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References: Laxative

Dig Dis Sci. 1998 Apr;43(4):738-45.
Effects of fiber laxatives and calcium docusate on regional water content and viscosity of digesta in the large intestine of the pig.

McRorie J, Pepple S, Rudolph C.

Procter & Gamble Company, Cincinnati, Ohio 45224, USA.

The aim of this study was to determine how bulk fibers and calcium docusate affect regional dehydration and digesta viscosity throughout the large intestine. Fifty-two pigs were fed a chow diet supplemented with a bulk laxative, placebo, or calcium docusate for three days, after which the pigs were sacrificed and the contents of the large bowel were analyzed. Digesta occurred as a continuum from liquid (cecum, 91.2% water content) to solid (rectum, 70.5% water content). The observed 20.7% difference in water content resulted in a 240-fold increase in viscosity. Half of this water is reabsorbed in the first 18% of the large bowel length where viscosity remains relatively low. Compared to placebo, calcium docusate and calcium polycarbophil had no significant effect on digesta water content or viscosity, polycarbophil exhibited significantly (P < 0.05) lower digesta viscosity in three bowel segments, and psyllium exhibited significantly (P < 0.01) lower viscosity in six bowel segments and higher water content in nine bowel segments. In conclusion, the majority of digesta dehydration occurs early in the proximal large bowel, while the greatest increases in viscosity occur in the distal bowel. Relatively small decreases in digesta water content result in large increases in digesta viscosity. Psyllium, and to a lesser extent polycarbophil, are able to resist dehydration, resulting in a softer digesta.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9558028&dopt=Abstract constipation laxative

Am J Gastroenterol. 1998 Apr;93(4):623-7.
Colonic chicken skin mucosa: an endoscopic and histological abnormality adjacent to colonic neoplasms.

Shatz BA, Weinstock LB, Thyssen EP, Mujeeb I, DeSchryver K.

Department of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri, USA.

OBJECTIVES: We recently described an endoscopic finding of pale yellow-speckled mucosa adjacent to colonic neoplasms. This resembled the appearance of chicken skin and was named chicken skin mucosa (CSM). CSM differs from previously reported gastrointestinal xanthelasmas in that this entity always occurs in association with colonic neoplasms. The prevalence, endoscopic characteristics, clinical significance, and possible etiology were investigated. METHODS: Eight hundred fifty-two consecutive colonoscopies were prospectively evaluated for the presence of CSM associated with either cancer or adenomas > or = 1 cm. Electron microscopy and histopathology using hemotoxylin and eosin, mucicarmine, and oil red O stains were performed. Twelve consecutive colon cancer resection specimens were prospectively examined to determine the presence of histologic CSM. RESULTS: CSM was adjacent to eight of 10 distal colorectal cancers, one of four proximal colon cancers, 16 of 42 distal adenomas, and three of 44 proximal adenomas. Four of seven resected distal cancers demonstrated histological evidence of CSM. Biopsies of the CSM revealed that lipid-filled macrophages in the lamina propria were responsible for this endoscopic appearance. Electron microscopy showed that the surface epithelial cells had small intestine-like microvilli. CSM was not seen with other colonic conditions and was not associated with the laxative preparation. In four instances, identification of the CSM alerted the endoscopist to the presence of polyps in locations difficult to visualize. CONCLUSIONS: CSM is an endoscopic entity that occurs as a result of fat accumulation in macrophages in the lamina propria of the mucosa adjacent to colonic neoplasms. Small in

J Psychosom Res. 1998 Mar-Apr;44(3-4):491-502.
Sexuality and reproduction in bulimia nervosa patients over 10 years.

Abraham S.

Department of Obstetrics and Gynaecology, University of Sydney, New South Wales, Australia.

The reproductive and sexual histories of women who had recovered or were recovering from bulimia nervosa were examined. Of 48 consecutive female patients, 43 were studied 10-15 years after first presenting for treatment. At follow-up, 74% were considered recovered and 26% still had an eating disorder. Only 2 women fulfilled the criteria for bulimia nervosa. A history of amenorrhea was common (81% of women), 63% of women being without their menstrual periods for more than 12 months. Menstruation was present in women at a body mass index of 19 or more who were no longer using the weight loss practices of self-induced vomiting, laxative abuse, and starvation. Bulimia nervosa women are more likely to be investigated for infertility when their eating disorder is active. Bulimia sufferers are sexually active, but have times of withdrawing from their partners and ceasing sexual behavior. They associate their sexual feeling with body weight, pregnancy, breastfeeding, and status of their relationships. Marital breakdown is also more common but only if the eating disorder was active at the time of marriage. Forty-five percent left their relationship had a negative effect on their eating disorder. Short-term episodes of bulimic-free behavior are associated with pregnancy and breastfeeding in some pregnancies. Termination of pregnancy occurs more often. The prevalence of miscarriage, hyperemesis gravidarum, and postnatal depression was greater among women who had not recovered from their eating disorder at the time of their pregnancy. Recovery from eating disorder behavior before attempting conception reduces the prevalence of the gynecologic, obstetric, and psychiatric problems associated with eating disorder behavior.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9587891&dopt=Abstract constipation laxative

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