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References: Laxative

Gerontology. 1983;29(3):181-4.
Constipation in long-stay elderly patients: its treatment and prevention by lactulose, poloxalkol-dihydroxyanthroquinolone and phosphate enemas.

Brocklehurst JC, Kirkland JL, Martin J, Ashford J.

37 long-stay geriatric patients were studied. All had 80% transit time (TT) in excess of 6 days. Only an average of 23% of markers were passed by day 6 and 30% of patients still had markers in situ after 2 weeks. Three daily enemas had no effect on TT and three daily enemas together with a laxative for 6 days normalized TT in 40% only. A further 3 weeks of laxatives did not prevent constipation from getting worse. The effectiveness of lactulose and poloxalkol-dihydroxyanthroquinolone, respectively, were the same and better than no treatment.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6852545&dopt=Abstract constipation laxative

Acta Pharmacol Toxicol (Copenh). 1982 Aug;51(2):165-72.
Interaction between diphenolic laxatives and intestinal bacteria in vitro.

Bergan T, Fotland MH, Sund RB.

The ability of the laxative diphenols desacetylbisacodyl, oxyphenisatin, and phenolphthalein to inhibit growth and cause leakage of potassium ion from microbial cells in vitro was studied with 25 aerobic and 25 anaerobic bacterial strains. None of the aerobes, but some of the anaerobes showed growth inhibition. Potassium release assayed by flame photometry was observed in strains which showed growth inhibition, but also in other strains including anaerobes and aerobes. The highest antibacterial activity among the diphenols was observed with phenolphthalein and the least with desacetylbisacodyl; this relationship as noted for both growth inhibition and potassium release. Enzymatic hydrolysis of picosulphate to the free diphenol desacetylbisacodyl carried out by three strains of anaerobic bacteria was indicated by high pressure liquid chromatography.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6896788&dopt=Abstract constipation laxative

Acta Pharmacol Toxicol (Copenh). 1982 Oct;51(4):377-87.
Uptake, conjugation and transport of laxative diphenols by everted sacs of the rat jejunum and stripped colon.

Sund RB, Hillestad B.

Phenolphthalein (PHEN), desacetylbisacodyl (DES) and oxyphenisatin (OXY) were incubated with everted sacs of the rat jejunum and stripped descending colon; the mucosal and serosal fluid were analysed with respect to free and conjugated diphenol by means of HPLC. Conjugates were measured as the amount of free diphenol in completely hydrolyzed samples less the amount before hydrolysis. A study with double-sided administration of PHEN revealed that diphenol uptake from and conjugate output to both sides followed a rectilinear course for 15-90 min. A standard incubation time of 60 min. was chosen for the subsequent experiments, in which the diphenols were administered at the mucosal side at a low and a high concentration. Diphenol uptake, i.e. the amount of free diphenol administered less the amount recovered at the mucosal side, varied in an order (PHEN greater than DES greater than OXY) which seems to be inversely related to the order of water solubility of the compounds. Tissue accumulation and conjugate output relative to uptake varied with the dose, and from one compound to another. At low initial concentration (20 nmol/ml), the compounds were transferred to the jejunal and colonic serosal fluid almost entirely as conjugates (greater than or equal to 95%); the transfer rates followed, qualitatively, the same order as above. In jejunum, more conjugates were released to the mucosal than to the serosal side; in colon the distribution was reversed. Increasing the dose to 100 nmol/ml caused a corresponding increase in uptake, but relative output decreased and tissue accumulation increased; thus demonstrating capacity limitation. With PHEN, the ratio of conjugated:free diphenol on the serosal side remained essentially unchanged; with DES in particular, but also with OXY the ratio decreased. These findings may be interpreted to mean

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