Laxatives For Constipation (cont.)
Stool Softeners (emollient laxatives)
Stool softeners, called emollient laxatives,
prevent
hardening of the feces by adding moisture to the stool. The
active
ingredient in most stool softeners is a medicine called
docusate.
Agents containing docusate do not by themselves stimulate
or increase
the number of bowel movements. They are used more to prevent constipation than to treat it.
Stool softeners are commonly recommended for patients who should avoid straining while defecating, including:
Stool softeners available OTC include Colace,
Surfak, and
pharmacy or store-branded products containing docusate.
Some
preparations (for example, Peri-Colace) combine a stool
softener
with a stimulant laxative to activate bowel movements.
Precautions for using stool softeners
Stool softeners are generally safe and well tolerated. They
should
not be combined with mineral oil, a lubricant laxative,
because stool
softeners may increase the absorption and toxicity of
mineral oil.
Mineral oil droplets absorbed into the body can
deposit and
cause inflammation in the lymph glands, liver, and spleen.
Lubricant Laxatives
Mineral oil (liquid petrolatum) coats and softens
stool. Like stool softeners, mineral oil is used by
patients who need
to avoid straining (for example, after hernia repair,
hemorrhoid
surgery, heart attacks, and childbirth).
Precautions for using lubricant laxatives
- Mineral oil should be avoided in patients taking blood
thinners,
such as warfarin (Coumadin).
Mineral oil decreases the absorption of vitamin K
(important in
forming clotting factors in the blood) from the intestines.
The
decreased assimilation of vitamin K in patients taking
Coumadin can
potentially lead to "over-thinning" of the blood and
increasing the
risk of excessive bleeding.
- Mineral oil should not be taken during
pregnancy since
it may
inhibit vitamin
absorption and decrease the availability of vitamin K to
the fetus.
- Mineral oil can cause pneumonia if it leaks into the
lungs.
Leakage of secretions and other contents from the mouth and
the
esophagus into the lungs is called aspiration. Certain
individuals
(for example, the very young, the elderly, stroke victims,
and those
with swallowing difficulties) are prone to aspirate,
especially while
lying down. Therefore, mineral oil should not be given at
bedtime or
to individuals who are prone to aspirate.
- Mineral oil should only be used for short periods of
time. A
significant absorption of mineral oil into the body can
occur if used
repeatedly over prolonged periods.
Next: Stimulant Laxatives »
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