CLINICAL STUDY OF SENNA ADMINISTRATION TO NURSING MOTHERS: ASSESSMENT OF EFFECTS ON INFANT BOWEL HABITS.
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Fifty nursing mothers were given regular doses of a senna compound (Senokot Granules) and 50 received mineral oil or magnesia (Magnolax) to determine whether senna was an effective laxative and whether senna affected the bowel habits of infants of nursing mothers. Senna laxative was effective in 49 of 50 mothers. Infant bowel habits were not affected by senna administration to nursing mothers. The evidence suggests that the active principles of senna if they are transmitted in breast milk have no effect on the evacuation patterns of nursed infants. (+info)
A study of the effect of Picolax on body weight, cardiovascular variables and haemoglobin concentration.
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This study compared the effect of Picolax when administered for large bowel preparation in combination with preoperative fasting on body weight, haemoglobin concentration, haematocrit, and cardiovascular variables with matched subjects who were fasted before surgery. Picolax resulted in significantly greater weight loss, increases in haemoglobin concentration combined with cardiovascular changes suggesting hypovolaemia in the Picolax group. Intravenous fluid replacement is recommended in patients receiving Picolax. (+info)
A laxative screening service was established and offered to gastroenterologists in hospitals covering the West and Central belt of Scotland. The prevalence of laxative induced diarrhoea was assessed in two populations and was found to be 4% in new patients presenting to a gastroenterology clinic with diarrhoea and 20% in patients already under investigation of chronic idiopathic diarrhoea. A high rate of missed diagnosis of laxative induced diarrhoea (71%) and a low request rate (eight per annum) confirm the low clinical awareness of this diagnosis. We found potential savings of 80% of the cost of investigations subsequently ordered which could have been avoided by performing laxative screens on all patients presenting with diarrhoea. The introduction of such a screening policy is recommended as a cost-effective measure. (+info)
Assessment of preoperative fluid depletion using bioimpedance analysis.
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BACKGROUND: Fluid depletion during the perioperative period is associated with poorer outcome. Non-invasive measurement of total body water by bioimpedance may enable preoperative fluid depletion and its influence on perioperative outcome to be assessed. METHODS: Weight and foot bioimpedance were recorded under standardized conditions in patients undergoing bowel preparation (n=43) or day surgery (n=44). Fifteen volunteers also followed standard nil-by-mouth instructions on two separate occasions to assess the variabilities of weight and bioimpedance over time. RESULTS: Body weight fell by 1.27 kg (95% CI 1.03-1.50 kg; P<0.0001) and foot bioimpedance increased by 51 ohm after bowel preparation (95% CI 36-66; P<0.0001). Weight change after the nil-by-mouth period in day-surgery patients (mean -0.22 kg, 95% CI -0.05 to -0.47 kg; P=0.07) correlated (r=-0.46; P=0.005) with an increase in bioimpedance (16 ohms, 95% CI 5-27 ohms; P=0.01). No difference between two separate bioimpedance measurements was seen in the volunteer group. CONCLUSIONS: Further work is warranted to determine if bioimpedance changes may serve as a useful indicator of perioperative fluid depletion. (+info)
Effect of ethanol extracts of three Chinese medicinal plants with laxative properties on ion transport of the rat intestinal epithelia.
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The effects of ethanol extracts of three Chinese medicinal plants Dahuang (Rheum palmatum L.), Badou (Croton tiglium L.), and Huomaren (Cannabis sativa L.), on ion transport of the rat intestinal epithelia were studied. Rat intestinal epithelia mounted in an Ussing chamber attached with voltage/current clamp were used for measuring changes of the short-circuit current across the epithelia. The intestinal epithelia were activated with current raised by serosal administration of forskolin 5 microM. Ethanol extracts of the three plants all augmented the current additively when each was added after forskolin. In subsequent experiments, ouabain and bumetanide were added prior to ethanol extracts of these medicinal plants to determine their effect on Na(+) and Cl(-) movement. The results suggest that ethanol extracts of the three medicinal plants may affect the Cl(-) movement more directly than Na(+) movement in the intestinal epithelial cells. The results provide evidence for the pharmacologic mechanism of the three Chinese medicinal plants on the intestinal tract. (+info)
Effect of four-day psyllium supplementation on bowel preparation for colonoscopy:A prospective double blind randomized trial [ISRCTN76623768].
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BACKGROUND: Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy METHODS: A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was self-administered over 4 hours on the day prior to colonoscopy. A questionnaire on pre-study bowel habits and side effects was completed. Efficacy of the preparation was visually evaluated on a pre-determined scale. RESULTS: There were no significant differences between the two groups in gender, race, age, pre-study stool frequency or consistency. Tolerability was equivalent but efficacy of the bowel preparation was worse in the psyllium group compared to placebo (P < 0.05). CONCLUSIONS: In non-constipated patients psyllium based fiber supplementation should not be initiated in the few days prior to endoscopy using a polyethylene glycol preparation. (+info)
Overanticoagulation associated with combined use of lactulose and acenocoumarol or phenprocoumon.
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Some medical textbooks on drug interactions take note of the potential interaction between laxatives and coumarin anticoagulants, but epidemiological evidence that this interaction is of practical importance is lacking. We conducted a follow-up study in a large population-based cohort to investigate which laxatives are associated with overanticoagulation during therapy with coumarins. Of the 1124 patients in the cohort, 351 developed an International Normalized Ratio > or = 6.0. The only laxative with a moderate but significantly increased relative risk of overanticoagulation was lactulose (relative risk 3.4, 95% confidence interval 2.2, 5.3). In view of the widespread use of lactulose, especially among the elderly, awareness of this potential drug interaction is required. (+info)
The role of intestinal bacteria in the transformation of sodium picosulfate.
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Sodium picosulfate, a laxative, was biotransformed to 4,4'-dihydroxydiphenyl-(2 pyridyl)-methane by intestinal flora that produced a novel sulfotransferase (not sulfatase). The biotransformation was activated by adding phenolic compounds such as phenol, acetaminophen and flavonoids. The enzyme activity related to this biotransformation was the highest in the contents of the caecum region of the intestine. The enzyme activity was 3.0 mumole/hr/g wet feces in humans and 0.75 in rats (pH 8.0). The optimal pH was 9.0. (+info)