Description:
Laxatives act through various mechanisms to induce the passage
of feces through the intestinal tract to cause a bowel movement.

Laxatives come in various forms -- liquids, tablets, suppositories, powders, granules, capsules, chewing gum, chocolate-flavored wafers, and caramels. The basic types of laxatives are bulk-forming laxatives, lubricant laxatives, stool softeners (also called emollient laxatives), and stimulant laxatives.

Uses:
Laxatives can be divided into groups based on composition and how they act. Here is a basic review:

Bulk-producing laxatives accomplish their action by absorbing water in the intestinal tract, swelling, and forming soft, bulky stool. This stimulates the bowel to pass the stool in a normal manner. Bulk laxatives include:  malt soup extract , malt soup extract and psyllium  methylcellulose, psyllium ,polycarbophil  psyllium hydrophilic mucilloid psyllium hydrophilic mucilloid and carboxymethylcelluose
Hyperosmotics pull water into the bowel from surrounding tissues. These form both a soft stool and also stimulate bowel action. This group can be further divided into saline and lactose type hyperosmotics. The saline forms are used to rapidly empty the lower intestine and bowel. They are for short-term use only. The lactose forms produce slower results and may be used to treat chronic constipation. Lactose forms may also be used in certain medical conditions to decrease the
amount of ammonia in the blood. Hyperosmotics include:
Saline:
magnesium citrate
magnesium hydroxide
magnesium oxide
magnesium sulfate
sodium phosphate
Lactulose
Lubricant laxatives aid in the passage of stool by coating the bowel and stool with a waterproof film. The stool remains soft and moist. Lubricant laxatives include mineral oil.
Stimulant laxatives act on the bowel wall to stimulate stool passage.

Dehydrocholic acid, a stimulant laxative, may be used to treat certain biliary tract conditions. Stimulant laxatives include:
bisacodyl, casanthranol, cascara sagrada, cascara sagrada and aloe, cascara sagrada and phenolphthalein  castor oil, dehydrocholic, phenolphthalein, senna, sennosides

Stool softeners are used to help mix liquids into the stool to prevent the stool from becoming hard, dry, and difficult to pass.
This type of laxative allows a person to have a bowel movement without straining. Stool softeners include:

docusate
poloxamer 188

Carbon dioxide releasing laxatives form gas that pushes the intestinal wall stimulating contractions that move the stool. This
type includes:

potassium bitartrate
sodium bicarbonate

Combinations of the above are also available to take advantage of the individual properties of the individual ingredients.

Possible uses for most laxatives include but are not limited to the following:

during pregnancy
treat constipation due to being bed-ridden, from other medications, poor eating habits, lack of physical exercise
postpartum (first few days after delivery)
before an examination or surgery, as well as after certain surgeries where straining should be avoided
medical conditions which might be made worse by straining

Saline laxatives are more restricted in their uses which include the following:

simple occasional constipation
before an examination or surgery
elimination of drugs or foods as a result of overdose or poisoning

Proper use:
If prescribed or recommended by your health care provider, follow his or her instructions.

If treating yourself, follow the instructions on the box. While taking any kind of laxative, drink at least 6 to 8 glasses (8 oz each)
of liquid during the day.

Enemas - Follow the manufacturer's directions carefully. Lubricate the anus with petroleum jelly before inserting the enema tip
into the rectum. Insert the applicator tip into the rectum gently to prevent any damage to rectal tissue.

Suppositories - Keep in the refrigerator, not the freezer, until needed. Unwrap the foil and moisten the suppository with cold
water. Lie on the side and gently insert the suppository. The suppository should be inserted well into the rectum.

Bulk laxatives - Do not swallow in dry form. Mix according to manufacture's instructions, drink, and follow with a second glass
of liquid. Drink plenty of fluids while taking this medication. Effects usually occur within 12 hours, but may take up to 2 or 3
days.

Stool softeners - Liquid forms may be taken with milk or fruit juice to improve their taste. Effects usually occur within 1 to 2
days but may take up to 3 or 5 days.

Docusate suppositories - These take about 2 to 15 minutes to work.

Hyperosmotic - Take each dose with a full glass of water or fruit juice, and follow with a second glass of liquid. The taste may
be improved by taking the medication with citrus juices or citrus flavored carbonated beverages.

Lactulose will usually produce its effect within 1 to 2 days.
Saline laxatives usually will produce its effect within 1/2 hour to 3 hours depending on amount taken and if there is any
food in the stomach. Larger doses on an empty stomach produce the fastest results. Do not exceed the manufacturer's
recommended dose unless instructed to do so by the health care provider.
Glycerin enemas and suppositories take about 15 minutes to an hour to work.
Sodium phosphate enemas take about 2 to 5 minutes to work.

Mineral oil - Do not take within 2 hours of mealtime to prevent possible interference with the digestion of the food and the
absorption of nutrients and vitamins. It is best to take mineral oil at bedtime. The effects of this medication usually occur about 6
to 8 hours after taking it, except mineral oil enemas, which take about 2 to 15 minutes to work.

Stimulant laxatives - Take on empty stomach for faster results. Many of the stimulant laxatives may be taken at bedtime and the
effects will occur the next morning. Some however may take 24 hours or longer to produce the desired effect.

Castor oil usually works within 2 to 6 hours. To mask the flavor castor oil, chill it for at least an hour prior to taking it.
Mix dose in full glass (8 oz) of orange juice just before taking.
Do not crush, chew, or take bisacodyl tablets within an hour of milk or antacids.
The effects of phenolphthalein may last up to 3 days for some people.
Bisacodyl enemas and suppositories take about 15 minutes to 1 hour to work.
Senna enemas and suppositories take between 30 minutes to 2 hours to work.

Carbon dioxide releasing laxatives - These releasing suppositories take about 5 to 30 minutes to work. If you miss a dose, take
or insert as soon as remembered.

Cautions:
INFORM YOUR HEALTH CARE PROVIDER

about any past reactions to:
bisacodyl
casanthranol
cascara sagrada
cascara sagrada and aloe
cascara sagrada and phenolphthalein
castor oil
dehydrocholic
docusate
lactulose
magnesium citrate
magnesium hydroxide
magnesium oxide
magnesium sulfate
malt soup extract
malt soup extract and psyllium
methylcellulose
mineral oil
phenolphthalein
poloxamer 188
polycarbophil
potassium bitartrate and sodium bicarbonate
psyllium
psyllium hydrophilic mucilloid
psyllium hydrophilic mucilloid and carboxymethylcelluose
senna
sennosides
sodium phosphate
if any of the following medical conditions are present
appendicitis
colostomy
diabetes mellitus (due to sugar content of some products)
heart disease
high blood pressure (due to sodium content of some products)
ileostomy
intestinal blockage
kidney disease (due to possible build-up of magnesium and potassium)
problems swallowing
rectal bleeding of unknown origin

Side effects:
SERIOUS
Notify the health care provider as soon as possible if any of these symptoms occur:

body as a whole
burning on urination
excessive thirst
muscle cramps
paralysis
pink or red colored alkaline urine and stools (phenolphthalein)
red to violet, red to brown, or pink to red, colored alkaline urine (senna, cascara, and/or danthron)
yellow to brown colored acid urine (phenolphthalein, senna, and/or cascara)
weakness
respiratory
difficulty breathing
eyes, ears, nose, and throat
difficulty swallowing
skin
itching
rash
gastrointestinal
intestinal blockage
sudden changes in bowel habits that last longer than 2 weeks
heart and blood vessels
irregular heartbeat
nervous system
confusion
dizziness
irritability
lightheadedness
unusual tiredness

MINOR
These effects need no attention unless they become annoying:

body as a whole
increased thirst
eyes, ears, nose, and throat
irritation of throat
skin
irritation (rectal area)
gastrointestinal
belching
cramping
diarrhea
gas
nausea

Special considerations:
Note:

Do not take any laxatives if signs or symptoms of appendicitis, intestinal blockage, or inflamed bowel are present.
Laxatives may become overused. Do not take for more than 1 week.
Do not take if not needed.
Do not take if a rash develops.

ALCOHOL

The sources used to create this product do not have advice on the use of alcohol with these medications.

ASTHMATICS

No information.

BREAST FEEDING

Laxatives that contain cascara, phenolphthalein, or danthron may pass into the breast milk. The American Academy of
Pediatrics considers cascara and senna usually compatible with breast-feeding. Ask your health care provider for advice
before using them if you are breast feeding.

DIABETES MELLITUS

Consult the ingredients before use as some contain sugar in various forms.

DISCONTINUING MEDICATION

Use only as long as necessary and never over a week unless instructed to do so by the health care provider. Sometimes
the bulk laxatives or other laxatives are given on a long-term basis for certain medical conditions.

DRIVING AND HAZARDOUS EQUIPMENT OPERATION

No problems are expected.

ELDERLY

The elderly have possible increased risk of side effects. Some elderly have a tendency to overuse laxatives. As a person
ages, the body systems start to slow down. What was a normal bowel pattern in youth may not be normal in older age.
Do not use laxatives to maintain this youthful bowel pattern.

FOODS

Proper diet and exercise is important to prevent constipation. Roughage such as white grain breads and cereals, bran,
leafy green vegetables, and fruit are an important part of a balanced diet. Fluids are also important and 6 to 8 8-oz
glasses of liquid should be consumed each day.
Constipation may be made worse by the eating such foods as sugar, candy, puddings, pastries, cake, and cheese.
If on a special diet, such as low sugar or low sodium, check the ingredients in the laxatives, because some of them
contain sugar and or sodium.

INFANTS AND CHILDREN

Consult a health care provider before giving a laxative to a child less than 6 years old. Mineral oil or bisacodyl should not
be used in children less than 6 unless otherwise directed.

PREGNANCY

Do not use mineral oil or caster oil during pregnancy.
Some stimulant laxatives may cause unwanted effects in the mother if incorrectly used.
If kidney function is not normal, do not take laxatives containing magnesium, potassium, or phosphates.
Some laxatives contain sugar or sodium, which may cause problems during pregnancy.

SEXUAL FUNCTION

No information.

SUN EXPOSURE

No information.