other minerals. As with all medications, the pregnant patient should consult her qualified health care professional prior to the use of non-prescription stool softeners like docusate, and should follow recommendations on the duration of use. The safest first-line treatments to use for constipation during pregnancy are those that are not absorbed systemically (e.g., fiber, bulk-forming laxatives) in order to minimize drug exposure to the fetus.

Breast-feeding

There appear to be no precautions for the use of docusate salts during breast-feeding. In general, stool-softeners are not significantly absorbed systemically and thus should not appear in breast milk in amounts that would generate clinical concern. Agents that are non-absorbed or poorly absorbed (e.g., bulk-forming laxatives or stool softeners) are often the preferred drugs for use in the lactating female when such therapy is necessary.

Geriatric

The federal Omnibus Budget Reconciliation Act (OBRA) regulates the use of medications in residents (e.g., geriatric adults) of long-term care facilities. The OBRA guidelines caution that stool softeners, such as docusate, may cause accumulation of stool and possible bowel obstruction if not used with a sufficient amount of fluid or in patients with other causes of impaired bowel motility.

ADVERSE REACTIONS

Mild

throat irritation / Early / 0-1. 0
diarrhea / Early / 0-1.0
rash / Early / 0-1.0

DRUG INTERACTIONS

Calcium Phosphate, Supersaturated: (Moderate) Patients should be instructed not to administer additional laxatives or purgative agents during treatment with sodium phosphate monobasic monohydrate; sodium phosphate dibasic anhydrous.
Dichlorphenamide: (Moderate) Use dichlorphenamide and docusate together with caution. Dichlorphenamide increases potassium excretion and can cause hypokalemia and should be used cautiously with other drugs that may cause hypokalemia including laxatives. Measure potassium concentrations at baseline and periodically during dichlorphenamide treatment. If hypokalemia occurs or persists, consider reducing the dichlorphenamide dose or discontinuing dichlorphenamide therapy.
Loop diuretics: (Moderate) Loop diuretics may increase the risk of hypokalemia especially in patients receiving prolonged therapy with laxatives. Monitor serum potassium levels to determine the need for potassium supplementation and/or alteration in drug therapy.
Mineral Oil: (Major) The concurrent use of docusate salts with mineral oil to relieve constipation is not recommended because docusate can increase the systemic absorption of mineral oil. Inflammation of the intestinal mucosa, liver, spleen and lymph nodes may occur due to a foreign body reaction. Mineral oil deposition has been detected at these sites.
Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous: (Moderate) Patients should be instructed not to administer additional laxatives or purgative agents during treatment with sodium phosphate monobasic monohydrate; sodium phosphate dibasic anhydrous.

PREGNANCY AND LACTATION

Pregnancy

Docusate salts are generally considered to be low risk in pregnancy, due to their lack of systemic absorption and lack of adverse effects on hydration and nutritional status of the pregnant mother. No reports linking the use of docusate salts to congenital defects in humans have been published and epidemiologic data do not support an association between the drug and congenital defects. Docusate salts are sometimes found within the formulations of prescription prenatal vitamins to help prevent constipation from iron or other minerals. As with all medications, the pregnant patient should consult her qualified health care professional prior to the use of non-prescription stool softeners like docusate, and should follow recommendations on the duration of use. The safest first-line treatments to use for constipation during pregnancy are those that are not absorbed systemically (e.g., fiber, bulk-forming laxatives) in order to minimize drug exposure to the fetus.

There appear to be no precautions for the use of docusate salts during breast-feeding. In general, stool-softeners are not significantly absorbed systemically and thus should not appear in breast milk in amounts that would generate clinical concern. Agents that are non-absorbed or poorly absorbed (e.g., bulk-forming laxatives or stool softeners) are often the preferred drugs for use in the lactating female when such therapy is necessary.

MECHANISM OF ACTION

Docusate is an anionic surfactant (i.e., a surface-active agent). It lowers the surface tension at the oil-water interface of the feces, allowing water and lipids to penetrate the stool. This helps to hydrate and soften the fecal material, facilitating natural defecation. At usual recommended doses, docusate exhibits little intrinsic stimulatory actions and thus cannot be considered a laxative. Docusate has a delayed onset of action, with softening of the stool becoming apparent after 1—3 days of therapy.

PHARMACOKINETICS

Docusate calcium is administered orally; docusate sodium is administered orally and rectally. Because docusate salts are minimally absorbed and exert their effects locally, standard pharmacokinetic parameters do not apply. Some systemic absorption occurs in the jejunum and duodenum, but the extent of this is unknown and unlikely to be significant; any systemically absorbed drug is subsequently excreted in the bile. Fecal softening begins 1 to 3 days following initiation of oral docusate administration.
 
Affected cytochrome P450 isoenzymes: none

Docusate Sodium Vs. Docusate Calcium

Stool softeners relieve you of constipation.

Medication stool softeners docusate sodium and docusate calcium, help relieve your bowel constipation. Each medication softens your stool creating easier evacuation from your rectum. Both stool softeners should not be used long term. By adding roughage and increased fluids to your diet, you will experience therapeutic effects of bowel movements. Before beginning a laxative or stool softener talk to your physician and obtain advice.

Rectal Laxatives

Rectal laxatives remain used in conjunction with oral stool softeners. Rectal Laxatives provide relief when pregnant, bedridden, after giving birth and after surgery.

Similarity and Differences

Docusate sodium and docusate calcium bring relief from constipation. Both medications need water in your bowel for absorption to soften your stool. Both have similar side effects. Both stool softeners require short-term use. Your doctor should take charge of these medications as well. Your doctor will provide the dosage for each stool softener. The difference is the way the medication is manufactured. Each stool softener contains a different base.

Your doctor may prescribe stool softeners to relieve you of constipation. The stool softeners docusate sodium and docusate calcium can be used interchangeably. Both medications soften your stool and relieve constipation. Do not use these stool softener medications long-term as health problems will occur. Health problems such as dehydration and dryness of stool occur with long-term use.

Causes of Constipation

Medications such as narcotics, which cause slow down of bowel activity may cause constipation. A low physical activity level such as lack of exercise will also cause constipation. Health problems and lack of proper nutrition cause constipation.

Contraindications

Stool softeners should not be used in cases of impacted feces, undiagnosed abdominal pain, an intestinal obstruction, appendicitis, nausea and vomiting.

Side Effects

Side effects may occur with stool softeners occurring as palpitations, dizziness and fainting. These side effects indicate you need medical help. Other side effects may include abdominal cramping, nausea, vomiting, flatulence and increased bowel activity such as diarrhea. If these side effects continue and become bothersome call your doctor for advice.

Docusate

src: www.biovea.com

Docusate, also known as docusate salts or dioctyl sulfosuccinate, is a laxative of the stool softener type used to treat constipation. It is considered a good choice in children who have hard feces. For constipation that occurs as a side effect of opiate use, it may be used alone or with a stimulant laxative. It may be taken as a capsule by mouth or as a rectal suppository. Usually it works within one to three days.

Side effects are uncommon. Rarely, there may be abdominal cramps or diarrhea. Efficacy decreases with long-term use, and may cause poor bowel function. Docusate is acceptable during pregnancy and breastfeeding. It works by allowing more water to be absorbed by the feces. It typically comes in the form of a sodium, calcium, or potassium salt.

It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication and is not very expensive. In the United States, one hundred doses are about 14 USD. The sodium salt, dioctyl sodium sulfosuccinate, also is used as a food additive, emulsifier, dispersant, and wetting agent, among other uses.

Video Docusate

Medical use

Constipation

Docusate is used to treat constipation, and in painful anorectal conditions such as hemorrhoids and anal fissures, to help avoid pain caused by straining during bowel movements.

Given orally, the effects usually are seen 1 to 3 days after the first dose. Given rectally, as an enema or suppository, a bowel movement usually occurs within 5 to 20 minutes.

The drug may be used in people who are receiving opioid medication, although prolonged use may cause irritation of the gastrointestinal tract. Data supporting its efficacy in treating chronic constipation are lacking.

The effectiveness of laxatives for constipation in those receiving palliative care is unclear, as it has not been sufficiently studied. The comparative effectiveness of different laxatives in this group also is unclear as of 2015.

Other

Docusate sodium, when used with ear syringing, may help with earwax removal.

Available forms

Docusate sodium may be given by mouth or rectally. It also is used as an emulsifier and dispersant in topical preparations. When taken by mouth it is typically recommended with plenty of water.

Maps Docusate

Contraindications

Docusate is contraindicated in patients with appendicitis, acute abdomen, or ileus. It is not suitable for the treatment of chronic constipation, since its mode of action is as a symptom reliever, not a cure for any specific underlying cause.

src: www.drugs.com

Side effects

Possible side effects are typically mild and include stomach pain, diarrhea, or cramping. Serious allergic reactions may occur with the drug. The most severe side effect of docusate, although very rare, is rectal bleeding.

src: rychlepujckyihned.pw

Interactions

Docusate should not be used in addition to mineral oil, as the emulsifier will result in mineral oil being absorbed rather than functioning as a lubricant for the bowel walls, possibly resulting in foreign body granulomas. The substance also might increase resorption of other drugs, for example, dantron (1,8-dihydroxyanthraquinone).

src: www.drugs.com

Other uses

Dioctyl sodium sulfosuccinate is used as a surfactant in a wide range of applications, often under the name Aerosol-OT. It is unusual in that it is able to form microemulsions without the use of co-surfactants, and it has a rich variety of aqueous-phase behavior including multiple liquid crystalline phases.

  • Dioctyl sodium sulfosuccinate is a pesticide adjuvant, used popularly for crops of olives, almonds, wine grapes, corn, and oranges.
  • It is used as an excipient in the production of tablets (as a lubricant) and suspensions (as an emulsifier).
  • It is the most widely used surfactant in reverse micelle encapsulation studies.

src: rychlepujckyihned.pw

Chemistry

Solubility of dioctyl sodium sulfosuccinate in water is 1:70 (14 g/l) at 25 °C, increasing to 1:20 at 70 °C. Solubility is better in less polar solvents: 1:30 in ethanol, 1:1 in chloroform and diethylether, and practically unlimited in petroleum ether (25 °C). It also is highly soluble in glycerol, although this is a rather polar solvent.

The ester groups are easily cleaved under basic conditions, but are stable against acids.

Docusate salts include docusate calcium, docusate sodium, and docusate potassium.

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Mechanism of action

Docusate does not stay in the gastrointestinal tract, but is absorbed into the bloodstream and excreted via the gallbladder after undergoing extensive metabolism.

The effect of docusate may not necessarily be all due to its surfactant properties. Perfusion studies suggest that docusate inhibits fluid absorption or stimulates secretion in the portion of the small intestine known as the jejunum.

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Toxicity

Toxicity for different species varies widely, but dioctyl sulfosuccinate biodegrades quickly in soil and water, a typical finding being >90% in 12 to 17 days. In the atmosphere, it is predicted to be removed by a photochemical reaction with an estimated half-life of 18 hours.

Humans

Dioctyl sodium sulfosuccinate is a strong irritant for eyes and lungs, and also a skin irritant. Ingestion may cause the side effects described above, such as diarrhea, intestinal bloating, and occasionally cramping pains. Dioctyl sodium sulfosuccinate is not known to be carcinogenic, mutagenic, or teratogenic.

Marine species

Dioctyl sodium sulfosuccinate has been determined to be of low toxicity for crustaceans such as the hermit crab Clibanarius erythropus and the shrimp Crangon crangon. The median lethal dose (LD50) for these species is about 100 mg/l of a docusate-containing formulation after 48 hours of exposition, although the concentration of the formulation is not specified in the study.

Toxicity for molluscs varies widely, with 48-hour LD50 found between 5 mg/l for the common limpet and 100 mg/l for the common periwinkle. Various species of phytoplankton have an LD50 around 8 mg/l. All of these doses refer to a particular formulation (mentioned in the reference), not the pure chemical.

In a 2010 study, dioctyl sodium sulfosuccinate exhibited higher toxicity against bacteria (Vibrio fischeri, Anabaena sp.) and algae (Pseudokirchneriella subcapitata) than did a number of fluorinated surfactants (PFOS, PFOA, or PFBS). Measuring bioluminescence inhibition of the bacteria and growth inhibition of the algae, the ED50 were in the range of 43-75 mg/l. Combinations of the fluorinated compounds with dioctyl sodium sulfosuccinate showed mid to highly synergistic effects in most settings, meaning that such combinations are significantly more toxic than the individual substances.

Freshwater species

The substance is highly toxic for rainbow trout with a median lethal concentration (LC50) of 0.56 mg/l after 48 hours for the pure substance. It is only slightly to moderately toxic for rainbow trout fingerlings, and slightly toxic for harlequin rasboras (LC50 27 mg/l of a 60% formulation after 48 hours).

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Society and culture

Brandnames

In the U.S., dioctyl sodium sulfosuccinate is available under multiple brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace, Docu Soft, Docucal, Doculax, Docusoft S, DOK, DOS, Doss-Relief, DSS, Dulcolax – Stool Softener (not to be confused with another drug marketed under the Dulcolax brand, bisacodyl, which is a stimulant laxative), Ex-Lax Stool Softener, Fleet Sof-Lax, Genasoft, Kasof, Laxa-basic, Modane Soft, Octycine-100, Pedia-Lax, Preferred Plus Pharmacy Stool Softener, Regulax SS, Sulfalax Calcium, Sur-Q-Lax, Surfak Stool Softener, and Therevac-SB. Generic preparations are also available.

In the UK, dioctyl sodium sulfosuccinate is sold under the brand name Docusol (Typharm Ltd) and DulcoEase (Boehringer Ingelheim).

In Australia, dioctyl sodium sulfosuccinate is sold as Coloxyl and Coloxyl with senna.

In India, preparations include Laxatin by Alembic, Doslax by Raptakos Laboratories, Cellubril by AstraZeneca, and Laxicon.

References

External links

  • Stool Softeners at the N.I.H. PubMed Health resource.

Source of article : Wikipedia

What is senna

what is senna Many naturopaths, herbalists and practitioners of traditional Chinese medicine consider senna leaves to be powerful natural laxatives and inappropriate Senna bicapsularis is a species of the legume genus Senna, native to northern South America, from Panama south to Venezuela and Colombia, and also the West Indies. The linear seedpods are 4 to 6 inches long, tend to be erect and contain numerous compressed Senna Clinical Teaching • Stop use and contact prescriber if you develop nausea, vomiting, persistent diarrhea, or abdominal cramps. • If constipation worsens or you experience no relief, contact prescriber. Each tablet contains 8. Image via Riot Games. Do not start, stop, or change the dose of any drug without checking with your Ayrton Senna (BRA) McLaren MP4/8 took a record sixth Monaco victory and a fifth success there in a row. If it hits an enemy it latches onto them hungrily, rooting them and everything nearby after a brief delay. Senna sends forth a wave of Black Mist. The dose of this medicine will be different for different patients. SENNA (SEN uh) is a laxative. This can be corrected by adding stomach herbs such as ginger or fennel, which make up 1/4 of the total. She originally had a yellow ribbon, but she later switched it with the red ribbon. Senna fruit seems to be gentler than senna leaf. The leaflets are oval and lance shaped with pointed tips. Concerns related to chronic use of the laxative have made the FDA reclassify it from category I (Generally Regarded as Safe) to Jun 04, 2018 · Senna is an herb that comes from a variety of flowering species of Cassia plants, often used to make senna tea. Senna is an FDA-approved over-the-counter (OTC) laxative. Senna normally causes a bowel movement within 6 to 12 hours, so it may be taken at bedtime to produce a bowel movement the next day. Its laxative effect has been investigated in detail. COMMON BRAND NAME (S): Colace, Dok Plus, Laxacin, Peri-Colace, Senexon-S, Senna Plus, Senna-S, Senna Jun 23, 2020 · Senna is best described as a Marksman type champion, like most in her archetype she finds her home in the bottom lane, though with Senna she does so as a support. Also an herb from the Senna plant. What Is Senna? Senna is a herbal flowering plant that has been used for hundreds of years, not only as a laxative but also as a hair dye. 27. This erect, shrubby herbaceous perennial is the larval food source for two sulphur butterflies. * Long term ratings: 3. This HolisticZine write-up provides information on the side effects of Senna. She is usually seen in a light-brown colored shirt with a brown skirt and maroon tie. His Formula One racing career began in Brasil in 1984 and ended in San Marino in 1994. It is used to treat constipation. Senna leaf, fruit and pods have been used in tea form as a purgative or natural laxative for centuries. Aug 01, 2021 · If you are taking other medicines, take senna 2 or more hours after these medicines. Senna is a herb that is generally used for its laxative properties. It may also be used to empty and prepare the bowel for surgery or examination. The senna plants are small shrubs of Leguminosae cultivated either in Somalia, the Arabian peninsula and near the Nile … SENNA (SEN uh) is a laxative. Dose: 4 to 5 fluid ounces. It can work faster than other alternatives, like docusate (Colace), but it can also cause cramps. Aug 31, 2019 · This McLaren Senna has about 1,000 hours of work put into it, and most of it is because of the amount of custom options chosen by the lucky owner. When dosed adequately, senna + docusate usually produces a bowel movement between 6 and 12 hours after a dose. It is may be taken once or twice daily. Sep 14, 2021 · Senna/docusate is an over-the-counter (OTC) product used to treat constipation. The lowest GoodRx price for the most common version of docusate sodium/sennosides is around $3. Senna is an herb. Using Magnesium For Constipation. Although it’s natural, it is not free of side effects. Many are used medicinally; some yield tanbark used in preparing leather. Includes senna side effects, interactions and indications. Senna bicapsularis is a species of the legume genus Senna, native to northern South America, from Panama south to Venezuela and Colombia, and also the West Indies. Flowers give way to arching, pea-like seed pods (to 4 in. Jun 11, 2021 · Senna is an herb. To observe the detailed work that has gone into every aerodynamic element of the McLaren Senna is mesmerising. Oct 05, 2013 · Senna contains active chemicals in it called sennosides. Senna alexandrina belong to Senna, which is a large genus of flowering plants. Senna is a natural laxative, derived from leaves of the Senna plant. DOCUSATE SODIUM; SENNA contains a stool softener and a laxative. This is a phase IV clinical study of how effective Senna (senna) is for Constipation and for what kind of people. It is very much based around his exploits on the track, his private Jun 24, 2019 · Senna tea is an herbal tea preparation made from the pods, leaves and fruit of the Cassia senna plant. Since it’s a nonprescription laxative, it is commonly used for treating constipation. Aug 06, 2015 · Senna plant medicinal uses and photos. To experience it all working in unison is truly incredible. 6 mg of senna and 50 mg of docusate. * Senna pods are the seed pods of the senna plant. Jun 11, 2021 · Senna is an FDA-approved nonprescription laxative. Follow your doctor’s orders or the directions on the label. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. It works by irritating and stimulating intestinal cells, producing contractions in intestines, water influx to the intestines and bowel movement. You should, however, take precautions when you use any laxative to treat constipation, including senna pods. It works by interacting with the bacteria in the digestive tract, resulting in intestinal contractions. It is a perennial and small hrub, which grows up to 10 meters. See full list on verywellhealth. . The following information includes only the average doses of this medicine. Senna leaves are often sold as part of detox teas because they have a powerful laxative effect and can help relieve constipation, which affects 16 to 33 percent of adults. This plant is easy to propagate by seeds started in the early fall or by The senna laxative is a well known treatment for constipation and in this article we’re going to dig a little deeper to find out if senna is the best and safe solution to help relieve your suffering. Senokot-S Generic Tablets generally produces bowel movement in 6 to 12 hours. Feb 19, 2020 · The Senna has a staggered wheel layout, with 19-inch rims in front and 20-inch wheels at the rear. Clinical trials have shown that Senna increases the frequency of bowel movements and is effective as a laxative for occasional constipation. If you notice any other effects, check with your healthcare professional. Do not start, stop, or change the dose of any drug without checking with your Senna (Senokot®, Senna) Available as tablets or capsules. Senna is generally safe and well tolerated, but can cause adverse events including clinically apparent liver injury when used in high doses for longer than recommended periods. DOCUSATE SODIUM; SENNA (doc CUE sayt SOE dee um; SEN na) contains a stool softener and a laxative. Riot promised to share details of what Senna will be like in-game during the Worlds 2019 quarterfinals on Oct. She Long term ratings: 3. senna, any of several plants, especially of the genus Cassia, in the pea family (Fabaceae), mostly of subtropical and tropical regions. acutifolia), Senna is a type of shrub native to North Africa, the Middle East and parts of Asia. Macerate for an hour in a covered vessel, and strain. 42, 61% off the average retail price of $8. She Dec 06, 2018 · Senna is a natural herb whose leaves come from the Cassia senna plant. Senna is a documentary based around the career of Ayrton Senna, regarded by many as the greatest racing driver who ever lived. It can be available as the sole ingredient in tea or it may be combined with other detoxifying herbs, such as chamomile, milk thistle, dandelion or turmeric. The medicinal plant is used mainly for severe constipation, for example, one that occurs against the background of fever. For Senna, the appearance of being a wraith is a form-swap while camouflaged (similar to Evelynn’s Demon Shade). SENNA- senna tablet, film coated HIMPRIT PHARMACHEM PVT LTD Disclaimer: Most OTC drugs are not reviewed and approved by FDA, however they may be marketed if they comply with applicable regulations and policies. Senna (茜雫, Senna) is a Shinigami that Ichigo Kurosaki and Rukia Kuchiki meet in the Human World. With good early game harras, a strong transition into the mid to late game, and a global ultimate at level 6, Senna is the type of support that can carry a match. Formula One World Championship, Rd 6, Monaco Grand Prix, Monte Carlo, 23 May 1993. A prescription is not required to purchase senna. Apr 18, 2019 · Senna is LIKELY SAFE for most adults and children over age 2 when taken by mouth, short-term. You may report side effects to the FDA at 1-800-FDA-1088. Senna is so effective it is an FDA-permitted monograph ingredient for the treatment of occasional constipation. Call your doctor for medical advice about side effects. Nov 26, 2021 · Senna tea is a popular herbal treatment made from the leaves of the senna plant, typically Cassia acutifolia or Cassia angustifolia. The study is created by eHealthMe from 100 Senna users and is updated continuously. This plant is easy to propagate by seeds started in the early fall or by Aug 01, 2021 · Incidence not known. Senna Plus Natural Vegetable Laxative with Stool Softener is a gentle strength laxative plus a stool softener, for hard dry stools. For kidney disease patients, they may experience more and more problems and complications with the progress of their illness condition. This medicine is used to relieve constipation. The active ingredients are compounds called anthraquinones . Senna leaves have been extensively used by Ayurveda and other traditional system of medicine as a laxative. The dose in powder is from 1/2 to 2 1/2 drachms. Nov 26, 2021 · Senna can take 8-12 hours to have an effect. Magnesium is often recommended to help ease the burden of constipation and is an easier solution than consuming May 01, 1994 · Ayrton Senna da Silva was the world’s fastest Grand Prix driver in the 1980s and 1990s. Available as soluble tablets? No. These chemicals irritate the lining of the stomach and prompt the body to empty its bowels, thereby being an effective constipation reliever. I’ve used Senna for years at the recommendation of a doctor and this brand because of the value, quality and known gentle relief without painful side effects. He died from injuries sustained in a high speed crash at the Tamburello corner at the Autodromo Enzo e Dino Ferrari Circuit at Imola, located in the tiny principality of . E Curse of the Black Mist. Senna draws the Mist she has stored in her weapon into a storm around her, embracing darkness and becoming a wraith within. The Senna plant is widely used in herbal medicine. For the infusion, add 1 ounce of the leaves and 1 drachm of coriander seeds to 1 pint of boiling water. However, long-term use of some types of laxatives is not recommended. Senna is one common herb, and its leaves and fruits can be made into medicines. The leaves are pinnate with opposite pair leaflets. Senna can cause some side effects including stomach discomfort, cramps, and diarrhea. Senna is a purgative, similar to aloe and rhubarb in having as active ingredients anthraquinone derivatives and their glucosides. Senna is a young girl with large amber eyes and purple hair tied with a red ribbon to it. Oct 18, 2019 · Senna is the first support marksman to join League. The Library of Medicine page, using the Natural Medicines Comprehensive Database, gives effectiveness ratings for various uses of senna. Jan 20, 2018 · Senna is an herb that comes from several different flowering species of the Cassia plants. Other side effects not listed may also occur in some patients. Senna contains sennosides which acts as a stimulant laxative. S. In fact, senna is approved by the U. blood in the stools. Mar 22, 2021 · Senna tea is a popular way to relieve constipation, thanks to its effectiveness as a laxative. Nov 22, 2019 · Senna arrived in League of Legends two weeks ago as a unique support marksman whose abilities are both offensive and defensive. Many species of senna are used medicinally, particularly to combat constipation. All models come with an audacious wing spoiler, and the car’s multitude of functional intakes and Aug 01, 2021 · Incidence not known. nausea or vomiting. Tablets. The meaning of senna is any of a genus (Cassia synonym Senna) of leguminous herbs, shrubs, and trees native to warm regions : cassia; especially : one used medicinally. Commonly found in tea and supplements, this herb is also an ingredient in many detox, or detoxification teas. The senna plants are small shrubs of Leguminosae cultivated either in Somalia, the Arabian peninsula and near the Nile … Senna is a herb that is generally used for its laxative properties. Food and Drug Administration (FDA) for use as a nonprescription laxative. When she transforms into a Shinigami Oct 27, 2020 · Senna can irritate the intestinal mucosa and cause colic, pain or nausea, as well as sparse stools or diarrhea. 85. Senna likewise has her aura buff and the ‘Wraith Form’ buff, but her ‘Wraith Form’ does not share gameplay functionality with other allies benefiting from Wraith Form. Indian senna decreases pita and allows free movement of vata in the body. Senna consists of the dried leaflets or fruits of Cassia senna (C. The senna laxative is a well known treatment for constipation and in this article we’re going to dig a little deeper to find out if senna is the best and safe solution to help relieve your suffering. Learn about side effects, dosages, drug interactions, and more. In ancient China, the leaves and the plant, in general, was used as a laxative. Senna, also known by its longer name, sennosides, is an over-the-counter (OTC) laxative that can help with occasional constipation. Clusters of brownish yellow, pea-like flowers top unbranched stems in summer. Feathery, compound, locustlike, green leaves. It’s also used to relieve hemorrhoid discomfort and to prep for colonoscopies. It is in a class known as stimulant laxatives. The leaves, flowers, and fruits of the senna plant have been used in tea as a laxative or stimulant for Senna was born in the Pro-Matre Maternity Hospital of Santana, a neighbourhood of São Paulo. Senna 1/5 that it is safe for you to take this drug with all of your drugs and health problems. This plant is drought tolerant once established and tolerant of wet soils. Herbalists and natural doctors recommend senna pod supplements to treat mild cases of constipation. Senna is cathartic and should be used in combination with other cathartic herbs of its kind to work best (see below Senna Works Best) for bowel elimination. Dec 05, 2018 · Laxatives can help relieve occasional constipation. Senna is a natural medicine derived from the senna plant. Senna leaves is believed to have various benefits as an herbal herb for constipation, detoxification and helps to lose weight. Feb 03, 2021 · Senna herbal use is very common in traditional medicine. Senna is an herb commonly used to treat constipation. What is the meaning of the name Senna? The name Senna is primarily a female name of English origin that means The Senna Plant. Some sennas are among the showiest flowering trees. 2/5. Senna is a medicinal plant used for its laxative capabilities. Apr 01, 2020 · Senna (Cassia species) is a popular herbal laxative that is available without prescription. Black, tarry stools. The middle child of a wealthy Brazilian family, he was born to landowner and factory owner Milton da Silva and his wife Neide Senna da Silva; he had an older sister, Viviane, and a younger brother, Leonardo. It is best taken in the evening. Senna was born in the Pro-Matre Maternity Hospital of Santana, a neighbourhood of São Paulo. Senna plant is a flowering plant. Senna is also known as wild senna, cassia marilandica, or locust plant. Steeping the leaves for 10 minutes in boiling water should make for a tea that will produce results in about 12 hours – it’s best to drink the tea Jun 04, 2018 · Senna is an herb that comes from a variety of flowering species of Cassia plants, often used to make senna tea. This 1,000 count bottle is a fantastic deal and especially for anyone requiring the recommended dose a few times a week initially, then occasional use during the month. People who like the name Senna also like: Lucia, Evangeline, Lily, Sadie, Anna, Zoe, Elsa, Felix, Leo, Silas, Kellan, Oliver, Peter, Vincent Names that sound like Senna: It acts like Senna, but is weaker, and should be combined with aromatics. The leaves and the fruit of the plant are used to make medicine. long) which turn black in fall and ornamental through winter. Available as a liquid? Yes. Alexandrian senna (C. com Jun 11, 2021 · Senna is an herb. stomach pain. Jul 08, 2017 · Senna + docusate (Senna-S) is commonly taken at home on a scheduled basis to prevent constipation and maintain normal, regular bowel movements daily or every other day. These investigations suggest that it helps to maintain a harmonious peristalsis of large intestine. It acts like Senna, but is weaker, and should be combined with aromatics. May 02, 2021 · Senna is a laxative is used treat constipation. Common names include rambling senna (formerly “cassia”), winter cassia, Christmas bush, money bush, and yellow candlewood. acutifolia) known in commerce as Alexandrian senna and of Cassia angustifolia commonly known as Tinnevelly senna. Dosing . Senna is an FDA-approved nonprescription laxative. Senna can be a traditional support in every aspect, from her runes Apr 26, 2012 · Senna typically does the trick for constipation because the chemicals in it, called sennosides, irritate the lining of the colon and force contractions in the bowel. American Senna is a perennial in the bean family native to moist forested areas and disturbed sites in eastern North America. These are powerful laxatives . Available as something for placing Nov 22, 2019 · Senna arrived in League of Legends two weeks ago as a unique support marksman whose abilities are both offensive and defensive. Anthraquinone derivatives or glycosides present in this species are responsible for the laxative effects of this herb. This website stores data such as cookies to enable essential site functionality, as well as marketing, personalization, and analytics. Its ascending, branching stem has spirally arranged compound leaves with four to six pairs of leaflets. It helps in lowering bowels and increasing the peristaltic movement of the intestines. Showy light orange to yellow flowers form seed pods that attract birds. But is that all true? This vid Apr 18, 2019 · Senna is LIKELY SAFE for most adults and children over age 2 when taken by mouth, short-term. Ayrton Senna (BRA) Williams FW16 ran for most of the race in 2nd position until he spun out and retired on lap 55. Indian senna purifies blood and restores the metabolic imbalance lost due to indigestion. Senna is an FDA-approved nonprescription medicine. It is used to treat constipation and also to clear the bowel before diagnostic tests such as colonoscopy. The plant is an effective natural laxative, and the leaves can easily be brewed into a tea with proven effects fighting constipation. Senna – Champions – Universe of League of Legends. The herb stimulates liver for proper secretion of enzymes in the body. Mar 31, 2021 · What is Senna Plant? Senna plant is a flowering plant that is native to North Africa, currently grown in China and India on a large scale. It is one of the safe and effective remedies in the treatment of constipation. If you are still constipated after taking senna for three days, make an appointment to speak with your doctor. Coffee senna is an erect, smooth, hairless, foul-smelling annual growing 2 to 6 feet tall. With medical big data and AI algorithms, eHealthMe enables everyone to run phase IV clinical trial to detect adverse drug The McLaren Senna is the ultimate distillation of the company’s ‘form follows function’ design mantra. Senna is also used for irritable bowel syndrome , hemorrhoids, and weight loss. Nov 23, 2021 · Senna comes as a liquid, powder, granules, chewable pieces, and tablets to take by mouth. Jun 24, 2019 · Senna tea is an herbal tea preparation made from the pods, leaves and fruit of the Cassia senna plant. Stimulant laxatives irritate your intestinal lining, which promotes bowel movement. what is senna

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How to make a poap

How to make a poap

how to make a poap Once you are there, connect your wallet and click “Show me my Badges” to be taken to your POAP collection. Quick and easy, while sharing HSSE advice as well!Subscribe to Peter’s View – FUN si Here’s how: Open your Microsoft Project plan (s), go to the Add-ins tab, and click the OnePager button. Nov 16, 2021 · What is a POAP Event? Each event grants one POAP token to attendees. Jul 24, 2016 · I can create the POAP view in MS Project using the Gantt. Who knows – maybe there will be a raffle for the holders of the POAP in future. Also try to make your bathroom environment relaxing and hygienic. 12. The last number of the gas spent on the block the raffle starts is used to eliminate all the POAPs with an ID terminating on that digit. Like Sign in to like this comment Dec 01, 2021 · Users may make their own POAP collections to show off their travels. These NFT badges are given out to prove attendance of an event, whether it took place virtually or in the real world. Aug 21, 2021 · Below is a flowchart representing the POAP process: To maintain system security and make POAP more secure, configure the following: Enable DHCP snooping. Back in the days in Windows Movie Maker, you had to speed up a clip or slow it down to change the pitch. Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For POAP. Create a POAP. The chain means that attendance at these events can not be faked or edited. In order to acquire badges and engage in various activities, users need to hunt for QR codes at POAP sponsored events. fun uses an elimination system based on the POAP token ID and the gas usage of ethereum blocks. Sep 05, 2021 · POAP (pronounced poh-ap) is an acronym for Proof of Attendance Protocol. Jun 29, 2020 · Make like a caveman and squat The Continence Foundation of Australia recommends sitting with your knees higher than your hips for optimal pooping. This helps soften stool in order to make it easier to pass without straining the body. If you ignore this reflex and go to bathroom according to your own timing, these abdominal forces will be absent. POAP use a very popular standard identified by the acronym ERC-721, they are minted on the xDai Ethereum sidechain by default which allows you to claim them without paying a single gwei of gas. Try a glycerin suppository. Create your collection of CriptoPOAPs. A person can take part in limitless events, but there are two stipulations. 1 RAIDs Log Below is an example RAIDs log template which can be used to track Risks, Assumptions, Issues and Dependencies (and other lists) for the project. 11. There are fiber supplements like Metamucil that you mix with water, or Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For These abdominal forces help you in pooping. Since we Aug 18, 2021 · I have created a POAP for my first 50 followers. It will provide an easier, more comfortable bowel movement. An Excel Plan On a Page (POaP) (daily and monthly tabs) are also included as a separate spreadsheet if required. So, follow your reflex if you want to have a big one. The move comes after the project saw a huge increase in its users as well as some “bad actors” who are fetching POAPs from events without attending them. Dec 01, 2021 · Users may make their own POAP collections to show off their travels. I can’t make you follow me, but I would be very happy if you would do! I will keep the list updated as best as I can. Only one POAP token is granted for each event. Many projects, programmes and portfolios manually produce such POAP summaries which consumes valuable time and the process is prone to errors. that never fade. Results are fully auditable using easy to operate open source tools. Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For These abdominal forces help you in pooping. If you don’t have OnePager Pro yet, download a free demo license and follow along. art is the newest experiment by POAP that sits at the intersection of art and technology. We use cutting edge technology to enable everyone to create collectible records of meaningful experiences. Agile Release Planning. So, an agile project generally has a fixed delivery cadence, fixed time-boxes, or a fixed number of iterations, but in general when to expect a piece of functionality to be delivered is only a forecast calculated from historical lead times rather than a fixed date. Click on the token you want to migrate and scroll down. Here you have to fill out the following details. A Plan-on-a-Page (POAP) is a vital tool to present your project plan in a easy to understand Summary Plan. Jun 11, 2021 · Special thanks to the team at POAP who helped facilitate the drop. Make sure you comply with all the image requirements. Create your souvenir or collection NFTs for proof of attendance or participation in a social experience. Set firewall rules to block unintended or malicious DHCP servers. Memories. Even organizers can issue POAPs for any event. POAP is supported on both MGMT ports and in-band ports. Feb 16, 2018 · However, making changes to diet and lifestyle should put a stop to constipation and help to keep bowel movements regular. The UI of an ongoing raffle shows the Max Gas per block and when auditing the elimination of poaps it is the last digit of this number which determines which poaps get knocked out. Nov 15, 2021 · Making POAP artwork in Figma with the ShapeShift DAO template Graymachine gives you a walkthrough of using the ShapeShift DAO Figma template to make the artwork for your next POAP. This generates codes that you provide to people that have somehow engaged with your event (again, this is pretty arbitrary). Unfortunately, the design has the unintended consequence of making collectors swarm for them. Creating a POAP is easy, just head to this link and fill out the form. Aug 18, 2021 · How to Create a Plan on a Page (POAP) If you have a complex project plan or even several project plans, you may be asked to create a plan on a page (POAP), which is another word for an executive summary timeline or Gantt chart. POAP (pronounced poh-app) is a platform that creates a new way of recording experiences by providing tokens in the form of NFTs stored on the Ethereum sidechain, xDai. Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For Click on ‘Create new POAP’. Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For Nov 01, 2021 · POAP Vote A sybil-resistant voting engine for anyone to run polls using Ethereum and POAP Create Poll. Enter, the blockchain -based POAP. You must attend the event to receive a token. Setting Up the Network Environment to Use POAP Procedure Dec 01, 2021 · Users may make their own POAP collections to show off their travels. This section just lists out the example HTTP request and response for reference. Make sure you wallet is connected to the Ethereum Mainnet. Nov 29, 2021 · Some larger festivals and events, like Burning Man, still create intricate collectible badges, but otherwise for the most part, “proof of attendence” tokens essentially disappeared. What is POAP? The Proof of Attendance Protocol is a dapp that distributes badges in the form of ERC-721 tokens to prove you participated in an event. It all starts by creating an event on the platform, customizing the badges, and handing them out to your community. A POAP is a digital collectible (token) with certain features that when it’s grouped together with other POAP tokens create a collection. Check the comments for the claim links, and make sure to claim your POAP. The examples will show the following steps to configure POAP: Nov 29, 2021 · Some larger festivals and events, like Burning Man, still create intricate collectible badges, but otherwise for the most part, “proof of attendence” tokens essentially disappeared. Get the Figma template here: POAP use a very popular standard identified by the acronym ERC-721, they are minted on the xDai Ethereum sidechain by default which allows you to claim them without paying a single gwei of gas. OnePager can help you filter your project plan (s) down to the correct level of detail, and will build your plan on a Dec 01, 2021 · Users may make their own POAP collections to show off their travels. Active Polls Finished Polls Active Polls Active 9 hours 50 . From the start screen, choose NEW to start creating your plan on a page: Aug 23, 2021 · 1- Create your POAP. Each badge is unique, meaning that the only way to get a certain POAP is to be at the event. Designs POAPs are an easy to customize token and you can make any type of design you desire as long as it’s within POAPs specifications. To do so, you might need to use a footstool. This creates exclusivity for the people who were really there and claimed the POAP. But, nothing beats excel for charts, pivots and data analysis. Here we show a great method to create your POAP for any type of project. . Lin: Make sure you’re drinking plenty of water with your fiber for maximum benefits. POAP Badge Artwork by Zexsoft Nov 25, 2021 · Users may make their own POAP collections to show off their travels. How to claim your POAP. Oct 17, 2021 · POAP, the Ethereum blockchain’s attendance badge project, has announced some major changes in its operations to enhance its security. Sep 01, 2020 · A stool softener is a type of laxative that contains docusate sodium and docusate calcium. Good sources of fiber include whole grains, nuts and seeds, and plenty of fruits and Dec 01, 2021 · Users may make their own POAP collections to show off their travels. 2) You will be taken to the Create Event page. POAP Examples How to use the DFA REST APIs to Control POAP You can use any programming language that supports Web services to create a Web services client that invokes the DCNM POAP Web services API. In general, a POAP may be released to you as a collector at special events, experiences, and other outings. This video walks you through the first step of creating a POAP. Whilst it is exciting watching one poap after the other getting eliminated, a question of unfair distribution came to my mind. art is an interactive digital canvas that allows artists of all skill levels to collaborate with one another, make original pieces of pixel art, and mint them as an NFT; effectively cementing your art digitally on the blockchain forever. Ideally the summary should be tailored to your audience and needs to be accurate and trusted. Aug 22, 2021 · How to create your own POAP. Events can be virtual or in-person, short or long-lasting. If you register four people, for example, for the Hawk Hustle and each of them would like a POAP, set up an account for each either by repeating the process above or, in your Metamask browser extension, click on the big circle in the upper right corner and “Create Account”. More info on the dapp and the multiclient token can be found here . (Art + Metadata) in IPFS + (NFT + ERC721) in Blockchain = POAP. POAP. In their absence it becomes difficult to make a poop. Mar 11, 2021 · Fiber won’t make you poop instantly, but if you increase your fiber now, you’ll start to see the effects in a day or two. POAP is an open-source protocol that anyone can use to issue digital collectibles. 2. 1. Stool softeners work best for people who have temporary, mild constipation. Pitch shifting is when you make a clip more high pitch or low pitch. In agile release planning, the unbound constraint is usually scope. 1) Follow the link to the POAP BackOffice and click on “Create new POAP”. Nov 29, 2021 · Users may make their own POAP collections to show off their travels. CRIPTOPOAP. In Vegas, all you have to do is click on the clip’s audio and press the plus (+) and minus (-) keys. Sep 15, 2021 · The POAProtocol provides you with a method to migrate your POAPs to the Mainnet at POAP Scan. Organizers may modify the looks and items they offer participants by creating their own event on the POAP platform. If you have any doubts about what you should include in these fields, please check out our FAQs. After creating the POAP event, you will receive a confirmation email which will indicate that you reply with the amount of codes you need for the attendees of your event. Walking, exercising, and drinking fluids are all ways to help. Aug 11, 2021 · You create a POAP event for this, listing location, dates, how long POAPs can be minted (more on this soon), and a few other details. It’s an easy and cool process to undertake, and we’ve now seen some of our community members jump on board to make their own — dropping badges for the Glade, Empire and Horde factions — which have been claimed more than a cumulative 500 times! Jan 04, 2021 · Making you feel heavy and lethargic by literally weighing you down… I’d like to show you this one unusual jungle fiber you can add to your diet… That Acts Like Nature’s Own “Drano For These abdominal forces help you in pooping. Name of the POAP: How should your POAP be called? You can just use the name of your event. Feb 15, 2021 · Pro tip, per Dr. Collectors can quickly accumulate a unique collection of POAPs An Excel Plan On a Page (POaP) (daily and monthly tabs) are also included as a separate spreadsheet if required. how to make a poap

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90,000 No taboo: constipation and how to avoid it

Blessed is he who early in the morning
has a chair without compulsion –
Tom and food are on their way,
and all pleasures are available.
A.S. Pushkin

We are ready to spend hours discussing headache and joint pain, sciatica, colds and allergies, but problems with stool are still a kind of taboo. It is not customary to talk about them not only with friends, but also with the closest people. It is all the more surprising that the great Russian poet did not ignore such a delicate problem with his attention, and even more – devoted a quatrain to this topic.However, the shyness that our contemporaries often display when it comes to constipation does not at all beg for its significance and the discomfort it brings to everyday life, poisoning not only the body as a whole, but also the mood, taking away vitality and energy.

Constipation, or as it is commonly called in medical practice, constipation / constipation, although it has become widespread in recent years – 30-50% of the adult population are familiar with this problem, it has been known for more than one millennium (Zvyagintseva T.D., Gridneva S.V., 2008). Treatment of chronic constipation includes a change in diet, correction of dysbiosis and treatment of the underlying disease, the appointment (if necessary) of laxatives, prokinetics.

Not all laxatives are created equal!

In cases where a balanced diet has not given the expected effect, they resort to various laxatives. However, when choosing such a drug, it should be borne in mind that many of them are not recommended to be taken for a long time, some may be addictive, requiring an increase in the dose.

Agents such as anthraglycosides and diphenols (eg senna leaf, rhubarb root, aloe, buckthorn) cause chemical irritation of the nerve endings of the intestinal wall. This leads to increased peristalsis, impaired absorption of water and electrolytes, as a result of which an increase in the volume of intestinal contents is achieved and the period of time required for its transit through the intestines decreases. However, it is very important to remember that irritating laxatives can cause degenerative changes in the intestinal receptor apparatus, resulting in the development of intestinal atony (Zvyagintseva T.D., Gridneva S.V., 2008).

In addition, there are studies indicating that colorectal cancer is associated with long-term use of irritating laxatives. Therefore, the admission of such should be treated with great caution and used only sporadically.

Another group of laxatives – substances that contribute to the softening of feces and their sliding. These include liquid paraffin, petroleum jelly, sodium docusate, almond and olive oils. They slow down the absorption of water from feces and soften intestinal contents.However, it is important to remember that with prolonged (more than 1 month) use of emollient laxatives, disorders associated with the absorption of fat-soluble vitamins A, D, E may occur (Loranskaya I.D., 2007), and after 6-12 months, the likelihood of addiction increases and as a result, it becomes necessary to increase the dose (Zvyagintseva T.D., Gridneva S.V., 2008).

An overdose of laxatives may be accompanied by the development of diarrhea and, as a consequence, dehydration, electrolyte disturbances.

Therefore, many of these drugs are not recommended for use in pregnant and breastfeeding women, children and the elderly, as well as in the presence of a number of diseases of the internal organs and the nervous system.

In this context, attention is drawn to substances with osmotic properties – salts, carbohydrates and alcohols of carbohydrates, the mechanism of action of which is based on an increase in osmotic pressure in the intestinal lumen, which contributes to the retention of water in it and its additional absorption from the plasma.As a result, the feces are liquefied and their passage through the intestines is accelerated. The degree of increase in osmotic pressure depends on the chemical structure of laxatives of this group: high – in saline, low – in lactulose.

Thus, lactulose has a mild laxative effect, so that it can be used by children from 1 year old.

Laxative for small and adults

Lactulose is a synthetic disaccharide consisting of galactose and fructose and does not occur naturally.The experience of using it for the purpose of obtaining a laxative effect has been going on for more than 50 years. During this time, a large number of studies were carried out in order to reveal the mechanisms of its influence and effectiveness (Grigoriev P.Ya., Yakovenko E.P., 2000).

In the human body there are no enzyme systems capable of breaking down lactulose, due to which it passes through the upper gastrointestinal tract without being absorbed. The mechanism of action of lactulose is based on its breakdown into short-chain carboxylic acids under the influence of bacteria in the large intestine, as a result of which the osmotic pressure in the large intestine increases, which contributes to water retention in it, and an increase in the volume of contents.Thus, the feces are liquefied and their transit through the intestines is accelerated.

In addition, acidification of the medium, which is achieved by increasing the concentration of short-chain carboxylic acids, activates peristalsis.

Also, lactulose has an ammonium-binding property (Shulpekova Yu.O., 2003). Moreover, it is also a prebiotic. As a nutrient substrate for bifidobacteria and lactobacilli, lactulose contributes to the reproduction of the normal flora of the large intestine, the displacement of opportunistic bacteria, the normalization of the intestinal biocenosis (Butorova L.I., Maksimova I.D., 2004).

Due to its safety profile, lactulose can be used to normalize stool in children and adults; elderly people with the presence of pathology of various organs and systems; pregnant and breastfeeding women; patients taking medications with constipation as a side effect.

Lactulose is recommended to be used to facilitate the act of defecation with hemorrhoids, anal fissures, after surgery, in patients adhering to bed rest (Grigoriev P.Ya., Yakovenko E.P., 2000).

Thus, lactulose promotes an increase in the number of bifidobacteria and lactobacilli in the colon (prebiotic effect) and is a mild osmotic laxative. Therefore, in order to normalize the stool or maintain the intestinal biocenosis, dietary supplements can be introduced into the daily diet, which include lactulose, for example, PRELAXAN.

PRELAXAN – up to 99% pure lactulose!

A novelty for the Ukrainian market – PRELAXAN in the form of a powder, which contains a large amount of lactulose (96-99%) and an insignificant amount of residual sugars, which makes it possible to use it to prevent constipation, constipation, intestinal dysbiosis, as well as to improve metabolism and strengthening immunity even for pregnant women, patients with diabetes mellitus and children over the age of 1 year.

In addition to the powder in sticks of 10 g, No. 10, PRELAXAN is also available in the form of syrup of 220, 400 and 900 g. Such a variety of dosage forms makes the use of this dietary supplement especially convenient.

The manufacturing company provides active promotional support for PRELAXAN – the advertising campaign is carried out on central TV channels! Therefore, do not forget to take care of the optimal stock of this product!

Manufacturer: Felitsata Ukraine LLC, tel.: +38 (044) 360-35-58, 360-69-10; fax: 360-35-57; www.zapora.net.ua.

Press service of “Weekly APTEKA”

Information for you:

China Docusate Sodium Cas 577-11-7 Suppliers and Manufacturers – Factory Direct Wholesale

What is Dokukat?

Docusate is a stool softener that makes bowel movements softer and easier to pass.

Dokuzit is used to relieve occasional constipation (irregularity).

There are many brands and forms of dokusata. Not all brands are listed in this brochure.

Dokusat may also be used for purposes not listed in this treatment guide.

Product Details

Item

Specification

Appearance (25 ° C )

Item

Description

white to white wax hard, exceptional odor, bitter taste, hygroscopicity

Solubility

Freely soluble in chloroform, PE and glycerol.Easily soluble in methanol and ethanol, slightly soluble in water.

Chemical reaction

Must be positive

Active content %

≥95.0

9000 substances,%

≥98.0

PH (1% aqueous solution)

4.0-7.0

Uses

This drug is used to treat occasional constipation. Certain medications and conditions can make constipation more likely. Stool softeners such as docusat are often the first method used to prevent and treat this type of constipation. Dokuzat is often used when straining to have a bowel movement should be avoided (for example, after a heart attack or surgery).Dokusad is a stool softener. It works by increasing the amount of water that the stool absorbs in the intestines, making the stool softer and easier to pass.

How to Use Dokuzuate Sodium

Follow all instructions on the product packaging unless otherwise directed by your healthcare professional. If you are unsure of any information, consult your doctor or pharmacist.

Take this medication by mouth, usually at bedtime with a full glass (8 ounces or 240 milliliters) of water or juice, or as directed by a healthcare practitioner.Dosage is based on your medical condition and response to therapy. Reduce your dose or stop taking this medication if you develop diarrhea.

If you are using the liquid form of this medication, carefully measure the dose with a special measuring instrument / spoon. Do not use a household spoon because you may not get the correct dose. If you are using drops, measure the medicine with the provided dropper or use a measuring spoon or device to make sure you have the correct dose.Mix syrup, liquid, or drops in 4-8 ounces of fruit juice, milk, or infant formula to prevent throat irritation and mask the bitter taste.

Use this medication only as needed. Do not use this product for more than 1 week unless directed by your doctor.

Hot Tags: docusate sodium cas 577-11-7, China, suppliers, manufacturers, factory, wholesale

Constipation in children – Evidence-based medicine for all

Constipation in children is a common cause of significant discomfort in children and anxiety in parents.According to various sources, constipation is the reason for seeking medical attention in 3-5% of cases. Constipation is detected in 1-30% of children.

A short episode of constipation in children is common and usually lasts only a few days. The correct diet and adequate fluid intake are, in most cases, sufficient. However, some children develop chronic constipation (persistent and severe). Regular soiling of laundry (often mistaken for diarrhea) can mean that the child has chronic constipation.

Normal stool frequency in children

Stool frequency in children is unstable, and varies within a fairly wide range. The following statements and norms are relatively generally accepted:

  • The first bowel movement (bowel movement from meconium) occurs within 36 hours of birth. In 90% of children, the release of meconium is observed in the first 24 hours from birth.
  • During the first week of life, the child has an average of 4 bowel movements per day.This indicator is very variable and depends on the type of feeding: artificial or natural.
  • Up to 2 years, the average number of bowel movements can vary from 3 times a day to 1 time in several days.
  • After two years, the number of bowel movements 1-2 times a day
  • After 4 years – once a day

Despite the above average statistical indicators, a breastfed baby may not have a stool for 7 or even 10 days, and this may be the norm.In formula-fed infants, the variability in normal stool frequency is even higher.

Classification of constipation

  1. Organic, i.e. caused by any disease
  2. Functional, i.e. constipation in the absence of anatomical and / or biochemical problems.

It is advisable to divide constipation in children into two broad categories:

  1. Mild and / or temporary constipation that lasts only a few days.This is a very common situation that can recur from time to time.
  2. Chronic (persistent and severe) constipation. It is much less common. Its treatment differs from the more frequent – mild, temporary constipation.

So what is constipation?

Constipation in children is called:

  • Difficulty defecation, or a bowel movement that requires considerable effort and / or
  • Pain during bowel movements.and / or
  • Stool less frequently than usual.

Note: there is a large range of normal frequency. One to three bowel movements per day are considered normal. Stool less than once every two days – may be constipation. However, it may still be normal if the child does not strain too much during bowel movements, does not experience pain, and has soft and shaped stools.

The following criteria have been developed for the diagnosis of functional constipation (Rome III)

Babies and toddlers

  • Chair less than twice a week
  • Episode of stool incontinence after acquiring hygiene skills
  • Previous episodes of severe stool retention
  • Painful or difficult bowel movements
  • Large chair volume
  • Large diameter fecal lump

The diagnosis is made by observing at least 2 of the six listed criteria within a month.

Children aged 4 to 18 years

  • Chair less than twice a week
  • Episodes of stool incontinence
  • Episodes of strong-willed stool delay
  • Painful or difficult bowel movements
  • Large chair volume
  • Large diameter fecal lump

The diagnosis is made by observing at least 2 of the six listed criteria within two months.

What are the causes of constipation in children?

Food and drink. Malnutrition is a common cause of constipation in children:

  • Insufficient content of dietary fiber, fiber (the coarse part of food that is not digested and remains in the intestines) and / or
  • Insufficient fluid intake.

Stool becomes dense, dry and difficult to defecate when the intestines contain little fiber and fluid.

Consciously holding the chair: the child feels the urge to defecate, but resists. This is a common cause of functional constipation. You may notice this in a child from flattened legs, sitting on the heels, or similar activities that help suppress the feeling of defecation. Prolonged deliberate holding of the stool increases the volume of the stool and, subsequently, makes it difficult to pass it. There are a number of reasons why children may struggle to hold a chair:

  • The previous bowel movement may have been difficult and painful.Therefore, the child tries to postpone the bowel movement, fearing again the pain and discomfort. (anal fissure, perianal irritation, sexual assault, hemorrhoids)
  • Unfamiliar or uncomfortable environment (for example, in public toilets). The child can “temporarily turn off” bowel movements until he returns home.
  • emotional problems, depression.

Disorders leading to constipation in children

Quite a lot of diseases can lead to constipation: diseases of the thyroid gland, as well as some intestinal disorders, one of the factors of constipation can be an allergy to cow’s milk.If constipation is a symptom of the disease, then, as a rule, other signs are present, because it is extremely unlikely that this will be the only manifestation of the disease. Some medicines can cause constipation as a side effect. In any case, if constipation is a chronic problem, a doctor should be consulted.

How can you prevent constipation in a child?

Eating foods with a lot of fiber and plenty of water increases stool volume, but at the same time, the stool becomes soft, the intestines are easily emptied.Regular physical activity also promotes normal bowel movements.

Dietary fiber (cellulose). Foods high in fiber and fiber

  • Jacket potatoes with baked beans or vegetable soup with bread.
  • Dried apricots or raisins for dessert.
  • Porridge or other high-fiber cereals for breakfast.
  • Fruit with every meal.
  • You may not want to let your child take the candy until they have eaten the fruit.

If children do not want to eat foods high in dietary fiber, add dry bran to yogurt. The yogurt will soften the off-flavor of the dry bran.

Drinks. Adequate fluid intake is essential for normal bowel function. However, some children have a habit of drinking only juice, soda, or milk to quench their thirst.They can satisfy their appetite and therefore eat few foods that contain high amounts of fiber. Try to limit these types of drinks. Give water as your main drink. However, some fruit juices that contain fructose or sorbitol have a laxative effect (such as prunes, pears, or apple juice). This can be helpful from time to time when the stool becomes steeper than usual and you suspect that you may soon develop constipation.

Some other tips that may help:

  • Try to get the child to get used to a certain time of going to the toilet.After breakfast, before school or kindergarten is the best option. Give it a try and set aside enough time so that he doesn’t feel rushed.
  • A reward system is sometimes useful for young children who are susceptible to stool retention. For example, a small treat after every successful trip to the toilet. However, try not to make a toilet problem a tragedy. The goal is for the situation to be normal and not stressful – an everyday matter.

Mild / temporary constipation in children and treatment.

Most episodes of constipation in children last only a few days. Many children strain to squeeze out a bulky or hard fecal lump. It doesn’t really matter, the consistency of the stool will soon return to normal. Treatments for temporary constipation are the same as for preventing constipation. That is, a diet with lots of fiber, drinking plenty of fluids, and possibly fruit juice that contains fructose or sorbitol. In some cases, your doctor may recommend a laxative for several days.In an episode of mild constipation, the function of the lower intestine (rectum) is not affected. Thus, you can stop the laxative treatment as soon as the stool becomes easy to pass again. Treatment usually takes several days.

This is in contrast to chronic constipation (see below), where rectal function is altered and laxatives are used for long courses.

Chronic (persistent and severe) constipation

Chronic constipation in children is a severe and long-lasting violation of bowel movements.It develops more often in children aged 2 to 4 years, but it also occurs in older and younger children. Symptoms and features of chronic constipation include:

  • Recurring situations where the child has difficulty or difficulty in emptying the bowel.
  • A child regularly stains linen with very soft stools or mucus-like faeces. This is often regarded by parents as diarrhea.
  • The child may become irritable, eat little, feel unwell, have abdominal pain from time to time, and generally have a low mood.
  • The physician can often feel the terminal intestines filled with hard, lumpy feces on palpation of the abdomen.

Next, we will try to explain how chronic constipation can develop and its symptoms. In particular, why contamination of laundry is a symptom of chronic constipation. Usually, feces accumulate in the lower part of the large intestine. If stool builds up, it begins to move into the rectum (the last part of the intestine), which expands.This sends signals down the nerves to the brain saying “you need to go to the toilet.” When relaxing the anus on the toilet, it takes a little effort to “squeeze out” the feces. But if the child ignores the signal, restrains, then the feces remain in the rectum. Gradually, a large, dense fecal lump forms in the intestine. The rectum then expands and enlarges much more than usual. This contributes to the formation of fecal blockage, in which dense feces “get stuck” in the rectum. If the rectum remains overstretched for a long time, then the normal sensations of the urge to defecate are weakened.In addition, the muscle strength of the rectal walls decreases, it becomes “lazy”.

Additional portions of feces are suitable for the fecal lump located in the rectum. The lowest part of the fecal lump lies just above the anus. Some of these “fresh” portions liquefy and flow out of the anus. This will stain your baby’s linen and bedding. In addition, some part of the soft stool, liquid stool from the overlying sections of the large intestine can “bypass” around the fecal lump. It also seeps out of the anus and can be mistaken for diarrhea.The child cannot (!) Control this leakage and contamination of the laundry. If the stool is eventually completely removed (by means of an enema), it will quickly fill up with hard stools again, due to the stretching and weakening of the rectal walls.

What is the treatment for chronic constipation in children?

A diet high in fiber and drinking plenty of fluids. This is described above, but, as a rule, in addition to this, the appointment of laxatives is required.

Laxatives

Laxatives are usually prescribed if a child develops chronic constipation. Their first goal is to empty the rectum, to resolve fecal impaction. This can usually be done quickly enough with only an adequate dose of a strong laxative. Sometimes laxative suppositories or cleansing enemas are needed to clear up stool. After the rectum has been emptied, it is important to continue taking laxatives as directed by your doctor. This may be necessary for several months, and sometimes even up to two years. When a child takes laxatives every day, the following happens:

  • The child goes to the toilet more often and has regular bowel movements. As he goes to the toilet more often, the stool becomes smaller and softer. Thus, the stool will be excreted more easily. The child will be freed from the fear of going to the toilet with a large, hard, painful lump.
  • The overstretching of the rectum is reduced, and it can gradually return to normal size, functions are restored properly.

Constipation is unlikely to recur. If laxatives are withdrawn prematurely, the fecal blockage is likely to recur again in the weakened rectal ampulla that has not had enough time to return to normal size and regain strength.

There are different types of laxatives which include:

  • Substances that increase the volume of stool. This is, for example, bran. They make the stool soft but voluminous.
  • Chair softeners.These substances thin and soften the stool. For example, sodium docusate (which also has a mild stimulant effect).
  • Osmotic laxatives. For example, lactulose and polyethylene glycol. These substances retain fluid in the large intestine by osmosis (reduce the absorption of fluid into the blood from the lumen of the colon).
  • Stimulant laxatives. For example, senna or sodium docusate. They act on the muscles in the intestinal wall “squeezing” weaker than usual. Sena preparations are not recommended for use in children.

The doctor will usually advise the use of laxatives. However, quite often you will need two laxatives at the same time for several months if one drug does not give the desired effect. For example, an osmotic laxative plus a stimulant. Over time, the dose is gradually reduced and the medication is discontinued. It is important to continue treatment for as long as the doctor advises. Chronic constipation often recurs if treatment is stopped too early.

Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Colace [OTC]; Diocto [OTC] [DSC]; DocQLace [OTC] [DSC]; Docu Liquid [OTC]; Docu Soft [OTC] [DSC]; Docu [OTC]; Docuprene [OTC] [DSC]; Docusate Mini [OTC]; Docusil [OTC] [DSC]; DocuSol Kids [OTC]; DocuSol Mini [OTC]; DOK [OTC]; Dulcolax Stool Softener [OTC]; Enemeez Mini [OTC]; GoodSense Stool Softener [OTC] [DSC]; Healthy Mama Move It Along [OTC]; Kao-Tin [OTC] [DSC]; KS Stool Softener [OTC] [DSC]; Laxa Basic [OTC] [DSC]; Pedia-Lax [OTC]; Promolaxin [OTC] [DSC]; Silace [OTC]; Sof-Lax [OTC] [DSC]; Stool Softener [OTC]

What is this drug used for?

  • This medication is used to treat constipation.

What do I need to tell my doctor BEFORE taking this drug?

  • If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
  • If you have any of the following health problems: bowel obstruction, abdominal pain, nausea, rectal bleeding, vomiting, or changes in bowel rhythm that persist for more than 2 weeks.
  • If you are taking mineral oil.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical condition and in combination with other drugs you are already taking.Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

  • Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
  • Do not use this medication for more than 1 week unless directed by your doctor.
  • If you have rectal bleeding or have no bowel movements after using this drug, talk to your doctor.
  • Do not use other laxatives or stool softeners unless your doctor recommends otherwise.
  • If you are on a low sodium or salt free diet, tell your doctor. Some of these preparations contain sodium.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your doctor right away or get medical help if you have any of the following signs or symptoms, which may be associated with serious side effects:

All forms of issue:

  • Signs of an allergic reaction, such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.

Rectal enema:

  • Rectal irritation.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

All oral preparations:

  • Stomach colic.
  • Diarrhea.

Liquid:

  • Sore throat.

This list of potential side effects is not comprehensive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088.You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

All oral preparations:

  • Take this drug with or without food.
  • Take this drug with a full glass of water.

Liquid:

  • Mix liquid with milk, juice, or formula as directed to prevent throat irritation or to neutralize bitterness.
  • Care should be taken to measure liquid doses. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for the dosing product for this drug.
  • Some of these medicinal products must be shaken before use.Make sure you know exactly if this drug needs to be shaken before use.

Rectal enema:

  • This medication is for rectal use only. Do not take this drug by mouth.
  • Remove the cover.
  • Apply lubricant to the enema tip and anus before using this drug.
  • Using light pressure, insert the tip of the enema into the rectum.Strong pressure is unacceptable.
  • Squeeze the bottle until almost all liquid has come out.
  • If the end of the tube or this drug is not injected into the rectum, do not use force. See your doctor.

What should I do if a dose of a drug is missed?

  • If you are taking this medication regularly, take the missed dose as soon as you can.
  • If it’s time to take your next dose, do not take the missed dose and then return to your normal dosage schedule.
  • Do not take 2 doses at the same time or an additional dose.
  • In most cases, this drug is taken as needed. Do not take this medicine more often than prescribed by your doctor.

How do I store and / or discard this drug?

  • Store at room temperature. Do not freeze.
  • Store in a dry place. Do not store in the bathroom.
  • Store all medicines in a safe place.Keep all medicines out of the reach of children and pets.
  • Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. There may be drug recycling programs in your area.

General information on medicinal products

  • If your health does not improve or even worsens, see your doctor.
  • Do not give your medicine to anyone or take other people’s medicines.
  • Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
  • Some medicines may have different patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
  • If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Consumer Use and Limitation of Liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient.This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, unwanted effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional.Check with your doctor for complete information on the possible risks and benefits of taking this drug. Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

90 000 10 Laxatives, prokinetics, antiparetics – StudIzba

S R E D S T V A V L I Y S I E N A M O R I K U K S H E CH N H I K A

MEANS USED WITH DECREASED

MOTOR FUNCTIONS OF THE INTESTINAL

Laxatives, prokinetics, antiparetics

Laxatives

Constipation is a violation of the passage through the colon, characterized by a stool frequency of less than 3 times a week.

By the nature of violations :

-organic

Recommended files

(tumor, strictures, other anatomical defects, adhesive disease).

-functional

According to the topography of the defect

– with transit delay = cologenic

– with defecation disorder = proctogenic

Possible causes of intestinal hypokinesia

-Diet (fiber deficiency2. hypersecretion

-Hypokinesia

-Disregulation of motility, operations on the gastrointestinal tract, pelvic organs.

Laxatives

Laxatives used in violation of transit:

1. Increasing the volume of intestinal contents , which leads to a

increase in intraluminal pressure and

stimulates intestinal peristalsis.

2. Stimulants

Containing or releasing irritating substances.

Act at the level of the enteric plexus,

Cause the release of substances that enhance the propulsive activity of the intestine.

3. Softening feces (almost never used in clinical practice).

Laxatives used in violation of the act of defecation:

Increasing intrarectal pressure (gas-forming)

Ferrolax (suppositories)

Calciolax

Intestinal

90 By localization

-Colon intestine

By origin

-Vegetable

-Mineral

-Synthetic

Indications for use

-Chronic constipation

-Poisoning operations (to prevent the absorption of poison

000

! Cannot be prescribed for intestinal obstruction and acute abdominal syndrome


Laxatives used for transit disorders:

90

0 Hydrophilicum

90

0 Polysaccharides

290

0

9000

290

0

290

0

sorbitol,

xylitol

Increasing fecal volume

Stimulating

Osmotic

Secretory

Irritant

Dietary fiber

cellulose pectin agar flaxseed

Salt

magnesium sulfate,

sodium sulfate

Pr.anthraquinone

Anthraglycosides

preparations

senna

senade,

senadexin,

reg

9000-repine

0009000

reg

glaxena

rhubarb roots

– preparations

buckthorn

extract

decoction

ramil

anthraquinone

Anthraglycosides

– drugs

senna

senade, senadexin, glaxena,

kafiol,

regulax

drugs

000 reagents

000 drugs buckthorn

extract

decoction

ramnil

Oils

Vaseline oil

Sunflower oil

Sunflower oil 9000

00 Polyethylene glycols

(macrogols)

Alcoholic

mannitol,

sorbitol,

glycerin

Synthetic

Ex.

Diphenylmethane

bisacodyl,

isaphenine,

guttalax

(phenolphthalein)

Synthetic

Ex.

Diphenylmethane

bisacodyl,

isaphenin,

guttalax

(phenolphthalein) 9000

Castor oil

Oligosacchara

la

9000


Dietary fiber – hydrophilic colloids.

Not absorbed, absorbs water and swells.

In a liquid medium, stable micelles are created,

significantly increasing the volume of intestinal contents and stimulating peristalsis.

For the successful action of dietary fiber, the daily volume of liquid

is not less than 1.5 liters.

Otherwise, they act as sorbents, absorbing fluid from the intestines, which increases constipation.

Use caution in elderly patients with cardiovascular diseases.

The effect develops within 12-24 hours after ingestion.

Application for chronic constipation.

Macrogol = Forlax

The main component is a polymeric substance – polyethylene glycol.

This is a high molecular weight compound.

When ingested, it swells, increases the fluid content in the intestine,

which leads to increased peristalsis.

Effect after 24-48 hours.

Usually well tolerated.

Polyhydric alcohols are hydrophilic colloids,

also have a moderate osmotic effect.

Due to these two effects, the volume of intestinal contents is increased.

Disadvantage – the effect develops slowly from 10 days to 3 weeks.

Use caution in elderly patients with cardiovascular diseases.

Mechanism of action

Not broken down and utilized in the small intestine.

Under the influence of bacterial enzymes of the large intestine are partially broken down to organic acids, which additionally activate peristalsis.

The drug taken internally is slowly absorbed from the intestines and by its osmotic effect retains water in the intestinal lumen, which contributes to the laxative effect.

Doses are purely individual.

Effect is observed after 1-3 days. Mild laxative effect.

Side effects – nausea, heartburn – are rare.

Osmotic

Despite the general mechanism, they differ in the area of ​​action.

Disadvantage – uncontrolled diarrhea and hypovolemia when taken regularly.

Application – bowel preparation for research and operations.

Not absorbed in the small intestine, because there are no enzymes that break them down.

Acts only in the colon.

Lactulose is a synthetic disaccharide composed of fructose and galactose.

Lactulose undergoes hydrolysis by bacterial enzymes in the colon.

Bifidobacteria and lactobacilli use lactulose as a nutrient substrate,

, which leads to an increase in their biomass.

The end products of lactulose metabolism are short-chain fatty acids, which have an osmotic effect.

The secretion of fluid into the intestinal lumen is lower than that of salt preparations, therefore the laxative effect is milder, but quick.

An increase in bacterial biomass contributes to an increase in fecal volume and stimulation of peristalsis.

Thus, lactulose has a dual mechanism of action:

– restores colonic microbiocenosis.

– increases the volume of intestinal contents due to

osmotic action and

stimulation of bacterial growth

Main indications

for long-term or permanent prescription of drugs that increase the volume of stool

– chronic functional cologenic constipation.

– drug constipation, when drugs causing constipation cannot be canceled

Contraindicated

for constipation with violation of the act of defecation.

interact with the epithelial structures of the intestine and cause active secretion of fluid into its lumen, while reducing absorption.

Effects

Virtually all of these agents cause short-term, and with prolonged use, permanent secretory diarrhea.

Side effect

This leads to excessive fluid loss and electrolyte disturbances, especially hypokalemia.

Potassium ions maintain the tone of intestinal smooth muscles,

therefore a decrease in its concentration in the blood leads to smooth muscle relaxation and increased constipation.

Violation of fluid homeostasis contributes to the development of secondary hyperaldosteronism, which in turn is accompanied by the loss of potassium and the circle is closed.

This mechanism is one of the main, causing “addiction” and increased constipation with prolonged use of all secretory laxatives.

The mechanism of addiction for anthraquinones – drugs, acting at the level of neurons of the submucosal plexus, cause the formation of nitric oxide, which relaxes smooth muscles and inhibits peristalsis.

With prolonged use, degenerative changes in the enteric ganglia may develop.

The safety of different members of this group is not the same.

Anthraquinone derivatives

Chemical irritation of the intestinal mucosa is caused by plant preparations containing anthraglycosides .

Receptors of the large intestine are sensitive to anthraquinones (emodin, chrysophanic acid),

which are formed under the influence of digestive juices and bacterial enzymes

from anthraglycosides in the alkaline environment of the digestive tract.

Receptors of the large intestine respond to concentrations of these substances that the receptors of the small intestine do not respond to.

In addition, the sugar moiety of the anthraglycoside molecule protects anthraquinone from oxidation during the passage of the small intestine.

Side effects

1) With prolonged use – damage to the mucous membrane , and then the muscle layer of the rectum.

Due to the deposition of anthraquinones or their decay products in macrophages of the mucous membrane, dysfunction of neurons and lymphocytes, atrophy of the muscle layer occurs and chronic constipation develops.

With prolonged use of anthraquinones, but not derivatives of diphenylmethane, pseudomelanosis of the colon may develop.

2) Long-term use is accompanied by liver dysfunctions.

Used in the form of infusions, extracts, tablets, powders, tinctures.

For constipation of various etiologies. The laxative effect develops after 8-12 hours.

Senna preparations

have a clear dose-dependent effect.

There is evidence that anthraquinones are mutagenic.

Stimulant laxatives are not indicated for long-term use.

Dignity fast and gentle onset of the effect.

Indications

-Patients who need to get a quick result and for whom an increase in intra-abdominal pressure is contraindicated.

In short courses of 5-7 days or more, 2 times a week in the minimum effective dose.

– acute or short-term functional constipation arising from changes in the usual environment and nutrition or stress.

Senade, Senadexin, Galaxena

Before meals, 1 tablet. Usually at night.

Kafiol, Regulax

Contains senna leaves, senna fruits, pulp of plums, figs, vaseline oil.

Laxative effect due to:

– chemical irritation (anthraquinones)

– mechanical irritation of the intestine (pectins of plum and fig fruits)

– facilitating the movement of intestinal contents (liquid paraffin)

Roots of rhubarb powder

At night. Coloring urine, sweat and milk yellow. Extract, decoction, Ramnil

At night.

The advantage is with diphenylmethane derivatives.

Bisacodyl

It is degraded in the alkaline contents of the intestine, causing irritation of the mucous membrane receptors.

When taken orally, it works after 5-7 hours. In the form of candles – in an hour.

Do not take simultaneously with alkaline solutions.

Side effects

Intestinal colic, diarrhea with excessive loss of fluid and electrolytes, convulsions,

arterial hypotension.

Special interest – original drug – Dulcolax . (Bisacodyl)

diphenylmethane derivative, prodrug.

In an aqueous medium, it hydrolyzes with the elimination of acetyl groups, as a result of which an active biphenolic compound is formed, which has a laxative effect.

Feature and advantage – pH dependent coating of tablets, providing the release of the drug in the initial part of the large intestine, and not in the small intestine,

as when using other bisacodyl preparations.

This makes it possible to avoid excess secretion and reduce the phenomenon of addiction.

Action in 6-10 hours, when taken before bedtime – in 8-12 hours.

Guttalax

Not absorbed in the gastrointestinal tract, in the large intestine

sulphate radical is cleaved from it (under the influence of bacteria producing sulfatase).

The sulfate radical is converted to its active form – free diphenol.

Use for various constipation and the need for bowel movement.

Laxative effect – after 6-12 hours.

Phenolphthalein

Acts mainly in the colon .

It dissolves in an alkaline medium in the presence of bile,

one seventh is absorbed into the blood,

the rest is excreted in the feces.

Mechanism of the laxative effect

-increased intestinal motility due to the effect on the kinetics of calcium of the smooth muscles of the intestine, -inhibition of Na +, K + – ATPase of the intestinal mucosa and impaired absorption of water.

Laxative effect develops after 4-8 hours.

As a result of the participation of phenolphthalein in the enterohepatic circulation

laxative effect can last 3-4 days – cumulation.

Side effects :

Nephro- and hepatotoxicity – now rarely used.

May cause allergic reactions up to to

– anaphylactic shock and

– allergic-hyperergic inflammation of the kidneys.

Severe osteomalacia occasionally occurs.

Indications

Same as for anthraglycosides (chronic constipation). You can alternate.

Isaphenine

Close to phenolphthalein. Less toxic.

Saline

Preparations contain such anions and cations ,

which are relatively poorly absorbed from the intestine into the blood.

Create increased osmotic pressure and prevent water absorption.

Up to 9 liters of water enter the alimentary canal per day, 60-150 ml is excreted by the intestines.

Saline laxatives inhibit the reabsorption of water in the intestine.

An increase in the volume of intestinal contents leads to its stretching and to reflex stimulation of peristalsis.

They act both in the small and large intestine (that is, throughout the intestine)

-Causes watery diarrhea (profuse loose stools) 3-6 hours after ingestion.

Not only the formed feces are removed, but also most of the chyme (“carry” effect).

A significant amount of water and salts is lost (violation of the general water-salt balance).

Inside on an empty stomach. Reception after a meal is inappropriate, since it enters the intestine in parts and does not create the necessary osmotic pressure.

Side effects

Systemic use can cause catarrh of the mucous membranes of the intestinal membranes.

Magnesium ion , when absorbed, can lead to depression of the central nervous system,

violation of the contractile activity of the heart (especially dangerous in pediatric practice).

Possible respiratory depression when administered parenterally.

Sodium Sulphate is preferred.

Indications

Food poisoning

(not only cleanse the intestines, but also prevent the absorption of poison and its entry into the blood).

Magnesium sulfate is also used as an antidote for poisoning with barium salts (gastric lavage).

Castor oil

Obtained from castor bean seeds.

In the duodenum, under the influence of bile, alkalis and pancreatic juice lipase

gland splits to form ricinolic acid and glycerol.

Ricinolic acid is a strong specific irritant of intestinal receptors.

– stimulates peristalsis

– inhibits the absorption of water and electrolytes,

which contributes to an increase in the volume of contents and activation of peristalsis.

Effective in the small intestine .

Part of the unchanged castor oil is removed to the outside, which contributes to softening

feces, facilitating their movement through the large intestine.

Laxative effect 2-6 hours after taking the drug on an empty stomach.

Contraindicated in case of poisoning with fat-soluble poisons.

Increasing and thinning intestinal contents

Softening stool:

Mechanically facilitates the movement of stool and causes its softening.

They are not degraded or absorbed in the intestine (liquid paraffin) or are partially degraded

(sunflower oil).

Vaseline oil

Take 1-2 tablespoons at night, has a slight laxative effect.

Capable of to dissolve some fat-soluble poisons and prevent their absorption.

Acute poisoning with gasoline, kerosene, dichloroethane, carbon tetrachloride.

Preparations impair the absorption of fat-soluble vitamins .

Dokuzat (anionic surfactant) = Norgalax

Derivative of butadionic acid. Apply rectally in the form of a gel, mini-enemas.

Miniklizma contains sodium docusate, carboxymethyl cellulose, glycerin, distilled water

. Causes softening of feces, reflex irritation of the intestinal mucosa.

In case of constipation caused by intestinal dyskinesia , it is effective to prescribe a diet enriched with ballast substances, and especially treatment with wheat bran.Also drugs from the group of modulators of gastrointestinal tract motility are used. The mechanism of their action is based on the normalizing effect on the anatomical and functional sphincters of the stomach and intestines. Moreover, their influence on transit through the colon is different: eglonil, domperidone, metoclopramide and cisapride stimulate it; reasec and loperamide inhibit. Cisapride is especially effective for constipation.

Modern laxatives, depending on the mechanism of action, can be divided into three groups.

The most physiological and effective is the group of drugs that increase the volume of intestinal contents . These include bran, lactulose, methylcellulose, seaweed, lacxiplant, crystalax. Means that lubricate the intestinal mucosa – vaseline and almond oil – are not very suitable for long-term treatment. Drugs that inhibit absorption and enhance secretion in the colon include: 1) plant substances containing anthraglycosides – senna, buckthorn, rhubarb; 2) phenolphthalein derivatives – bisacodyl; 3) saline laxatives, 4) castor oil. The inexpediency of constant intake of laxatives is due to

1) “getting used to” them and the gradual extinction of the therapeutic effect;

2) quite pronounced side effects.

Laxatives with prolonged use can lead to disorders of water and electrolyte metabolism, impaired renal function

, some have hepatotoxic and neurotoxic effects.

Laxatives should be prescribed if dietary measures, bran intake and motility modulators are ineffective. Drugs should be changed and prescribed for relatively short periods.

With dyskinesic constipation caused by violations of the very act of defecation , the main method of treatment can be the use of drugs that increase intrarectal pressure – gassing suppositories ferrolax, calciolax, with lithium.The recipe for one of them: ferrolax (Ferri lactici 0.8, Ac.citrici 0.1, Natrii bicarbonici 0.6, Butiri cacao). Candles 1 time per day in the morning after meals.

Calciolax – 1 candle contains 0.6 calcium lactate, 0.5 sodium bicarbonate, 0.1 citric acid

Candles with lithium bicarbonate – 1 candle contains 300 mg of lithium bicarbonate, 150 mg of sodium bicarbonate, 200 mg citric acid, 250 mg fumaric acid

PROKINETICS

Agents that stimulate gastrointestinal motility.

An increase in motility is observed upon stimulation of

– parasympathetic (via acetylcholine),

– dopamine

– serotonin receptors.

Decreased motility – upon stimulation

– sympathetic nervous system and possibly

– purinergic receptors

– “receptive relaxation” of the stomach body

– relaxation antrum

64 9000

– relaxation of the lower esophageal press

Dopamine receptors on the nerve endings in the plexuses of the gastrointestinal tract

prevent the release of acetylcholine (stimulating motility).

Serotonin – inhibitory mediator of ACC release.

Stimulating effect of prokinetics on gastric motility:

– decrease in relaxation of the stomach body

– increase in the contraction of the antrum

– relaxation of the pyloric sphincter and duodenum

– reduction

70009000 evacuation of stomach contents

– elimination of reflux

– antiemetic reflex

– increased motility of the small intestine

Application

– Functional disorders of gastric motility, dyspeptic syndrome, gastroparesis, stomach atomic

-Reflux esophagitis.

-Nausea, vomiting, hiccups.

– X-ray examination of the intestine.

Metoclopramide (cerucal)

Blocks dopamine receptors in the chemoreceptor trigger zone of the brain stem, as a result of which the gag reflex, nausea, hiccups are suppressed.

It increases the tone of the lower esophageal sphincter with simultaneous relaxation of the pyloric pulp, helps to reduce intragastric pressure, thereby facilitating gastric emptying and prevents gastroesophageal reflux.

Due to the effect mainly on the upper gastrointestinal tract , the drug is indicated with

– reflux esophagitis,

– ulcerative disease,

– dyskinesias of the abdominal organs,

– vomiting of various origins.

Prescribe orally, intramuscularly, intravenously.

Side effects : dry mouth, drowsiness, tinnitus, parkinsonism, hypotension.

The lecture “Diplomacy during the Second World War” also contains a lot of useful information.

Very common in children and young people, with more severe extrapyramidal disorders occurring in children and women.

Domperidone (motilium)

Similar in mechanism of action to metoclopramide, but more effective.

Poorly penetrates the BBB. It also has an antiemetic effect.

Readings : same.

Side effects : intestinal spasms, rarely extrapyramidal disorders.

“Constipation in children” – Yandex.Q

Constipation in children is a common cause of significant discomfort in children and anxiety in parents. According to various sources, constipation is the reason for seeking medical attention in 3-5% of cases. Constipation is detected in 1-30% of children.
A short episode of constipation in children is common and usually lasts only a few days. The correct diet and adequate fluid intake are, in most cases, sufficient. However, some children develop chronic constipation (persistent and severe).Regular soiling of laundry (often mistaken for diarrhea) can mean that the child has chronic constipation.

Normal stool frequency in children
Stool frequency in children is variable, and varies within a fairly wide range. The following statements and norms are relatively generally accepted:

  • The first bowel movement (bowel movement from meconium) occurs within 36 hours of birth. In 90% of children, the release of meconium is observed in the first 24 hours from birth.
  • During the first week of life, the child has an average of 4 bowel movements per day. This indicator is very variable and depends on the type of feeding: artificial or natural.
  • Up to 2 years, the average number of bowel movements can vary from 3 times a day to 1 time in several days.
  • After two years, the number of bowel movements 1-2 times a day
  • After 4 years – once a day

Despite these averages, a breastfed baby may not have a stool for 7 or even 10 days, and this may be the norm.In formula-fed infants, the variability in normal stool frequency is even higher.

Classification of constipation

  1. Organic, i.e. caused by any disease
  2. Functional, i.e. constipation in the absence of anatomical and / or biochemical problems.

It is advisable to divide constipation in children into two broad categories:

  1. Mild and / or temporary constipation that lasts only a few days. This is a very common situation that can recur from time to time.
  2. Chronic (persistent and severe) constipation. It is much less common. Its treatment differs from the more frequent – mild, temporary constipation.



So what is constipation?
Constipation in children is called:

  • Difficulty defecation, or a bowel movement that requires considerable effort and / or
  • Pain during bowel movements. and / or
  • Stool less frequently than usual.


Note: there is a large normal frequency range.One to three bowel movements per day are considered normal. Stool less than once every two days – may be constipation. However, it may still be normal if the child does not strain too much during bowel movements, does not experience pain, and has soft and shaped stools.
The following criteria have been developed for the diagnosis of functional constipation (Rome III)
Infants and toddlers

  • Chair less than twice a week
  • Episode of stool incontinence after acquiring hygiene skills
  • Previous episodes of severe stool retention
  • Painful or difficult bowel movements
  • Large chair volume
  • Large diameter fecal lump

The diagnosis is made upon observation of at least 2 of the six listed criteria within a month.
Children from 4 to 18 years old

  • Chair less than twice a week
  • Episodes of stool incontinence
  • Episodes of strong-willed stool delay
  • Painful or difficult bowel movements
  • Large chair volume
  • Large diameter fecal lump

The diagnosis is made by observing at least 2 of the six listed criteria within two months.

What are the causes of constipation in children?

Food and beverage. Malnutrition is a common cause of constipation in children:

  • Insufficient content of dietary fiber, fiber (the coarse part of food that is not digested and remains in the intestines) and / or
  • Insufficient fluid intake.

Stool becomes dense, dry and difficult to defecate when the intestines are low in fiber and fluid.
Consciously holding the chair: the child feels the urge to defecate, but resists.This is a common cause of functional constipation. You may notice this in a child from flattened legs, sitting on the heels, or similar activities that help suppress the feeling of defecation. Prolonged deliberate holding of the stool increases the volume of the stool and, subsequently, makes it difficult to pass it. There are a number of reasons why children may struggle to hold a chair:

  • The previous bowel movement may have been difficult and painful. Therefore, the child tries to postpone the bowel movement, fearing again the pain and discomfort.(anal fissure, perianal irritation, sexual assault, hemorrhoids)
  • Unfamiliar or uncomfortable environment (for example, in public toilets). The child can temporarily turn off bowel movements until he returns home.
  • emotional problems, depression.

Diseases leading to constipation in children
Quite a number of diseases can lead to constipation: thyroid disease, as well as some intestinal disorders, one of the factors of constipation can be an allergy to cow’s milk.If constipation is a symptom of the disease, then, as a rule, other signs are present, because it is extremely unlikely that this will be the only manifestation of the disease. Some medicines can cause constipation as a side effect. In any case, if constipation is a chronic problem, a doctor should be consulted.

How can you prevent constipation in a child?
Eating foods with a lot of fiber and plenty of water increases stool volume, but the stool becomes soft and easy to empty.Regular physical activity also promotes normal bowel movements. Dietary fiber (cellulose). Foods containing a large amount of dietary fiber and fiber

  • Jacket potatoes with baked beans or vegetable soup with bread.
  • Dried apricots or raisins for dessert.
  • Porridge or other high-fiber cereals for breakfast.
  • Fruit with every meal.
  • You may not want to let your child take the candy until they have eaten the fruit.

If children do not want to eat foods high in dietary fiber, add dry bran to yogurt. The yogurt will soften the off-flavor of the dry bran.
Drinks. Adequate fluid intake is essential for normal bowel function. However, some children have a habit of drinking only juice, soda, or milk to quench their thirst. They can satisfy their appetite and therefore eat few foods that contain high amounts of fiber.Try to limit these types of drinks. Give water as your main drink. However, some fruit juices that contain fructose or sorbitol have a laxative effect (such as prunes, pears, or apple juice). This can be helpful from time to time when the stool becomes steeper than usual and you suspect that you may soon develop constipation.
Some other tips that may help:

  • Try to get the child to get used to a certain time of going to the toilet.After breakfast, before school or kindergarten is the best option. Give it a try and set aside enough time so that he doesn’t feel rushed.
  • A reward system is sometimes useful for young children who are susceptible to stool retention. For example, a small treat after every successful trip to the toilet. However, try not to make a toilet problem a tragedy. The goal is for the situation to be normal and not stressful – an everyday matter.

Mild / temporary episode of constipation in children and its treatment.
Most episodes of constipation in children last only a few days. Many children strain to extrude a bulky or hard fecal lump. It doesn’t really matter, the consistency of the stool will soon return to normal. Treatments for temporary constipation are the same as for preventing constipation. That is, a diet with lots of fiber, drinking plenty of fluids, and possibly fruit juice that contains fructose or sorbitol. In some cases, your doctor may recommend a laxative for several days.In an episode of mild constipation, the function of the lower intestine (rectum) is not affected. Thus, you can stop the laxative treatment as soon as the stool becomes easy to pass again. Treatment usually takes several days. This is in contrast to chronic constipation (see below), where rectal function is altered and laxatives are used for long courses.

Chronic (persistent and severe) constipation
Chronic constipation in children is a severe and long-lasting violation of bowel movements.It develops more often in children aged 2 to 4 years, but it also occurs in older and younger children. Symptoms and features of chronic constipation include:

  • Recurring situations where the child has difficulty or difficulty in emptying the bowel.
  • A child regularly stains linen with very soft stools or mucus-like faeces. This is often regarded by parents as diarrhea.
  • The child may become irritable, eat little, feel unwell, have abdominal pain from time to time, and generally have a low mood.
  • The physician can often feel the terminal intestines filled with hard, lumpy feces on palpation of the abdomen.

Next, we will try to explain how chronic constipation can develop and its symptoms. In particular, why contamination of laundry is a symptom of chronic constipation. Usually, feces accumulate in the lower part of the large intestine. If stool builds up, it begins to move into the rectum (the last part of the intestine), which expands.This sends signals down the nerves to the brain saying “you need to go to the toilet.” When relaxing the anus on the toilet, it takes a little effort to “squeeze out” the feces. But if the child ignores the signal, restrains, then the feces remain in the rectum. Gradually, a large, dense fecal lump forms in the intestine. The rectum then expands and enlarges much more than usual. This contributes to the formation of fecal blockage, in which dense feces become stuck in the rectum. If the rectum remains overstretched for a long time, then the normal sensations of the urge to defecate are weakened.In addition, the muscle strength of the rectal walls decreases, it becomes “lazy”.
Additional portions of feces are suitable for the fecal lump located in the rectum. The lowest part of the fecal lump lies just above the anus. Some of these “fresh” portions liquefy and flow out of the anus. This will stain your baby’s linen and bedding. In addition, some part of the soft stool, liquid stool from the overlying sections of the large intestine can “bypass” around the fecal lump. It also seeps out of the anus and can be mistaken for diarrhea.The child cannot (!) Control this leakage and contamination of the laundry. If the stool is eventually completely removed (by means of an enema), it will quickly fill up with hard stools again, due to the stretching and weakening of the rectal walls.

What is the treatment for chronic constipation in children?
A diet high in fiber and drinking plenty of fluids. This is described above, but, as a rule, in addition to this, the appointment of laxatives is required.

Laxatives
Laxatives are usually prescribed if a child develops chronic constipation. Their first goal is to empty the rectum, to resolve fecal impaction. This can usually be done quickly enough with only an adequate dose of a strong laxative. Sometimes laxative suppositories or cleansing enemas are needed to clear up stool. After the rectum has been emptied, it is important to continue taking laxatives as directed by your doctor. This may be necessary for several months, and sometimes even up to two years. When a child takes laxatives every day, the following happens:

  • The child goes to the toilet more often and has regular bowel movements. As he goes to the toilet more often, the stool becomes smaller and softer. Thus, the stool will be excreted more easily. The child will be freed from the fear of going to the toilet with a large, hard, painful lump.
  • The overstretching of the rectum is reduced, and it can gradually return to normal size, functions are restored properly.

Constipation is unlikely to recur. If laxatives are withdrawn prematurely, the fecal blockage is likely to recur again in the weakened rectal ampulla that has not had enough time to return to normal size and regain strength.
There are different types of laxatives which include:

  • Substances that increase the volume of stool. This is, for example, bran. They make the stool soft but voluminous.
  • Chair softeners.These substances thin and soften the stool. For example, sodium docusate (which also has a mild stimulant effect).
  • Osmotic laxatives. For example, lactulose and polyethylene glycol. These substances retain fluid in the large intestine by osmosis (reduce the absorption of fluid into the blood from the lumen of the colon).
  • Stimulant laxatives. For example, senna or sodium docusate. They act on the muscles in the intestinal wall “squeezing” weaker than usual. Sena preparations are not recommended for use in children.

Your doctor will generally recommend the use of laxatives. However, quite often you will need two laxatives at the same time for several months if one drug does not give the desired effect. For example, an osmotic laxative plus a stimulant. Over time, the dose is gradually reduced and the medication is discontinued. It is important to continue treatment for as long as the doctor advises. Chronic constipation often recurs if treatment is stopped too early.

90,000 direct connection with constipation – LIFEKOREA.ru

Chemotherapy and constipation: links, drugs and causes

Patients receiving certain types of cancer treatments, such as chemotherapy, may experience side effects such as constipation. Doctors sometimes refer to this side effect as chemotherapy-induced constipation. This is one of the most common reasons doctors reduce chemotherapy doses or delay or stop treatment.

Not only chemotherapy can cause constipation. Other factors associated with cancer treatment can also contribute to hard or difficult stools.This may include changes in diet and fluid intake, as well as decreased physical activity. Certain cancers, such as tumors in the abdomen or pelvis, can also directly cause constipation.

This article will explain the link between chemotherapy and constipation and discuss treatment options.

Chemotherapy and constipation: what is the connection

Constipation is a decrease in the frequency of bowel movements and hard and dry stools. Researchers estimate that among cancer patients, the prevalence of constipation caused by chemotherapy is about 16%.They note that 5% have severe constipation and 11% have moderate constipation.

The underlying cause of chemotherapy-induced constipation is unclear. Doctors speculate that constipation is due to a combination of factors associated with chemotherapy. This includes:

  • inflammation of the digestive tract
  • violation of intestinal secretion
  • violation of movements in the digestive tract
  • changes in how the digestive tract reacts to the nervous system

Specific chemotherapy drugs associated with constipation include:

  • gemcitabine (gemzar)
  • oxaliplatin (eloxatin)
  • thalidomide (contergan)
  • vinblastine (wellban)
  • vincristine (oncovin)

Other causes of constipation

Patients on chemotherapy may also need to take additional medications to relieve side effects, including nausea.Some may need opioids to relieve pain that cancer can cause. Therefore, it can be difficult for doctors to determine which medication is causing constipation.

Tumors in the intestines or pelvis can also cause constipation. Other factors that can contribute to constipation include:

  • lack of physical activity
  • bed rest
  • changes in diet
  • low fluid consumption

Some also take vitamins and minerals such as iron or calcium during cancer treatment, and this can also cause constipation.

Chemotherapy-induced constipation is treated with laxatives, but overuse of these drugs can worsen your condition.

Thyroid problems and depression associated with cancer can also cause constipation.

Home remedies for constipation

In addition to medication, measures can be taken at home to relieve constipation caused by chemotherapy. These include:

  • sports if possible
  • increasing fluid intake to 8-10 glasses during the day
  • Increase fiber intake by adding whole grains, brown rice, raw fruits and vegetables, legumes and beans, dried fruits, popcorn, seeds and nuts to the diet

A dietitian can help you choose fiber-rich foods and include them in your diet.Fiber supplementation can sometimes help.

Patients should also log their stool information along with details of their diet and fluid intake. With this information, doctors can make recommendations for improving bowel movement.

Some natural laxatives include:

Hot drinks such as cocoa, tea, or hot water with lemon can also help stimulate bowel function.

Other tips include:

  • Do not delay bowel movements as soon as you want to visit the bathroom
  • Avoid gas-causing foods such as apples, avocados, beans, peas, cabbage, broccoli, milk and sodas until constipation has disappeared
  • avoid chewing gum
  • refraining from using straws
  • avoid constipation-causing foods such as eggs and cheese

Treatment options

Doctors may recommend over-the-counter or prescription medications along with general guidelines for increasing fiber, fluid, and exercise.Emollients, osmotic, stimulant, and lubricating laxatives may help.

Volume-forming laxatives

Bulking laxatives act by swelling within the intestines, allowing the intestines to dilate slightly and facilitate passage of stools. A slight expansion of the bowel stimulates bowel movements and shortens the time it takes to pass stools. Bulking laxatives include:

  • methylcellulose
  • psyllium (metamucil)
  • polycarbophil

Osmotic laxatives

Osmotic laxatives include:

These laxatives help relieve constipation by drawing fluid into the intestines and keeping it there.Osmotic laxatives promote bowel movement for 24-72 hours).

Emollient laxatives

Emollient laxatives are also called stool softeners. These drugs work by increasing intestinal fluid and mixing fats and watery substances in the intestines, which softens hard and dry stools and makes it easier for them to pass.

Emollient laxatives are ineffective if constipation causes lack of bowel movement. Doctors often recommend emollient laxatives with volume-forming supplements.Examples of emollients include:

  • calcium docusate
  • sodium docusate
  • docusate potassium

Stimulant laxatives

These laxatives stimulate the neurons in the intestines, causing contractions that push the stool. Research shows that these laxatives work better than enemas and bulking agents and are often effective for constipation caused by opioid use. Examples of stimulant laxatives include:

Lubricating laxatives

Lubricating laxatives act by covering the stool and rectum with a slippery film, thereby facilitating bowel movement.The most common laxative lubricant is mineral oil, which can be used orally or rectally.

Rectal laxatives

Doctors recommend these manual stimulants only for fecal insufficiency or neurogenic bowel dysfunction. The most commonly used rectal laxatives are bisacodyl suppositories and glycerin suppositories.

The use of enemas or suppositories should be avoided without first consulting a doctor.It’s important to always ask a cancer therapist before trying any laxative.

Chemotherapy: When to see a doctor

Patients receiving chemotherapy and suffering from constipation should see a doctor if they have not had a bowel movement for 3 days. However, this duration depends on the type of chemotherapy and the protocols at the specific cancer center. Some cancer therapists may specify a different interval between bowel movements when medical attention is needed.

Patients taking laxatives or stool softeners to relieve constipation should see a doctor if medication does not work. If the patient does not have a bowel movement within 1-2 days after taking a laxative or stool softener, he needs medical attention.

The following symptoms of constipation also require medical attention:

  • blood in or around the anus
  • blood in the stool
  • persistent abdominal cramps or vomiting
  • loose or watery stools

The specialist may also indicate additional symptoms of constipation that require medical attention.Patients must follow the instructions given by their doctor.

Common complications from hard, dry stools include:

Some patients with severe constipation may develop constipation, which is persistent, severe constipation. Constipation can have life-threatening consequences such as intestinal obstruction.

Completely blocked stools can increase pressure in the intestines and cause decreased blood flow and tissue death. Sometimes, intestinal rupture can occur.

Output

Constipation is common when cancer patients receive certain treatments, such as chemotherapy. Constipation can occur for a variety of reasons. For example, certain chemotherapy drugs, decreased activity, or decreased fluid intake can cause constipation.

Exercise, fiber and fluid intake are ways to naturally stimulate bowel movement. Sometimes medications are needed to relieve constipation.Medication options may include bulking, emollient, stimulant, and osmotic laxatives.