Schweiz Rundsch Med Prax. 1990 Jul 17;79(29-30):885-8.
[Irritable colon and colonic disease due to laxatives]
[Article in German]
Wienbeck M, Lubke HJ.
III. Medizinische Klinik, Zentralklinikum, Augsburg.
Diarrhea of colonic origin is fairly common in irritable colon and after long term abuse of laxatives. This form of diarrhea causes difficulties not only in diagnosis but also in treatment. Irritable colon is a functional disorder sometimes involving other segments of the bowel. The term "irritable bowel disease" is thus more appropriate. Extraintestinal symptoms are in addition quite common. Although the diagnosis can be established with great reliability using an index we consider some laboratory tests, recto-sigmoidoscopy and abdominal sonography essential to rule out organic lesions. Therapy comprises (small) psychotherapy, dietary measures and eventually transient medication. Symptoms usually persist but tolerance of the disorder should be improved. Laxative-induced colonic dysfunction results usually from false assumptions about normal defecation. Loss of water and potassium deteriorates the symptomatology leading to a vicious circle. Alterations of neurons in the enteric nervous system of the colon can be the cause but eventually the consequence of chronic intake of laxatives. Hidden abuse of laxatives can cause great diagnostic difficulties. The therapy of choice is weaning which usually is only possible gradually. Cisapride can be a useful adjuvant.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2197702&dopt=Abstract constipation laxative
Dig Dis Sci. 1986 Mar;31(3):281-8.
Effects of laxative and nonlaxative hydrophilic polymers on canine small intestinal motor activity.
Russell J, Bass P.
Bulk-forming laxatives increase fecal volume and elicit aborally directed colonic motility patterns. Recently, it was demonstrated that test meals of the bulk-laxative fibers (cellulose and bran) elicited organized jejunal motor activity while nonlaxative fiber meals (guar) elicited unorganized jejunal motor activity. However, whether bulk-forming laxatives, as a class of compounds, differentially affect small intestinal motility has not been studied. Therefore, a study was made of the effects of the bulk laxatives psyllium and polycarbophil and the nonlaxative pectin on canine jejunal motor activity. Psyllium and pectin are examples of dietary fiber, while polycarbophil is a synthetic polymer. Pectin and psyllium test meals presented as viscous gels. In contrast, polycarbophil meals presented as a combination of discrete particles plus meal water. After each meal, measurements were made of the jejunal motility index, the time of reappearance of interdigestive burst activity, and overall motility patterns. Pectin and psyllium meals increased in viscosity as meal fiber content increased. As meal content and hence viscosity increased, both the laxative (psyllium) and nonlaxative (pectin) fiber meals elicited increasing jejunal motor activity and delays in the reappearance of the burst interval. For both fiber types, motor activity presented as randomly appearing contractions. In contrast, meals of the laxative polycarbophil elicited no more motor activity than the saline control meal. However, this control-level amount of activity presented as propagated clusters of contractions, ie, the "laxative-induced pattern." Polycarbophil did not delay the reappearance of burst activity.(ABSTRACT TRUNCATED AT 250 WORDS)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3948632&dopt=Abstract constipation laxative
J Pediatr. 1986 Apr;108(4):562-6.
Abnormal defecation dynamics in chronically constipated children with encopresis.
Loening-Baucke VA, Cruikshank BM.
We studied the ability to defecate water-filled balloons in 16 healthy and 37 chronically constipated children with encopresis. The act of bearing down for defecation was evaluated by measuring intra-abdominal pressure, rectal pressure, anal pressure, external anal sphincter EMG activity, and rectal sensation and rectal volume necessary to inhibit the anal sphincters. Fifteen control children and 20 constipated children were able to defecate rectal balloons. External sphincter activity decreased during the act of bearing down for defecation in 100% of controls, in 58% of constipated children able to defecate balloons, and in only 7% of patients unable to defecate balloons. Constipated children unable to defecate balloons were significantly less likely to recover after conventional laxative treatment than constipated children able to defecate balloons (P less than 0.02). Increased external sphincter activity during defecation appears to be the factor that prevents balloon expulsion in constipated children and could be the cause of their chronic fecal retention.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3958829&dopt=Abstract constipation laxative
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