laxative



References: Laxative






QJM. 2000 Mar;93(3):175-81. Click here to read 
Gastric acid suppression does not promote clostridial diarrhoea in the elderly.

Shah S, Lewis A, Leopold D, Dunstan F, Woodhouse K.

Department of Geriatric Medicine, University of Wales College of Medicine, Llandough Hospital, Penarth, Cardiff, UK.

Gastric acid prevents bacterial colonization of the stomach and suppression of its secretion might predispose to Clostridium difficile (CD) diarrhoea. We retrospectively studied elderly patients admitted to medical wards of an acute hospital to determine whether the incidence of CD diarrhoea was greater among those previously treated with gastric acid suppressants. From records of stool CD toxin tests undertaken in 1995 and 1996, we found 126 cases with positive results, and selected 126 controls with negative results. Information about pre-morbid illness, predisposing factors for CD and medication received in the preceding 16 weeks was obtained from case-notes. A greater number of CD positive cases had received antibiotics such as Cefuroxime, ciprofloxacin or macrolides with or without metronidazole, were more severely disabled, required assistance for feeding, or had hypoalbuminaemia before the onset of diarrhoea. A greater number of controls had received lactulose, suggesting either that its laxative effect resembled CD infection prompting frequent stool tests, or that it offered protection against CD in this group. Both groups were similar for the use of proton-pump inhibitors or H2-receptor antagonists, suggesting that susceptible elderly patients are not more likely to develop CD diarrhoea after receiving gastric acid suppression therapy.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10751237&dopt=Abstract constipation laxative



Gut. 2000 May;46(5):651-5. Click here to read 
Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study.

Nusko G, Schneider B, Schneider I, Wittekind C, Hahn EG.

Department of Medicine I, University of Erlangen, Germany.

BACKGROUND: Anthranoid laxatives are the most commonly used purgatives in the therapy of acute and chronic constipation. Recent experimental data and a prospective cohort study provide evidence of a possible risk of anthranoid use for the development of colorectal neoplasms. MATERIALS AND METHODS: We performed a prospective case control study at the University of Erlangen to investigate the risk of anthranoid laxative use for the development of colorectal adenomas or carcinomas. A total of 202 patients with newly diagnosed colorectal carcinomas, 114 patients with adenomatous polyps, and 238 patients (controls) with no colorectal neoplasms who had been referred for total colonoscopy were studied. The use of anthranoid preparations was assessed by standardised interview, and endoscopically visible or microscopic melanosis coli was studied by histopathological examination. RESULTS: There was no statistically significant risk of anthranoid use for the development of colorectal adenomas (unadjusted odds ratio 1.0; 95% CI 0.5-1.9) or carcinomas (unadjusted odds ratio 1.0; 95% CI 0.6-1.8). Even after adjustment for the risk factors age, sex, and blood in the stools by logistic regression analysis the odds ratio for adenomas was 0.84 (95% CI 0. 4-1.7) and for carcinomas 0.93 (95% CI 0.5-1.7). Also, there were no differences between the patient and control groups for duration of intake. Macroscopic and high grade microscopic melanosis coli were not significant risk factors for the development of adenomas or carcinomas. CONCLUSION: Neither anthranoid laxative use, even in the long term, nor macroscopic or marked microscopic melanosis coli were associated with any significant risk for the development of colorectal adenoma or carcinoma



J Pharm Biomed Anal. 2000 Apr;22(3):433-49.
Quantitation and validation of cis-camphoric acid 3-methyl ester and cis-camphoric acid 1-methyl ester using CE.

Baur L, Jehle H, Watzig H.

Institute of Pharmacy and Food Chemistry, University of Wurzburg, Germany.

The 1- and 3-methyl esters of cis-camphoric acid, the active agents of a mild laxative (Flubilar) have been simultaneously assayed using capillary electrophoresis (CE). The compounds are completely separated using a sodium acetate buffer pH 4.0, 40 mmol/l. In order to obtain reproducible results, [+]-naproxen has been used as internal standard (IS). Initially migration times changed over 50% within a series of 20 runs. This problem has been overcome by using an overnight capillary preconditioning (1 mol/l NaOH, 1.5 h) and subsequent equilibrating (running buffer, 12 h). Thereby a precision corresponding to a CV %, of about 1.17 and 1.42 for the cis-camphoric acid methyl esters has been obtained (six series of n = 10 runs each). The method has been validated regarding specificity, accuracy, precision, linearity and robustness. In order to test robustness, all key parameters have been considered. The result of the validation is given in nine tables. In the case under investigation, lamp age and wavelength accuracy are the most critical parameters. Therefore, the lamp age should be limited to about 1000 h. The wavelength accuracy can be indirectly controlled using quality assurance samples. According to the fundamental mechanisms in CE, changes in the voltage and in the temperature influence migration times and peak areas. However, these effects are very well compensated using an IS. Slight variations of the parameters buffer pH and molarity rinsing times, storage conditions of buffers and samples as well as the capillary material had little or no influence on the analytical results.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10766361&dopt=Abstract constipation laxative



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