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References: Laxative

Ned Tijdschr Geneeskd. 1997 Apr 26;141(17):823-6.
[Laxative policy for terminal patients ineffective]

[Article in Dutch]

Schoorl J, Zylicz Z.

Rijksuniversiteit Limburg, Faculteit der Geneeskunde, Maastricht.

OBJECTIVE: To determine the prevalence of constipation and the use of laxatives in terminal patients. DESIGN: Retrospective. SETTING: Hospice Rozenheuvel, Rozendaal, the Netherlands. METHOD: Of patients who were admitted for terminal care between 1 January 1995 and 15 July 1996 the anamnestic data were recorded about presence of constipation and use of medicines, notably opioids and laxatives. RESULTS: The study population (n = 121) consisted of 65 male and 56 female patients. 95 patients (79%) suffered from cancer. The median survival time was 18 days (spread from 1-180 days). 58 (48%) of the patients were constipated at the time of admission and 62 (51%) used opioids. The opioid users were more often constipated (68% versus 27%; p < 0.001). 35 out of 62 (56%) opioid users were given laxatives. The laxative users, however, were more often constipated (65% versus 36%; p < 0.01). Neither in users nor in non-users of opioids did laxatives have any effect on presence of constipation. Of the laxative users 37 (73%) were given lactulose in a fixed dosage. CONCLUSION: Present laxative policy in terminal patients is ineffective. Monotherapy with fixed lactulose doses is not effective as a laxative in either users or non-users of opioids.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9221363&dopt=Abstract constipation laxative

Arch Pediatr Adolesc Med. 1997 Aug;151(8):833-8.
Adolescent vegetarians. A behavioral profile of a school-based population in Minnesota.

Neumark-Sztainer D, Story M, Resnick MD, Blum RW.

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.

OBJECTIVE: To compare a population-based sample of vegetarian and nonvegetarian adolescents regarding food intake patterns, disordered eating, and a range of other non-food-related health-compromising and health-promoting behaviors. DESIGN: A cross-sectional school-based survey. SETTING: Public schools within nonurban areas of Minnesota. PARTICIPANTS: Adolescents (n = 107) aged 12 to 20 years who reported on the Minnesota Adolescent Health Survey that they follow a vegetarian diet and a comparison group of nonvegetarian youth (n = 214) matched for sex, age, and ethnicity. The percentage of self-identified vegetarians in the study population was relatively low (0.6%); most of the vegetarians were female (81%). MAIN OUTCOME MEASURES: Food intake patterns, disordered eating (frequent dieting, binge eating, self-induced vomiting, and laxative use), health-compromising behaviors (tobacco, alcohol, and marijuana use and suicide attempts), and health-promoting behaviors (seat belt use, physical activity, and brushing teeth regularly). RESULTS: Vegetarian adolescents were twice as likely to consume fruits and vegetables (P < .001), one third as likely to consume sweets (P < .001), and one fourth as likely to eat salty snack foods (P < .001) more than once a day compared with nonvegetarians. Vegetarians were almost twice as likely to report frequent dieting (P < .001), 4 times as likely to report intentional vomiting (P < .001), and 8 times as likely to report laxative use (P < .001) than nonvegetarians. Overall, associations with other health-compromising and health-promoting behaviors were not apparent. CONCLUSIONS: A vegetarian diet may be beneficial because of increased fruit and vegetable consumption and decre

Gastrointest Endosc. 1997 Aug;46(2):131-8.
The pigment of melanosis coli: a lectin histochemical study.

Benavides SH, Morgante PE, Monserrat AJ, Zarate J, Porta EA.

Department of Pathology, School of Medicine, University of Buenos Aires, Argentina.

BACKGROUND: The compositional nature of the pigment of melanosis coli is essentially unknown. Previous histochemical studies suggested that this pigment has certain similarities with lipofuscin (i.e., age-dependent pigment) and ceroids (i.e., pathologically derived pigments) and that it may contain, therefore, polymerized glycolipids and glycoproteins. However, the saccharide composition of this pigment was never explored by lectin histochemical procedures, which was the main object of this study. METHODS: Colonoscopic biopsy specimens from eight patients with melanosis coli and from three normal control subjects were studied by fluorescent microscopy and by standard and lectin histochemistry. The number of apoptoses in the lining colonic epithelium was also evaluated histologically. RESULTS: Apoptotic bodies were significantly more numerous in patients with melanosis coil than in control subjects. The pigment that accumulates in macrophages of the lamina propia showed autofluorescence, sudanophilia, acid-fastness, and positiveness to PAS and Schmorl's reactions, all of which are common to lipofuscin and ceroids, plus an intense argentaffin reaction abolished by bleaching, indicative of a melanic substance. Lectin histochemistry showed, in decreasing order of frequency, the presence of alpha-D-mannose, sialic acid, beta-D-galactose (lactose), gal-beta-(1-3)acetyl-galactosamine, alpha-D-galactose, and alpha-L-fucose, but no terminal alpha-D-acetyl-galactosaminyl residues. CONCLUSIONS: The significant increase of apoptotic bodies in the lining colonic epithelium indicated that this type of cell death is not due to the natural programmed cell renewal, but to the action of laxatives. Because the autofluorescent pigment of melanosis coli contains melanin

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