Constipation medications for older people: if the intestines take a break

The body must regularly get rid of undigested food debris; they are excreted from the rectum, forming stool. If you have bowel movements regularly, ideally every morning, before or after breakfast, and don’t experience any difficulty, that’s great. But, alas, not everyone finds this process as effective or comfortable as they would like. When stool retention occurs or defecation brings discomfort, is painful, and the excrement is dense and dehydrated - this is constipation. They need to be dealt with effectively, otherwise they will seriously complicate your normal life.

Constipation is a common problem, but it has a much broader meaning than is commonly believed. Even if the stool is regular, daily, but dry and painful, this is also constipation. Most of us think of constipation as the inability to have a full bowel movement after a few days of delay (three or fewer times a week is a generally accepted criterion), but the problem can actually take many forms. Experts say symptoms of constipation include:

• a feeling of inability to completely empty the rectum of stool;
• straining or making a serious effort to have a bowel movement;
• Lumpy or hard, dry stools—feeling narrower than normal or having a different volume than usual;
• assistance is needed to empty the rectum.

Regarding constipation, everything is very individual. If there is no stool for 2-3 days, but then a soft “sausage” comes out and there is no discomfort, no constipation pills for adults are needed. This is an individual feature of digestion. Perhaps you should reconsider your diet, drink more water - you will have bowel movements more often. If even daily trips to the toilet are a problem, you need to strain, several visits for relief - you should consult a doctor and pick up laxatives with him to help with bowel movements while you eliminate the causes of constipation.

It is important not to constantly take laxatives; these are not therapeutic drugs, but only measures to alleviate the condition. You shouldn't abuse them, it will only get worse. Constant stimulation of the intestines can lead to the fact that without taking medications the intestines will refuse to work at all. And one more thing - only a doctor can select the best anti-constipation pills for adults that will help well without side effects or complications. Constipation has many causes and each has its own effective remedy.

The most effective drugs for treating constipation.

October 1, 2022
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Content

• Why does constipation occur in adults?
• Constipation symptoms
• How to choose the right laxative
• What types of laxatives are there?
• The most effective laxatives
• Mukofalk
• Forlax
• Guttasil
• Exportal
• Senna leaves
• Guttalax Express
• Duphalac
• Magnesium sulfate
• Regulax Picosulfate

Such a delicate problem as constipation has happened to everyone, and this is the most common disorder of the gastrointestinal tract. Constipation is dangerous to your health, especially if it is chronic. We will talk about the causes of this condition and the best laxatives. Read also The most effective probiotics for the intestines: top 5 How to choose a probiotic and for what problems it is prescribed.

Literature:

1. Minushkin O.N. Functional constipation: dynamics of ideas, diagnosis, some therapeutic approaches. Medical advice. 2017; 20:92-95
2. Turchina M.S. The use of complex laxatives in the treatment of chronic constipation. Medical advice. 2017; 5:77-79
3. Minushkin O.N. Chronic constipation (definition, epidemiology, diagnosis): modern drug therapy. Medical advice. 2015; 13: 100-105
4. Plotnikova E.Yu., Krasnov K.A. Constipation needs to be treated. Medical advice. 2018; 14:61-66
5. Stepanov Yu.M., Vlasova O.N. et al. Negative effects of laxative abuse in medical practice. Gastroenterology. 2018; 52 (3): 168-173
6. Luzina E.V. Safety of using laxatives. Russian medical journal. 2014; 5:41-44
7. Parfenov A.I. Three options for the pathogenesis and treatment of chronic constipation. Gastroenterology. 2012; 3:7-19
8. Plotnikova E.Yu. Modern ideas about constipation. Attending doctor. 08/2015
9. Pharmacology of drugs affecting the function of the digestive organs: textbook by A.N. Leventa, L.B. Kuklina, S.G. Alexandrov, N.V. Verlan, L.O. Gutsol, I.Zh. Seminsky, O.V. Shabaturova; GBOU VPO IGMU of the Ministry of Health of Russia - Irkutsk, 2013. -112 pp. 102-103
10. Global practical recommendations of the World Gastroenterological Organization. Probiotics and prebiotics. 2022 - 37s.
11. Instructions for use of MICROLAX® microenemas. // Reg. number P N011146/01 // GRLS of the Russian Federation. – URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=f052fb31-5426-4bc1-958f-9fce793aa43f&t= (date accessed 05/05/2010).
12. Erdes S.I., Matsukatova B.O. and others. Episodic and chronic constipation in children: a step-by-step approach to therapy within the framework of the IV Rome criteria. Pediatrics. Consilium Medicum. 2019; 1:71-76
13. Constipation in young children: causes and features of dietary correction O.N. Komarova, A.I. Khavkin (Questions of modern pediatrics. 2014; 13 (1): 114–118
14. Clinical recommendations. Constipation in adults (as a manifestation of systemic diseases). Scientific Society of Gastroenterologists of Russia (NOGR), Russian Scientific Medical Society of Therapists (RNSOT) - 2019
15. Lactulose: arguments and facts. Yu.O. Shulpekova. EFFECTIVE PHARMACOTHERAPY. Gastroenterology. 5/2011 - pp. 28-71.
16. Clinical guidelines: Constipation / Russian Gastroenterological Association. Association of Coloproctologists of Russia - 2022.
17. Minushkin O.N. 1, Elizavetina G.A. Forlax in the treatment of chronic constipation: features of therapy for elderly patients / “Breast Cancer” No. 1 - 2006.

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Watch in our video which laxative to choose for constipation: tablets, syrup or microenemas

Why does constipation occur in adults?

There are many reasons for constipation (both medical and social). Temporary constipation can occur due to stress, some illness, a certain lifestyle, poor diet, while traveling, or taking certain medications. There are organic and functional causes of constipation.

1. Organic causes of constipation.

Among these reasons are any diseases of the intestines or stomach that prevent normal bowel movements:

• congenital anomalies of intestinal development;
• postoperative period (treatment of the stomach or intestines);
• inflammatory processes in the stomach or intestines;
• tumors of the intestine and surrounding tissues.

2. Functional causes of constipation.

These reasons are not associated with gastrointestinal diseases. Among them:

• emotional disorders (depression, stress, insomnia, conflict situations, phobias and fears, etc.);
• problems with intestinal peristalsis (muscle contraction).

Intestinal motility is disrupted due to insufficient water, poor nutrition, and lack of fiber in the diet. It is plant fiber that increases the volume of feces in the intestines and makes it work properly. Therefore, to prevent constipation, you need to eat vegetables, fruits and grains. Peristalsis is also disrupted if a person leads a sedentary lifestyle - lack of physical activity reduces muscle tone, and intestinal contraction slows down.

• Taking certain medications can also negatively affect intestinal function (reduce its motility). Among the drugs that cause constipation are non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen), antispasmodics, antibiotics, drugs for the treatment of fungal infections, etc.

If a person takes laxatives for a long time and then stops, he may also develop constipation due to decreased intestinal tone and the development of dysbiosis.

Chronic constipation negatively affects overall well-being and quality of life in general. Constipation causes abdominal pain, increased gas, loss of appetite and nausea. If you don't go to the toilet for a long time, your risk increases:

• development of dysbacteriosis;
• intoxication (poisoning of the body);
• enterocolitis;
• hemorrhoids;
• problems with the functioning of internal organs;
• the appearance of intestinal polyps and malignant tumors.

Table 1. Main causes of constipation (Zlatkina A. R., 2002)

Neurogenic factors	VSD
Neurological diseases (peripheral level of neuropathology)	Parkinson's disease, multiple sclerosis, sacroleitis, Hirschsprung's disease
Diseases of the rectoanal area	Strictures (benign and malignant), proctitis, anism, hypertonicity of the anal sphincter
Iatrogenic diseases	Adhesions after surgery, radiation therapy, taking medications
Insufficient physical activity	Physical inactivity
Nutritional factors	Low fiber content

Inhibition of intestinal motor function and the appearance of constipation, especially in elderly and old people, is facilitated by insufficient physical activity (physical inactivity). Special attention should be paid to medications that can cause constipation, especially with long-term use. This is inherent in atropine, various narcotic drugs, some anticonvulsants (diphenin), calcium bicarbonate (baking soda). Psychotropic drugs (tranquilizers, antidepressants), some diuretics, iron supplements, aluminum hydroxide (Almagel) can cause constipation. Depending on the etiology of constipation, there are: nutritional; conditioned reflex neurogenic (“habitual” neglect, situational constipation); functional (essential, primary, idiopathic) constipation (causes: irritable bowel syndrome, hypomotor dyskinesia of the colon, chronic idiopathic intestinal pseudo-obstruction); constipation associated with organic intestinal pathology (causes: neoplasms, diverticula, ischemia, stenosis); constipation associated with neuromuscular disorders of the intestines (multiple sclerosis, neuromatosis, systemic scleroderma, amyloidosis); constipation (dyschezia) associated with pathology of the rectal and anal area (fissures, fistulas, enteroceles, rectoceles, abscesses, strictures, viral or syphilitic condylomas); symptomatic constipation; with endocrine pathology (diabetes mellitus, hypothyroidism); for neurological pathology (Parkinson's disease, spinal cord injury, organic pathology of the central nervous system); constipation associated with inflammation of the urogenital organs; drug-induced constipation (taking psychotropic drugs, clonidine, calcium antagonists, narcotic analgesics, anticholinergics, antidepressants, tranquilizers and antiparkinsonian drugs, non-steroidal anti-inflammatory drugs, antacids, tricyclic antidepressants, iron supplements, sympathomimetics, bismuth preparations, lithium preparations, barbiturates, phenothiazines, diuretics, barium sulfate). In clinical practice, a classification of constipation according to its course is accepted: acute and chronic. In acute constipation, there is a sudden absence of stool for more than two days. The most common causes of acute constipation are: intestinal obstruction (tumors, inflammation, diverticulitis), pathology of the anorectal region, acute cerebrovascular accident, traumatic brain injury, bed rest and side effects of medications. Sudden onset of constipation requires the exclusion of a neoplasm in the left half of the colon. Constipation, which is based on inflammatory processes, is characterized by the presence of fever, and constipation associated with a neoplasm is characterized by a gradual increase in clinical symptoms and lengthening of the intervals between bowel movements. In patients with chronic constipation, dysbiosis must be excluded. In patients suffering from constipation due to decreased intestinal motor function, as a rule, it is necessary to exclude organic pathology of the gastrointestinal tract (gastritis, duodenitis, peptic ulcer). Chronic constipation can cause various complications: secondary colitis, proctosigmoiditis (inflammation of the sigmoid and rectum). With prolonged stagnation of contents in the cecum, it may be thrown back into the small intestine with the development of enteritis (reflux enteritis). Constipation can be complicated by diseases of the biliary tract, hepatitis, and contribute to the appearance of various diseases of the rectum. The most common occurrence is hemorrhoids. With constipation, rectal cracks and inflammation of the peri-rectal tissue (paraproctitis) can also occur. Long-term constipation sometimes causes the colon to expand and lengthen (acquired megacolon), which makes it even more persistent. The most dangerous complication of long-term constipation is cancer of the rectum and colon. Stagnation of contents in the intestines, caused by the consumption of foods poor in dietary fiber, leads to a high concentration of carcinogenic (cancer-promoting) substances formed in the intestines and their long-term effect on the intestinal wall. The basis of treatment for constipation is to eliminate its cause, and the use of laxatives is auxiliary. Prescribing a laxative without identifying the cause of constipation is unacceptable. The choice of therapeutic tactics is also determined by the cause of constipation. Nutritional constipation requires nutritional correction. If constipation occurs on the road or at a time when it is difficult to eat regularly, you should take a laxative for a short time. Constipation, especially if it occurs when moving or on business trips, can also go away when taking eubiotics (Bifikol, Acylact, Bufidumbacterin, etc.). The only type of laxative allowed for self-medication is laxatives that help increase the volume of intestinal contents, such as seaweed, oatmeal, bananas, agar-agar, lactulose. But even their reception should be episodic. Laxatives that help increase the volume of intestinal contents usually begin to act after a time interval of 12 hours to 3 days. For patients suffering from constipation, the dietary fiber content of foods should be taken into account. With a large amount of coarse fiber in food, people with complaints of bloating produce on average 2 times more gases than with a diet with moderate fiber content, and almost 5 times more than with a liquid, chemically homogeneous diet without dietary fiber. Patients with constipation and complaints of bloating should limit or even exclude foods rich in dietary fiber from their diet. Avoid dishes made from beans, cabbage, sorrel, spinach, etc., which cause increased gas formation. Apple and grape juices are not recommended. If there are no special contraindications (heart disease, edema), then a patient suffering from constipation should drink approximately 1.5–2 liters of fluid per day. Taking enough fluid is very useful, since due to the slow evacuation of feces from the intestines, they dry out, which, in turn, makes it difficult for them to move through the colon. It is important to maintain a proper diet. Food must be taken at least 5 times a day. Long breaks between meals are unacceptable. Bran provides a very significant therapeutic effect for constipation. They are resistant to the action of digestive juices, are not a significant source of energy and at the same time stimulate the evacuation function of the intestines to a greater extent. A rather difficult problem in the treatment of constipation is the use of laxatives. They are very effective at first, but with prolonged use, addiction is possible, accompanied by a complete loss of the independent urge to defecate. Laxatives are contraindicated for constipation of nutritional origin. The use of laxatives should be differentiated depending on the etiology and pathogenesis of constipation. The most complete classification of laxatives today can be considered (Y. S. Zimmerman, 1999) [4, 13], given in Table 2.

Constipation symptoms

In European countries, the Thompson scale is used to diagnose constipation .

If during the course of a year a person regularly experiences at least one of the following symptoms, we can talk about constipation:

• every third or fourth act of defecation requires obvious effort;
• with every third or fourth act of defecation - hard stool;
• the volume of feces per day does not exceed 35 g;
• you have to use aids to go to the toilet;
• dry, fragmented stool;
• stool frequency is less than three times a week.

Causes of constipation
Photos from open sources

Compliance with diet

Constipation is a delicate disease that causes pain, stress, and a feeling of insecurity in a person. Adjusting your weight and getting all the necessary vitamins, minerals, proteins, fats, and carbohydrates stabilizes the gastrointestinal tract. A balanced diet is an important method for preventing constipation in adults and children. Recommendations for creating a healthy diet to prevent constipation:

• Tea, chocolate, starch-based jelly slow down the contraction of intestinal muscles, so you need to reduce their consumption.
• It is necessary to include in the menu bread made from wholemeal flour, unpolished rice, and bran, which should be soaked overnight.
• Nutrition correction includes mandatory breakfasts. Eating in the morning stimulates the intestines and normal digestion.
• It is necessary to introduce into the diet laxative products containing dietary fiber - nuts, bran, beans, fruits, vegetables.
• For prevention, you should reduce the amount of meat, flour foods, astringent products, pureed dishes, and viscous porridges.

A diet to prevent constipation includes drinking plenty of water, which softens the thick consistency of intestinal contents. It is recommended to drink at least one and a half to two liters of liquid without gas and sugar. Bran helps stool move faster through the intestines.

How to choose the right laxative

Often, to normalize stool, it is enough to establish proper nutrition. It happens that even a one-time intake of vegetables or fruits can improve intestinal motility. If adding plant fiber to your diet does not help, you need to take laxatives. We recommend that you consult with your doctor about medications for constipation, because many of them have contraindications and side effects. When choosing such drugs, you need to consider some points.

1. Type of constipation.
   If you are constipated due to poisoning, you need to rid your body of toxins as quickly as possible. Saline laxatives are suitable here. If constipation is chronic, irritant drugs (anthraglycosides) are prescribed.
2. Age.
   Many laxatives are contraindicated for children because they contain toxic substances (they are safe for adults). Well, the form of release of the drug matters. Tablets are not suitable for children; it is better to choose syrup or suppositories.
3. Pregnancy and breastfeeding.
   Most laxatives are not suitable for pregnant or breastfeeding women because they can have a negative effect on the fetus. In extreme cases, lactulose-based constipation medications are allowed during pregnancy. But it is better to carefully read the instructions for a particular drug.

Almost all laxatives should not be taken for a long time, because the body gets used to them. The natural work of the intestines decreases over time, because it adapts to the fact that the drugs “do the work” for it.

Read also How to treat dehydration: 5 solutions for rehydration What drugs for dehydration are most often prescribed by doctors?

Osmotic laxatives

If a person has diseases of the digestive system and is plagued by chronic constipation, one should not try to cope with the problem with the help of osmotic laxatives. They are recommended to be taken only once, when stool retention is acute, or a person has poisoning (food or drug). Also, osmotic laxatives are prescribed for high-quality preparation of the intestines for diagnostic measures.

Drugs in this group do not cause intestinal atony, so some of them, for example, Kolokit, Forlax, can be taken for up to 3 months. However, it must be borne in mind that they do not affect the cause of constipation, but simply eliminate it. Patients do not develop addiction to the drug [7].

How do osmotic laxatives work? After taking an osmotic laxative, fluid begins to accumulate in the intestines, water is removed from fat cells and blood plasma. This allows you to soften the stool and make it larger in volume. Emptying of the organ occurs against the background of increased osmotic pressure.

Side effects. Drugs in this group, when taken for a long time, promote the removal of salts from the body and disrupt its water-electrolyte balance. Therefore, they should be prescribed with extreme caution to children and people with heart disease.

After taking osmotic laxatives, abdominal pain occurs, which can be quite intense.

Indications and contraindications. Osmotic laxatives are prescribed for nutritional poisoning or intoxication with medications. They are also used to relieve acute constipation. Polyethylene glycol is approved for the treatment of nursing and pregnant women.

Carlsbad artificial salt

This drug is a substitute for geyser Karlovo salt and is classified as a saline laxative. Its intake promotes increased secretion of bile. The drug is prescribed for nutritional poisoning, constipation and chronic cholecystitis. It is forbidden to take salt to patients with intestinal obstruction, as well as at high body temperature.

Side effects from taking Carl's salt:

• Atony of the large intestine.
• Water and electrolyte imbalances.
• Diarrhea.

Take salt on an empty stomach. Give a teaspoon to children over 2 years old, dilute the specified amount of the drug in half a glass of water. Adults are advised to take a tablespoon of salt, which is diluted in a glass of water. Start eating after 40 minutes.

pros

The drug helps not only cope with constipation, but also improves the functioning of the gallbladder. Charles salt makes it easier to cope with poisoning caused by ingesting expired foods, alcoholic beverages, medications, etc.

The drug has virtually no side effects. It does not cause allergies. It can be used to treat children, but salt is contraindicated for pregnant and lactating women.

Minuses

Carl's salt cannot be combined with other medications, as it will reduce their effectiveness. It is prohibited to drink diuretics during treatment, as the likelihood of dehydration increases many times over. Violation of storage conditions leads to changes in the properties of salt, as a result of which it may lose its qualities. Therefore, the drug must be kept at a temperature of +22-27 °C.

Macrogol (Lavacol, Osmogel, Fortrans, Relaxan, Tranzipeg, Forlax, Forteza Rompharm)

Macrogol is often used as a laxative. It can be taken for a long time (up to 3 months). This will normalize intestinal function. To ensure that after completing the course there is no malfunction in the digestive system, a person will need to follow a diet and also exercise.

The drug is not absorbed into the blood; it works only at the intestinal level. After taking it, patients do not experience abdominal discomfort and gas formation does not increase. Macrogol softens stool and facilitates bowel movements.

The drug does not lead to dehydration and does not interfere with metabolic processes. The effect develops 1-2 days after the first dose. It is recommended to drink Macrogol during breakfast. The dosage is determined by the doctor [8].

pros

The drug allows you to thoroughly cleanse the intestines and completely remove all contents from it. This is especially true for people who are undergoing an organ examination. You can take Macrogol for a long time. The drug acts only in the intestines and is not absorbed into the systemic circulation.

Minuses

Many patients note the unpleasant taste of the drug. To feel the laxative effect, you need to take a large amount of the drug. Most Macrogol-based drugs are prohibited for use by children, nursing and pregnant women.

Magnesium hydrate sulfate (bitters salt, Epsom salt, magnesium, epsom salt)

The drug is prescribed for biliary dyskinesia, to relieve constipation, for inflammation of the gallbladder, to prepare for a diagnostic examination of the intestines, and for intoxication with heavy metal salts.

In addition to the laxative effect, magnesium sulfate has a choleretic effect on the body. For your appointment, take one packet of the drug, which is diluted in 100 ml of water [9].

pros

Magnesium sulfate is an effective and fast-acting remedy for relieving constipation. It is widely used in medical practice. It liquefies even the hardest stones and does not cause inflammation of the intestines and gastrointestinal tract as a whole.

Minuses

The drug is not prescribed to children under 15 years of age, patients with heart disease and disorders of the central nervous system. It relieves constipation but does not address its cause. With uncontrolled use of the drug, a person develops dehydration. If you take magnesium sulfate for more than 3 months, it will negatively affect the functioning of your kidneys and heart.

What types of laxatives are there?

There are a lot of laxatives in pharmacies that are used in certain cases. Let's figure out which laxative to choose.

1. Laxatives that stretch the intestines and irritate its receptors
   (salt laxatives also fall into this category). Such drugs begin to act quickly, but their effect is short-lived. Among the natural remedies for constipation are the same vegetables and fruits rich in fiber, which, when entering the intestines, stretch it. Receptors on the intestinal mucosa sense pressure and contraction occurs. Drugs with this effect are prohibited if the patient has intestinal obstruction, renal failure or an “acute abdomen”.
2. Stool softeners.
   This group of laxatives includes various oils (olive, petroleum jelly). Often, such drugs are prescribed to older people whose intestines contract poorly and their stool becomes hard due to a sedentary lifestyle. Oils soften stool and help it pass out easily, enveloping the intestinal mucosa. Oily laxatives are used in preparation for colonoscopy.
3. Anthraglycosides.
   These include natural laxatives (rhubarb root, marshmallow syrup, senna leaves, etc. These products contain special substances that irritate receptors on the intestinal mucosa, which promotes its contraction. Anthraglycoside laxatives are suitable for cleansing the intestines before diagnostic procedures.
4. Antispasmodics.
   For constipation caused by spasms, antispasmodics are prescribed, which relax the intestinal muscles and help stool pass more easily. The spasm is usually caused by stress or poor diet. With such a spasm, a person feels pain, and feces do not move well through the intestines. No-Spa helps well with spastic constipation.

Treatment of constipation requires mandatory adherence to a diet. It is very important to change your diet to include foods that stimulate intestinal contractions. If you fight constipation only with the help of laxatives, the body will get used to them and “forget how” to work on its own. Therefore, nutrition should be a parallel treatment!

Read also How to treat gastritis: 8 best drugs The best drugs for gastritis: reducing acidity, eliminating excess acid and fighting Helicobacter pylori.

Suppositories

For constipation in the elderly, rectal suppositories are rarely used. This is due to the fact that it is quite difficult for elderly patients to insert them on their own. But if there is a need to use suppositories to facilitate bowel movements, then it is advisable to give preference to such drugs as Glitselak, Evacue, Ferrolax.

Relief and sea buckthorn suppositories not only help soften stool, but also improve the healing of mucous membranes.

Suppositories should be selected taking into account general contraindications, the presence of hemorrhoids and anal fissures. When they form from constipation, it is better to use combination drugs, that is, those that will relax the intestines and at the same time restore tissue.

Mukofalk

A German herbal laxative (psyllium husk) is sold in powder form from which a suspension is prepared. This is convenient for those who have problems swallowing. Plantain seeds absorb a lot of water, which has a positive effect on constipation. In addition to plantain seeds, “Mukofalk” contains a lot of plant mucus, which ensures easy passage of feces. This laxative is prescribed to children from 12 years of age, and is also used in the complex treatment of high cholesterol. Among the advantages of the drug are a pleasant orange taste, excellent tolerability, long-lasting effect and the possibility of use during pregnancy. There are some side effects that you should definitely read in the instructions.

Mukofalk

Dr. Falk Pharma, Germany

- constipation (including during pregnancy);
- anal fissures; - haemorrhoids; - postoperative period during interventions in the anorectal area (in order to create a softer stool consistency); - functional diarrhea; - irritable bowel syndrome. from 421

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Enteric fillers

Intestinal fillers are substances that the gastrointestinal tract is unable to digest. They are not absorbed into the systemic circulation. The laxative effect is achieved by increasing the volume of feces. Fillers can be represented by both modified saccharides and herbal agents.

Some patients suffering from chronic stool retention refuse to take these laxatives, since their effect does not always develop. There is also a high probability of flatulence, rumbling in the stomach, and pain along the intestines.

Intestinal fillers: agar-agar, flax and flaxseed, wheat bran, sterculia, methylcellulose, psyllium husk (oval or ovoid) [11].

How do enteric fillers work? Fillers, regardless of their type, absorb water. The intestinal walls stretch, so the organ tries to get rid of excess fluid. Feces come out along with the water. However, with atony of the organ, these remedies are ineffective. To develop a laxative effect, you need to drink as much water as possible (at least 2 liters per day).

Fillers are classified as mild agents that do not immediately relieve constipation. Depending on the chosen drug, the effect develops after 12 hours (when taking agar-agar) or after 24 hours (when taking flyavort seeds). Methylcellulose will help you cope with constipation in only 1-3 days.

• Side effects. When taking fillers, the intestinal walls stretch, the organ fills with gases, and strong rumbling may occur. In order for the full effect to develop, a person must drink a lot of water, which is not always possible. An obstacle to this can be various diseases of the urinary system and not only.
• Contraindications. Pregnant women should not take medications for constipation, as this increases the likelihood of spontaneous abortion. Fillers are prohibited for people with IBS, as well as bedridden patients, people with intestinal obstruction and diseases of the nervous system.

Forlax

A synthetic laxative whose active ingredient is macrogol. Forlax is prescribed for the symptomatic treatment of constipation in adults and children over 8 years of age. Doctors consider this laxative to be as safe as possible, but it is better to familiarize yourself with the list of contraindications. Among them: Crohn's disease, ulcerative colitis, gastrointestinal perforation, intestinal obstruction (or suspicion of it), abdominal pain for unknown reasons, hypersensitivity to the main or auxiliary substances. The laxative effect after taking Forlax occurs within 24-48 hours. The drug is not suitable for emergency relief from constipation. Forlax is considered one of the best laxatives. The active ingredient of the drug retains water in the intestines, which causes its walls to stretch and the urge to evacuate. This is a very mild drug that does not stimulate frequent urge to go to the toilet, so you do not need to be at home during treatment. “Forlax” for constipation is approved for pregnant women, there is a dosage for children from 6 months, addiction does not develop when taking it, the body does not lose electrolytes, and there are no side effects.

Forlax

IPSEN (Bofur Ipsen), Ukraine

Forlax powder helps restore normal intestinal motility in young children.
The duration of the intestinal “training” effect ranges from 1 to 6 months and depends on the duration of taking the drug. from 137

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Drugs that increase the volume of intestinal contents

Bulk laxatives retain water, swell and stretch the intestinal walls with increased volume. Excessive distension triggers peristalsis and bowel movements are accelerated17.

This group of drugs includes3,16:

• alimentary fiber;
• osmotic laxatives - macrogol, lactulose, salts.

The listed medications are difficult to digest, and some are not digested at all, so they are practically not absorbed through the mucous membrane into the blood17.

Alimentary fiber

Dietary fiber (fiber) is found in bran, seaweed, psyllium seed hulls and flax14. They are also found in vegetables and fruits. Fiber can swell in the intestinal lumen, increasing the mass of feces, which mechanically irritates the intestinal wall3,7. But the effect does not appear immediately, but after 10 days, sometimes you have to wait up to 3 weeks for results6.

To get a laxative effect when using dietary fiber, do not forget to drink enough water3 - 1.5-2 liters per day17, because to increase the volume of feces, fiber must absorb a lot of liquid3,7.

When choosing between wheat bran and psyllium, you should keep in mind that wheat bran can cause flatulence7,16. Therefore, elderly people are advised to use psyllium seeds, which are better tolerated16.

Macrogol

Products based on polyethylene glycol (macrogol) are poorly absorbed substances6,9. Thanks to this property, they are able to retain fluid in the intestinal lumen7,9.

Macrogol does not cause dehydration, but only slows down water absorption14. After taking a laxative, the stool becomes thinner, its consistency improves, and the frequency of bowel movements increases7.

The disadvantage of macrogol is a rather slowly developing effect and intestinal hypotension1, and the main side effect is potentiation of fecal incontinence7. According to the instructions, the recommended duration of taking macrogol is up to 14 days8.

Saline laxatives

Concentrated salts - magnesium sulfate, sodium sulfate, Carlsbad salt8, 9 - act at the level of the small intestine and increase the osmotic pressure in it17. On the one hand, this attracts fluid into the intestinal lumen1,4,5,6,7, and on the other, it retains water in it7,8.

Under the influence of salts, feces become liquid, like diarrhea, and are easily excreted,8,17.

But it is precisely because of severe diarrhea that salt laxatives are not suitable for long-term use. With the constant release of loose stools, imbalances in water and ions may occur17. Also, these drugs are not recommended for people with kidney and heart diseases, because salts can be absorbed into the bloodstream in minimal quantities and retain water in the body14. When using Carlsbad salt, a problem for patients may be its unpleasant taste8.

Lactulose

Lactulose has a laxative effect not directly, but with the help of beneficial bacteria. Using it as food10, 13, bifidobacteria and lactobacilli that live in the intestines secrete substances that act like osmotic laxatives7,10,13,17. But at the same time, severe diarrhea does not occur, because lactulose “works” exclusively in the large intestine15,17.

The laxative effect of lactulose develops gradually:

• with a single dose every 24-48 hours;
• with systematic - after 2-4 hours15.

Since lactulose is not digested, it is practically not absorbed and has no systemic side effects15. Sometimes, if the dose is incorrectly selected, bloating may occur while using the drug15,17.

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Guttasil

Guttasil tablets have a mild laxative effect, do not cause intestinal spasms, and are prescribed to adults and children over 10 years of age. The active substance of the drug stimulates the nerve endings of the intestine, as a result of which its peristalsis improves. Doctors often prescribe Guttasil for irritable bowel syndrome. Among the advantages of the drug: it helps to get rid of constipation due to errors in diet, softens stool well, and is suitable for constipation caused by taking medications and problems with the gallbladder. But if you exceed the dosage of Guttasil, severe abdominal pain is possible.

Guttasil

PAK "Farmak", Ukraine

Constipation caused by hypotension and sluggish peristalsis of the colon.
Regulation of stool for hemorrhoids, proctitis, anal fissures. Preparation for surgical operations, instrumental and x-ray examinations. from 131

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Stimulant laxatives

Stimulants of peristalsis (intestinal contractions) are irritating substances that act on nerve endings in the intestinal mucosa 3,4,5,6,7.

Medicines with an irritating effect can act on different parts of the digestive tract3,4,5:

• the small intestine is the zone of action of castor oil and laxative resins;
• The activity of the colon is increased by preparations of senna, buckthorn, rhubarb, sulfur, sodium picosulfate and diphenylmethane derivatives.

They also secrete drugs that are converted into an active form under the influence of intestinal enzymes, so they “work” in both the small and large intestines3,4,5,6.

It is important to remember that if you abuse stimulant laxatives, side effects are possible:

• Diarrhea with cramping pain in the abdomen . Due to diarrhea, the body loses the potassium, sodium and chloride ions it needs. With their deficiency, general weakness is a concern, and due to an imbalance of ions, there is a likelihood of arrhythmias and a decrease in blood pressure5,16.
• The "lazy gut" phenomenon . “Lazy” is a colon that has become an enlarged tube that has lost its tone. Without taking large doses of laxatives, it is unable to contract and move stool. This often happens if the drug accumulates in the colon mucosa and its nerve plexuses, and then destroys the smooth muscles that push feces1,5,16.

Lazy bowel syndrome is manifested by the progression of constipation, which is difficult to correct2,5. Due to rapid addiction7, peristalsis stimulants are not recommended for use for more than 14 days5,16.

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Exportal

Lactitol is a hydrocarbon alcohol that is obtained from lactose (milk sugar). This alcohol destroys putrefactive bacteria in the intestines and stimulates the growth of acidophilic (beneficial) bacteria. It is this alcohol that is contained in the drug “Exportal”, which is prescribed not only for constipation, but also for preparation for intestinal examinations, operations, intestinal dysbiosis, hepatic encephalopathy, increased levels of ammonia in the blood, etc. Among the contraindications: galactosemia, obstruction intestines, organic lesions of the gastrointestinal tract, rectal bleeding, abdominal pain of unknown origin, intolerance to the active substance of the drug. After taking Exportal, the laxative effect usually occurs within a day. If the drug is used for the first time, the effect may occur later - after two to three days. Doctors warn that sometimes flatulence and abdominal discomfort are possible during treatment with this laxative. But this quickly passes as soon as the body gets used to the drug.

Exportal

Ellara LLC, Russia

- constipation;
- the need to regulate stool for medical purposes (cleansing the intestines in preparation for endoscopic and x-ray examinations, surgical interventions on the rectum, anal sphincter and the area adjacent to it); — intestinal dysbiosis; - hepatic encephalopathy, hepatic coma and precoma, hyperammonemia. from 199

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Laxatives with a delayed effect - prebiotics

Prebiotics are safe drugs that can be used to relieve constipation in women during lactation and after childbirth. They are carbohydrates that the digestive organs are unable to digest. Therefore, they enter the colon in their original form. There, prebiotics activate the growth processes of beneficial bacteria.

Prebiotics are represented by inulin, lactulose and fructooligosaccharides. They do not provide immediate relief from constipation, but do not pose a health hazard. The effect of their use lasts longer than that of saline or irritating laxatives.

How do prebiotics work? Taking prebiotics stimulates the growth of beneficial bacteria in the intestines. The laxative effect is achieved due to the osmotic effect and slight irritation of the intestinal wall. Fermentation of prebiotics causes them to produce organic acids, which cause the muscles of the organ to contract. Lactulose is a prebiotic that is used more often than others. Taking it in a large dosage (45 ml) ensures that stool occurs within 2 hours.

Side effects. The drugs have virtually no side effects. Taking them is associated with flatulence, but after three days the bloating goes away on its own. Constipation can be dealt with with standard doses in about 2 days. The effect is delayed in time, since lactulose must pass through the entire digestive system.

Indications, contraindications, advantages. Prebiotics are used to treat acute and chronic constipation, intestinal dysbiosis, accompanied by a lack of stool. The undoubted advantage of such drugs is their detoxification effect. They are prescribed for hepatic encephalopathy, as they remove nitrogen-containing substances from the body. Thanks to prebiotics, phosphorus and calcium are absorbed better. These substances are destructive to pathogenic flora.

Lactulose (Normaze, Portalac syrup, Duphalac, Goodluck, Lactulose Poly, Livolyuk-PB, Lactulose Stada, Romphalac)

Preparations based on lactulose act mildly; they are prescribed to patients with constipation, encephalopathy, and also to prepare the digestive system for diagnosis.

Lactulose removes ammonium ions from the body, allows for better absorption of calcium and phosphorus, and stimulates the intestines to work actively. The stool becomes softer, the feces swell, and more bile is produced. All this has a positive effect on the functioning of the digestive system [5].

Contraindications to the use of Lactulose are:

• Intestinal obstruction.
• Hypersensitivity to the components of the drug (lactulose and fructose).
• Diabetes. This contraindication is not absolute, but diabetics should take lactulose-based medications with caution.

The dose is determined individually. Prescriptions must be made by a doctor. Lactulose is recommended for use for constipation in children as a safe and effective drug.

pros

Lactulose acts gently and does not cause irritation to the intestinal walls. After taking it, a person does not develop diarrhea. The time-delayed effect can also be considered an advantage, not a disadvantage. The body does not experience stress, feces come out easily. Lactulose is not addictive. It regulates the functioning of the intestines; after its withdrawal, atony of the organ does not develop, and its peristalsis does not suffer. Constipation goes away, and the physiological rhythm of the intestines is restored. Beneficial microflora is activated and copes better with harmful microbes. The drug can be used to treat children and pregnant women.

Minuses

The drug can cause bloating, which is accompanied by characteristic pain. The taste of Lactulose is not always pleasant, so children may refuse to take it. The drug has no other disadvantages.

Lactitol (Exportal, Importal N - powder for solution)

Lactitol can be found in products for diabetics. It acts as a sugar substitute. Doctors prescribe Lactitol to patients prone to constipation. Taking the drug allows you to make stool softer, they swell and leave the intestines more easily. Stool occurs a day after taking Lactitol. When a lasting effect can be achieved, the dose of Lactitol is gradually reduced.

Side effects after taking the drug are limited to bloating and the appearance of a certain discomfort against this background [6].

pros

The drug not only helps to cope with constipation, but also has an antitoxic effect, removing nitrogen-containing compounds from the body. Its intake has a positive effect on the intestinal microflora. Harmful microbes die, and beneficial flora, on the contrary, multiply.

The drug acts exclusively at the intestinal level and does not have a systemic effect on the body. Taking Lactitol is convenient because it can be mixed with almost any liquid, for example, juice, coffee or tea.

Lactitol can be used to treat constipation in children and people with diabetes.

Minuses

The effect does not come as quickly as we would like. A person's stool occurs only after a day. After the first dose of Lactitol, bowel movement will occur only after 2-3 days. The drug can cause increased gas formation, which leads to abdominal discomfort. In case of overdose, vomiting may occur. During treatment you need to drink a lot of water, which causes some difficulties for some patients.

Senna leaves

Perhaps this is the most natural laxative on this list. Senna leaves are the most harmless laxative that irritates the intestinal mucosa. Senna leaves, in addition to stimulating contractions of the intestinal muscles, also improve its normal functioning. Laxatives serve as an excellent prevention of constipation in the future. Senna leaves are prescribed for adults and children over 12 years of age as a remedy for constipation. By the way, this particular medicine is often used for weight loss, but it is harmful to the body. Among the advantages of senna are the absence of an addictive effect, a mild effect on the intestines, an affordable price, a neutral taste, and the ability to combine the drug with other drugs. But overdose must be avoided.

Senna leaves

Lek S+, Russia; OJSC Krasnogorskleksredstva, Russia

Senna leaves are a herbal laxative.
Sena leaves contain flavonoids, anthraglycosides (senosidine A and B, rhein, aloe-emodin), organic acids, and resinous substances. This complex of biologically active substances has a mild laxative effect. The laxative effect of a decoction of Sena leaves appears 6-10 hours after administration and is due to anthraglycosides, which enhance the motor function of the large intestine. from 12

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Table 2. Classification of laxatives (Zimmerman Ya. S., 1999)

I. Drugs that inhibit fluid absorption and stimulate secretion (irritation of the intestinal wall)	Anthraglycosides (senna, buckthorn, rhubarb) Diphenylmethane derivatives (isafenin, bisacodyl) Castor oil Surfactants (sodium and calcium dioctyl succinate)
II. Drugs that increase the volume of intestinal contents	Saline laxatives (Glauber's salt, Carlsbad salt, etc.) Macrogels (macrogol) Herbal laxatives (seaweed, bran, agar-agar, flaxseed, psyllium husk) Sugars and their derivatives (sorbitol, lacthiol) Lactulose (duphalac)
III. Agents that lubricate the intestinal mucosa	Vaseline oil, almond oil, etc.
IV. Combined products	Guttalax (sodium picosulfate + sorbitol) Regulax Laxative teas
V. Other means	Rectal (glycerin suppositories, sodium docusate, etc.) Probiotics, prebiotics Prokinetics: cholinergic agonists (betanecol), prostaglandin agonists (misaprostol), 5-HT4 agonists (tegaserod)

In general terms, the mechanism of action of laxatives is presented in Table 3.

Guttalax Express

This laxative produced in France has the fastest effect. The active substance of rectal suppositories is bisacodyl. Guttalax Express begins to act within 20 minutes after administration, so the drug is considered ideal for the emergency treatment of constipation in bedridden patients and those after surgery. This laxative can also be used in children over 10 years of age. Among the advantages: does not affect digestion, can be used during breastfeeding, excellent prevention of hemorrhoids, very fast action. Disadvantages: if used for a long time, addiction may develop; Guttalax Express suppositories must be stored in the refrigerator.

Guttalax Express

Institute de Angeli, Italy

Guttalax Express is a local laxative from the group of diphenylmethane derivatives with a slight antiresorptive effect.
As a laxative in the following cases: - constipation caused by atony and hypotension of the colon (including in old age, in bedridden patients, after operations, after childbirth and during lactation); - constipation caused by taking medications; - to regulate stool in case of hemorrhoids, proctitis, anal fissures (to soften the consistency of stool); - gallbladder diseases, irritable bowel syndrome with a predominance of constipation; - constipation caused by intestinal dysbiosis and diet disorders. from 171

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1999

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Names of medications for constipation in older people

Most often, to normalize the process of bowel movements, people of all ages use medications in the form of tablets. In medical practice, they are conventionally divided into two groups: instant-acting drugs that promote rapid evacuation of intestinal contents, and drugs that act more slowly but more gently.

Soft tablets for constipation in older people include only Normaze and Prelax, which are prebiotics. The remaining tablets are considered quick drugs, among them having an irritating effect: Senade, Guttalax and Endofalk, which increases osmotic pressure.

The following laxatives are most effective for constipation in older people:

• Bisacodyl
  - acts as an irritant, increases the secretion of intestinal mucus. The drug contains a chemical substance of the same name. The result appears after 6 hours, and when taken in the evening before bed - after 8 hours. Contraindications for the use of Bisacodyl are hemorrhoids, intestinal obstruction, spastic constipation, internal bleeding (from the gastrointestinal tract and uterus), water-salt imbalance, cystitis. Elderly people are prescribed 1 to 3 tablets once, either at night or 30 minutes before breakfast. Taking the drug with plenty of water is a prerequisite for taking it correctly.

• Picolax
  - a drug for the treatment of constipation in the elderly, acting as a receptor irritant. The active substance is sodium picosulfate. The drug is available in the form of tablets and drops. Effective six hours after consumption. The product must be taken in the morning or before bedtime. You need to take the medicine with plenty of water. The dosage is prescribed to each elderly patient individually. Picolax can only be used for ten days. Despite the good tolerability of the drug, older people must first obtain a prescription from a specialist.

• Lactusan
  - a probiotic that reduces intestinal acidity and stimulates the growth of acidophilus bacteria. The active ingredient of this drug for constipation is lactulose syrup. Can be purchased in syrup or tablet form. Elderly people are recommended to take 4-5 tablets or 10 ml of syrup in the morning and evening with meals. Long-term therapy of up to 14 days is required to achieve results. A side effect in the first three days of use may be flatulence. Contraindications to the use of Lactusan: lactose deficiency and galactosemia.

The fastest way to relieve constipation in older people is with topical products. These include rectal suppositories and Microlax microenemas. Such drugs have a laxative effect within five minutes after use, but act for no more than 30 minutes. These remedies do not work if tumors or scarring in the intestines are present in older adults.

Depending on the composition, suppositories are divided into natural preparations for constipation and synthetic ones. Suppositories based on plant materials, for example, Rectative are made from chestnut seeds; to achieve results, you must undergo a course of treatment. Synthetic rectal suppositories Bisacodyl act faster. If older people suffer from chronic constipation, they may be prescribed gas-forming suppositories, for example, preparations with rhubarb extract: Calciolax, Ferrolax.

The most popular topical medications for constipation for older people are:

• Sea buckthorn candles
  - not only normalize bowel movements, but also have an analgesic, anti-inflammatory, and wound-healing effect on the walls of the rectum. Made from sea buckthorn oil. Directions for use: after a cleansing enema, before bedtime. The course of treatment lasts from seven to ten days. When using sea buckthorn suppositories, local side effects such as swelling of the anorectal area, redness, and burning sensations may occur.

• Glycerin suppositories
  - a remedy for constipation, stimulating intestinal motility, accelerating the movement of its contents. Suppositories are made on an oil base. Directions for use: once a day, after breakfast. Contraindications for use: tumors and inflammatory bowel diseases, hemorrhoids, rectal fissures.

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Duphalac

This combined laxative is based on lactulose. Duphalac not only relieves constipation, but also removes toxins from the body and reduces the number of pathogenic organisms in the intestines. Duphalac can be taken when there is an “overdose” of protein foods in the diet (to avoid the processes of putrefaction in the intestines). Among the advantages of this drug are the possibility of taking it from birth, it is not prohibited for inflammatory processes in the intestines, there are a minimum of contraindications, it is indicated for dysbacteriosis, diabetes, pregnancy, and is suitable for people with severe liver diseases.

Duphalac

Solvay Pharma, Germany

Constipation: regulation of the physiological rhythm of colon emptying;
softening of stool for medical purposes (for hemorrhoids, conditions after surgery on the colon and in the anal area); hepatic encephalopathy in adults: treatment and prevention of hepatic coma or precoma. from 248

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Fast-acting folk remedies

In addition to medications, you can resort to traditional medicine. There are plants that have strong and quick actions that relieve constipation much more gently than medications.

Nettle tincture

It is prepared from the stinging nettle plant. You can take both raw and dried raw materials. For a serving of infusion, use 2 tablespoons of chopped stems and leaves, pour in 300 ml of boiling water and infuse for 24 hours. The medicine is taken in portions throughout the day. The effect occurs after the second dose.

Red rowan juice

To activate digestion, enhance bile secretion, and cleanse blood vessels, you need to take 1 tsp. half an hour before meals; for constipation, the single dosage is increased to 50-70 ml. To gargle with a sore throat, add it to warm boiled water (1 tablespoon per glass) and apply it 6-8 times during the day. For rheumatoid manifestations, it is recommended to drink 1/3 cup of rowan juice, half diluted with milk, 3 times a day before meals.

Sea buckthorn decoction

The berries of this plant are even more effective than rowan berries. They make a fast-acting laxative, which can be taken four times a day at a dose of half a glass for one week every other day. A handful of fresh berries is poured with half a liter of boiling water. Everything is cooked over low heat for three minutes, settled, and filtered. For each day of administration, the decoction is prepared anew.

Magnesium sulfate

Magnesium sulfate is a strong saline laxative that promotes the accumulation of water in the intestines, causing muscles to reflexively contract. Magnesium sulfate also has a choleretic effect, which stimulates digestion and prevents constipation due to dietary errors. The advantages of this laxative: the effect after taking lasts all day, blood pressure decreases slightly, swelling decreases, and sleep improves. Among the obvious disadvantages is an unpleasant taste.

Magnesium sulfate

YuzhPharm, Russia

Constipation, bowel cleansing before diagnostic procedures.
Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead, barium). from 12

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Why fast is not always great

Instant laxatives, although considered effective, are not always beneficial to health. In addition, the very concept of “instant” in relation to relaxing drugs is very conditional. In any case, the medicine must first penetrate the esophagus into the stomach and then into the intestines in order to begin its work.

“Instant” drugs include potent salt preparations, which are unsafe and require administration under the supervision of a doctor or even in a hospital setting:

• Lavage;
• Magnesia.

By the way. For example, saline solution (enteral or lavage) is a special mixture used exclusively in hospital conditions, for intestinal blockage and fecal impaction.

Magnesium sulfate

Also called magnesia, a saline solution classified as hypertonic, which is taken orally for emergency indications, in an amount of about 200 ml of solution or one gram of powder per one full year of age (mostly, this is how it is dosed for children).

By releasing and retaining water, stool becomes liquefied. The product also irritates mucosal receptors throughout the gastrointestinal tract, which enhances peristalsis and removes fluid along with feces. When taking magnesium sulfate, bowel movements may begin as early as half an hour after taking the medicine.

This is a quick remedy with undoubted effectiveness, but it can only be taken once. If you use it regularly, you can disrupt the water-electrolyte balance, lead the body to dehydration and destroy the intestinal microflora.

Magnesium sulfate solution is not recommended to be taken in the following cases:

• low pressure;
• existing dehydration;
• hypersensitivity to magnesium or excess of this substance in the body;
• problems with the respiratory system;
• any cardiac pathology;
• intestinal obstruction;
• intestinal perforation;
• inflammation of the intestines or gastrointestinal tract.

Method of intestinal lavage procedure

The intestinal lavage procedure is carried out on an empty stomach (the fasting period should be at least 5-6 hours). It is better to carry out the procedure, especially the first one, in the morning. The temperature of the solution is “room” for atonic constipation and 35–38 degrees. With - spastic. The patient drinks the solution in portions of 150–200 ml every 5 minutes. Typically, the intestine begins to empty after the patient drinks 1.5–2.5 liters of solution. Patients who are prone to constipation may not have bowel movements at this point. In this case, a single dose of the solution should be reduced by 1/2. A patient with spastic constipation is prescribed a suppository, for example, with papaverine. If there is no stool after the patient has drunk 3.2–3.5 liters, he is given an enema with the same solution in a volume of approximately 1.5 liters (25–30 ml per 1 kg of body weight) and/or given an injection of an antispasmodic (single dose of papaverine, no-spa, platiphylline, etc., excluding atropine).

The procedure continues until the stool becomes transparent (it may be yellowish in color). After this, the patient stops drinking the solution and is given 30 to 60 drops of Hilak Forte inside. Over the next 30–40 minutes, bowel movements continue, then the “work” of the intestines stops. During 1 procedure, the number of bowel movements can be from 3 to 12 (usually 5–7 times). The total volume of the solution drunk is 3.5–4.2 liters. The duration of the CL procedure is 2–4 hours, after which the patient can carry out normal activities.

Regulax Picosulfate

A popular German laxative in drops, which also helps with complicated constipation: hemorrhoids, rectal fissures, fistulas - all cases where constipation only worsens the patient’s condition. Regulax Picosulfate is prescribed to older people and in the second and third trimesters of pregnancy (but only once). Among the advantages of the drug: mild action, low price, acceptable taste, many positive reviews from patients.

Regulax Picosulfate

Meuselbach-Pharma, Germany

- atonic constipation;
- regulation of stool (hemorrhoids, proctitis, anal fissures); — preparation for surgical operations, instrumental and x-ray examinations. from 190

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Microclysters

For emergency release of the intestines from dense feces, laxatives in the form of microenemas can be used12. This form includes drugs with a combined mechanism of action, that is, working “together”. They subject feces to peptization (break down dense masses), increase its volume and make it soft2,11.

Microclysters are also used to correct constipation due to the “lazy colon” ​​syndrome2.

Microenema MICROLAX® acts locally and has a mild laxative effect due to the presence in its composition11:

• sodium citrate, which displaces bound water from the feces;
• sodium lauryl sulfoacetate, which thins stool;
• sorbitol, which increases the flow of water into the intestinal lumen.

Thanks to the complex effect of the three components, the laxative effect occurs quickly - on average from 5 to 15 minutes, according to the instructions for use.

MICROLAX® is easy to use; no special knowledge or training is required11. The tube with a tip contains the required single dose of the drug, and the microenema format facilitates the use of a laxative, including for “fecal impaction” or preparation for rectal examination11.

MICROLAX® is approved for use in adults and children from birth11. It acts only on feces, softens them and facilitates bowel movements11. At the same time, the drug is not addictive and does not affect the function of other parts of the gastrointestinal tract.

Remember that laxatives do not eliminate the cause of constipation, they only reduce unpleasant symptoms. Their independent, prolonged or uncontrolled use can aggravate the course of the causative disease if stool retention is one of its manifestations2.

All laxatives should be taken only after consulting a doctor. To get rid of constipation comfortably and effectively, be sure to get examined by a therapist or gastroenterologist. Only a specialist will be able to take into account all contraindications, the risk of side effects and prescribe medications so that they are not addictive.

Combating constipation will require patience and a comprehensive approach. Changing your lifestyle, adjusting your diet, and physical activity will help restore bowel regularity2. It is important to follow the recommendations of a specialist, and if necessary, use laxatives prescribed by a doctor.

The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist

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