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References: Laxative

Dig Dis Sci. 1998 Dec;43(12):2708-14.
Investigation and diagnosis of diarrhea caused by sodium phosphate.

Fine KD, Ogunji F, Florio R, Porter J, Ana CS.

Division of GI Research and the Gastrointestinal Physiology Laboratory, Baylor University Medical Center, and Veterans Affairs North Texas Health Care System, Dallas 75246, USA.

Because there are no published reference values for fecal phosphate concentration or output, diagnosing surreptitious use of phosphate laxatives has been difficult. The purposes of this study were to determine normal fecal phosphate levels and to quantitate and chemically analyze diarrhea produced by sodium phosphate. Timed stool collections were obtained from 20 normal subjects during 25 study periods (normal controls), from 27 normal subjects with diarrhea induced by a variety of laxatives not containing phosphate during 234 study periods (diarrhea controls), and from 10 normal subjects during 14 periods after ingestion of 45 or 22.5 ml of a commercially available 66% sodium phosphate solution (Fleet Phospho-Soda). All stools were analyzed for soluble phosphate concentration, and daily output was calculated. The upper limits of normal for soluble fecal phosphate concentration and output, derived from the normal controls and diarrhea controls, respectively, were 33 mmol/liter and 15 mmol/day. Diarrhea produced by 45 ml of sodium phosphate was watery and voluminous, with fecal weights averaging 1078 g/day (range 601-1713 g/day). Measured fecal phosphate concentrations and outputs averaged 85 mmol/liter and 92 mmol/day, respectively, and all values were significantly elevated. Soft, less voluminous stools were produced with 22.5 ml of sodium phosphate but all had an abnormally high soluble phosphate concentration and 24-hr output. In conclusion, the upper limits of normal for soluble fecal phosphate concentration and output established in this study should be useful in the chemical diagnosis of phosphate-induced diarrhea.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9881503&dopt=Abstract constipation laxative [PubMed - indexed for

Z Ernahrungswiss. 1998 Dec;37(4):358-62.
Small intestinal transit and digestibility of lactitol in Wistar rats.

Soontornchai S, Kruger D, Grossklaus R.

School of Health Science, Sukhotai Thammathirat Open University, Nonthaburi, Thailand.

The study was conducted to evaluate if the recovery of lactitol and its cleavage products varied when different doses of this disaccharide sugar alcohol (150 and 1,200 mg/kg body weight, respectively) were given by gastric gavage to unadapted male rats. Phenol red added to the test solution as marker dye served to determine the intestinal transit and distribution areas. Marker transit revealed that the test substance did not reach the cecum in all series. Gastric emptying was more retarded after the high dose. Administration of low doses did not alter intestinal transit and luminal volume as compared to control animals. But a much larger luminal volume was found in the third intestinal quarter after the high doses, although the marker transit through this segment was equal under all experimental conditions. The total gastrointestinal recovery of lactitol at 63.2 (+/- 3.9) and 75.5 (+/- 4.5)% was significantly different (p < 0.001) 1 hour after administration of 150 mg and 1200 mg/kg body weight, respectively. Only free sorbitol was detected in the gastrointestinal contents in both dosage groups. Based on these results and correcting the values for marker recovery (85% in both groups), it is reasonable to assume that the maximum amount of lactitol that can be hydrolyzed and absorbed by the small intestine is 11.2 and 25.2%, respectively, and not zero. In conclusion, the caloric availability of lactitol is dose-dependent and should be determined under normal conditions in which the laxative threshold is not exceeded.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9894685&dopt=Abstract constipation laxative

Palliat Med. 1998 Sep;12(5):375-82.
The relationship between opioid use and laxative use in terminally ill cancer patients.

Sykes NP.

St Christopher's Hospice, London, UK.

The frequency of the use of laxatives, and the relationship between doses of laxatives and of opioid analgesia, were determined by a prospective study of 498 hospice inpatients with advanced cancer. Laxatives were required by 87% of patients taking oral strong opioids, 74% of those on weak opioids and 64% of those not receiving opioid analgesia. The form of the relationship appears to be hyperbolic, as suggested by the presentation of the results arranged by opioid quartile and by the improved correlation obtained by subjecting the opioid data to a logarithmic transformation. It is concluded that opioids account for about a quarter of the constipation found in terminally ill cancer patients in a hospice. However, the dose of laxative required is likely to be significantly higher if an opioid is being taken than if not. The form of the relationship between laxative and strong opioid doses is what might be expected from the mediation of opioid-induced constipation by opioid receptors.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9924600&dopt=Abstract constipation laxative

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