John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Stimulant laxatives induce bowel movements by increasing the contraction of muscles in the intestines, and are effective when used on a short-term basis. Examples of stimulant laxatives include aloe, cascara, senna compounds, bisacodyl, and castor oil.
Bisacodyl (Dulcolax, Correctol) is available OTC in oral pill form and as a suppository or enema. The oral form takes
6 to 10 hours to work. Bisacodyl is commonly used in cleansing the colon for
colonoscopies,
barium enemas, and intestinal surgeries. While effective for occasional constipation, bisacodyl should not be taken for more than a week, and a doctor should supervise repeated use.
Other stimulant laxatives include senna (Ex-Lax, Senokot), cascara sagrada (Nature's Remedy), and casanthranol. These laxatives are converted by the bacteria in the colon into active compounds which then stimulate the contraction of colon muscles. After taking these products orally, bowel movements occur after
8 to 24 hours. Prolonged, chronic use of these laxatives can cause the lining of the colon to become darker than normal (melanosis coli) due to the accumulation of a pigment (melanin).
Castor oil (an ingredient of Purge Concentrate) is a liquid
stimulant
laxative that works in the small intestine. It causes the
accumulation of fluid in the small intestine and promotes
evacuation
of the bowels. Castor oil should not be taken with food,
although
juice or other flavored liquids can help hide its
unpleasant taste.
This laxative works rather quickly, usually within 2 to 6 hours.
Castor oil is usually used to cleanse the colon for
surgery, barium
enema, or colonoscopy. The absorption of nutrients and
minerals by
the small intestine can be impaired by the frequent use of
castor
oil. This medicine is not recommended for the
repeated
treatment for constipation.
Precautions
The intensity of the action of stimulant laxatives is
dose
related. A large dose of any stimulant laxative can
produce
serious adverse effects.
There is concern that chronic, long-term use of stimulant laxatives can lead
to loss of
colon function (cathartic colon). After years to decades of
frequent
use of stimulant
laxatives, the nerves of the colon slowly disappear, the
colon
muscles wither, and the colon becomes dilated.
Consequently,
constipation may become increasingly worse and unresponsive to
laxatives. It is not clear, however, which comes first; a progressive decrease
in colon function that leads to the use of stimulant laxatives, or the use
of laxatives that leads to a decrease in colon function. Nevertheless, long term
use of stimulant laxatives usually is reserved for use after other treatments
have failed.
Hemorrhoid is an enlarged vein in the walls of the anus and sometimes around the
rectum, usually caused by untreated constipation, but occasionally associated
with chronic diarrhea. If untreated, hemorrhoids can
worsen, protruding from the anus. Also known as piles.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Digestion RSS
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