Acta Pharmacol Toxicol (Copenh). 1981 Jan;48(1):73-80.
Enterohepatic circulation, urinary excretion and laxative action of some bisacodyl derivatives after intragastric administration in the rat.
Sund RB, Songedal K, Harestad T, Salvesen B, Kristiansen S.
Bisacodyl (BIS), the parent diphenol (DES) and its sulphuric acid di-ester (picosulphate = PICO) were given by stomach tube to fasted rats at a dose of 3.1 mumol/100 g rat. Bile was sampled in the periods 0-6, 6-12 and 12-18 hrs after drug administration, and assayed for total diphenol (= free + conjugated) by HPLC. Mean fractions (% of dose +/- S.E.M.) excreted in 5 rats per compound and period were: BIS 74.0 +/- 4.7, 51.9 +/- 7.9 and 30.8 +/- 2.5; DES 41.2 +/-4.3, 46.8 +/- 4.7 and 25.1 +/- 2.5; PICO 9.0 +/- 0.9, 26.0 +/- 5.4 and 19.6 +/- 3.1. Only minor amounts were excreted as free diphenol. Urine samples taken by bladder puncture and assayed as above furthermore showed that the renal excretion of total diphenol was insignificant compared to the amounts excreted in bile. Practically no diphenol was present in urine 0-6 hrs after the administration of PICO. In experiments with BIS and DES at 0.85 mumol/100 g, total diphenol excreted in bile during 0-6 hrs was: BIS 67.1 +/- 2.6 (n = 5); DES: 55.4 +/- 3.0 (5). - The latency time for laxative effect was studied in groups of 10 unfasted rats per compound. cumulative time response curves showed that PICO caused diarrhoea more promptly at 0.85 mumol/100 g than either BIS or DES. In most rats, this delayed action of BIS and DES persisted also at 1.7 mumol/100 g. At 3.1 mumol/100 g, however, the majority of the rats reacted as promptly to these two compounds as to PICO. These results are discussed in relation to the biliary excretion experiments, and interpreted in terms of the relative importance at the different dose levels of: 1. The enterohepatic recirculated fraction, and 2. The non-absorbed fraction, which passes directly to the large intestine. For PICO, the latter fraction is the single determinant of the eff
Leber Magen Darm. 1981 Apr;11(2):94-6.
[Diagnosis of functional abdominal complaints (author's transl)]
[Article in German]
Abdominal complaints require careful diagnostic investigations even if they are thought to be functional. In about 40% of patients seen in a gastroenterologist's office in a big city no organic causes of gastrointestinal complaints can be found. In about 36% false nutrition (for instance overeating, furfurism), gastrointestinal infectious disease, abuse of laxatives or food allergies are underlying factors. Microscopic examination of the stool should be done right from the beginning in mediterranean people in order to rule our parasitic disease. Early gastroscopy may be rational however sometimes not feasible; cholecystography may explain in some cases symptoms thought to be gastrointestinal.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7231037&dopt=Abstract constipation laxative
Am J Gastroenterol. 1980 Nov;74(5):451-8.
Laxative abuse syndrome.
Oster JR, Materson BJ, Rogers AI.
Laxative abuse syndrome (LAS) is a type of Munchausen syndrome characterized by surreptitious abuse of purgatives. Clinical findings are often perplexing and may mimic inflammatory bowel disease or malabsorption syndromes. Patients frequently complain of diarrhea alternating with constipation and may have nausea, vomiting and weight loss. Psychiatric disturbances are common and may include anorexia nervosa. Melanosis coli and cathartic colon, acid-base disturbances (usually metabolic alkalosis), sodium, potassium and water depletion, hyperuricemia, hyperaldosteronism and other electrolyte changes are possible complications. Diagnosis may be extremely difficult and may require special chemical analysis of urine and feces and search of the patient's possessions. Treatment is frustrating because the patient is rarely willing to admit to laxative abuse let alone cooperate in attempting to stop it. Physicians must be aware of the LAS in order to avoid harming the patient with extensive, expensive and often invasive (including laparotomy) procedures.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7234824&dopt=Abstract constipation laxative
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