Laxatives For Constipation (cont.)
Saline Laxatives
The active ingredients in saline laxatives are mostly magnesium, sulfate, citrate, and phosphate ions. These ions draw water into the intestines. The additional water softens the stool, increases pressure within the intestines, and increases intestinal contractions resulting in the discharge of softer stool. Fleet Phospho-Soda, milk of magnesia, and magnesium citrate are examples of saline laxatives.
Oral doses of saline laxatives should be taken with one
to two
glasses of water. The onset of bowel response is usually
1/2 to 3 hours after consuming the laxative. Small doses are
sometimes
recommended for the treatment of occasional constipation,
while
larger doses can produce complete evacuation of the
intestine.
Complete cleansing of the bowel is useful in preparing for
colonoscopy, sigmoidoscopy, and barium enema.
Precautions
Since there may be some absorption of the active ingredients from the intestines into the blood circulation, saline laxatives should not be used in certain patients. Patients with impaired kidney function should not use laxatives containing magnesium or phosphate salts. Excess accumulation of magnesium and phosphate in the blood of these patients can lead to toxicity. Patients who need to limit their sodium intake, such as those with congestive heart failure, kidney disease, and high blood pressure, should not use laxatives that contain sodium.
Enemas and Suppositories
Rectally administered enemas and suppositories are
commonly used
to cleanse the rectum and the sigmoid colon (the part of
the colon
closest to the rectum) prior to surgery, child delivery,
and flexible
sigmoidoscopy. Enemas and
suppositories are also used to relieve constipation and
rectal fecal
impaction (blockage of the rectum by hard, compacted
stool). They can
also be used in conjunction with oral laxatives in
cleansing the
colon in preparation for barium enema studies.
Enemas and suppositories include docusate (Microenema), bisacodyl
(Dulcolax Suppository), and sodium phosphate (Fleet Enema). These products are intended for occasional use and are not recommended as a chronic laxative regimen unless directed by a physician.
Patients should carefully follow instructions in using enemas. The patient should lie on the left side with the knees bent. The enema solution should be inserted slowly into the rectum. The person should retain the solution in the rectum until definite rectal pressure and the urge to have a bowel movement are felt. Evacuation usually occurs within minutes to an hour.
Precautions
- Soapsuds enemas can cause rectal irritation and
sometimes rectal
gangrene. Therefore, soapsuds enemas are not
recommended.
- Enema solutions can cause fluid and electrolyte
disturbances in
the blood if used on a chronic basis.
Next: Laxatives for Constipation At A Glance »
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