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References: Laxative

Pharmacology. 1993 Oct;47 Suppl 1:234-41.
Retrospective study on laxative use and melanosis coli as risk factors for colorectal neoplasma.

Nusko G, Schneider B, Muller G, Kusche J, Hahn EG.

Department of Medicine I, University of Erlangen-Nurnberg, FRG.

In a retrospective study a cohort of 2,277 patients was defined by colonoscopy. Among other factors it was tested whether in these patients laxative use or the endoscopically diagnosed presence of melanosis coli were risk factors related to colorectal neoplasma. In comparison to patients taking no laxatives there was no significant increase in colorectal cancer rate either in laxative users or in patients with melanosis coli. However, there was a statistically significant association between the occurrence of colorectal adenomas and laxative use (relative risk of all patients exposed to laxatives = 1.72; of patients exposed to laxatives without melanosis coli = 1.47). The relative risk of adenoma development in patients with melanosis coli was 2.19. Taking into account that polyps can be diagnosed in the dark mucosa of melanosis coli patients more easily, even this relative risk of 2.19 seems to be related to a generally enhanced risk of laxative intake rather than to a special group of (anthranoid containing) laxatives.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8234435&dopt=Abstract constipation laxative

Pharmacology. 1993 Oct;47 Suppl 1:242-8.
Influence of senna, fibre, and fibre + senna on colonic transit in loperamide-induced constipation.

Ewe K, Ueberschaer B, Press AG.

I. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universitat Mainz, FRG.

Retarded colonic transit and disturbed defecation are the most prominent pathophysiological mechanisms in constipation. Both may be influenced by bulking agents and by laxatives such as senna. Direct measurements of the influence of such substances on colonic transit are rare mainly because of technical problems. We measured gastric emptying, small and large intestinal transit in 24 healthy volunteers by a newly developed method employing a metal detector. Twelve persons taking a normal diet received loperamide in a dose sufficient to double the individual transit time. All subjects measured gastrointestinal transit time under normal conditions and with Sennatin containing purified sennosides 20 mg, Agiocur (30 g) as a fibre product containing 20 g Plantago ovata seeds/husks, or Agiolax (10 g) as a combination of 5.4 g P. ovata seeds/husks + 1.2 g senna pod with a sennoside content of 30 mg. Colonic transit was reduced by Sennatin and by Agiolax from 39 +/- 4 h to 17 +/- 3 h (p < 0.005). Agiocur did not influence colonic transit (39 +/- 3 h). Loperamide prolonged colonic transit from 27 +/- 0.7 to 72 +/- 12 h. This effect was abolished by Sennatin (30 +/- 5 h) and Agiolax (27 +/- 1 h) (p < 0.005), but not by Agiocur (64 +/- 13 h). The same effects were seen when right and left colonic transit were analyzed separately. Neither gastric emptying nor small intestinal transit were affected by either substance. All of the three study drugs increased stool weight significantly (p < 0.05). When stool frequency and consistency were compared, the effects were less clear.(ABSTRACT TRUNCATED AT 250 WORDS)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8234436&dopt=Abstract constipation laxative

Pharmacology. 1993 Oct;47 Suppl 1:32-9.
In vitro effects of sennoside on contractile activity and fluid flow in the perfused large intestine of the rat.

Rumsey RD, Squires PE, Read NW.

Department of Biomedical Science, University of Sheffield, UK.

The effect of sodium rhein on contractile activity and fluid flow in the rat complete large intestine was studied in vitro. Contractile activity was recorded using serosal strain gauges and volume transducers recorded distal fluid flow from the segment. Luminal sodium rhein (1 mM) produced a protracted increase in caecal activity yet increased colonic contractility transiently. Fluid flow from the preparation was increased and the number of propagated complexes was elevated after the initial 10 min of exposure. The effect did not appear to be related directly to dose. Sodium rhein (0.1 mM) did not significantly stimulate contractility and a higher dose (5 mM) only produced a transient effect on propagated contractions. However, this dose had the effect of significantly reducing activity when the rhein was replaced by normal buffer. The data suggest that the action of sodium rhein is subtle; after an initial excitation, the glycoside shifts the pattern of motor activity in favour of propulsion at the expense of segmentation. The large intestine is more able, therefore, to expel luminal contents in a caudal direction following the addition of this anthraquinone laxative.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8234440&dopt=Abstract constipation laxative

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