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References: Laxative

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The inhibitory effect of repetitiously administered loperamide, a peripheral mu-opioid receptor agonist and well-recognized antidiarrheal agent, on mouse gastrointestinal transit was compared with that of morphine in order to examine the development of tolerance to mu-opioid receptor agonist-induced constipation (antitransit effect). When administered subcutaneously 15 min before the oral injection of charcoal meal, loperamide (0.1-30 mg/kg) and morphine (1-8 mg/kg) dose-dependently and significantly inhibited gastrointestinal transit of charcoal with the ID(50) values of 1.6 (0.3-7.1) mg/kg and 3.6 (1.5-8.5) mg/kg, respectively. When loperamide (30 mg/kg) was administered twice daily for 2 days, the antitransit effect was significantly reduced. On the other hand, morphine did not develop tolerance in even more severe conditions than those of loperamide. It is known that P-glycoprotein, an ATP-dependent drug efflux pump, is involved in the development of tolerance to morphine analgesia. The tolerance observed with loperamide was significantly prevented by cyclosporin (30 mg/kg, i.p.), a P-glycoprotein inhibitor, thus the ID(50) value in loperamide-tolerant mice was markedly reduced from >1000 mg/kg to 40 (2.7-603.0) mg/kg by cyclosporin. These results indicate that loperamide, different from morphine, readily develops tolerance to the inhibitory effect on mouse gastrointestinal transit, and the P-glycoprotein may be involved in the development of tolerance to the antitransit effect of loperamide.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14592702&dopt=Abstract [PubMed - in process]

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Pol Merkuriusz Lek. 2003 Jul;15(85):47-50.
[Changes of the position and length of the transverse colon causing abdominal pain and chronic constipation during adolescence]

[Article in Polish]

Prandota J, Iwanczak F, Pytrus T.

Oddzial Nefrologiczny i Ostrych Zatruc Dolnoslaskiego Centrum Pediatrii, Wroclawiu.

In 12 patients aged 9 to 17 years (14.1 +/- 2.3 SD years) (11 girls, 1 boy) complaining of abdominal pain and chronic constipation, barium large bowel X-ray examination showed the following anatomical and positional abnormalities: ptosis of the transverse colon to the small pelvis was found in 11/12 patients, ptosis of the hepatic flexure of the transverse colon (2/12), ptosis of both the hepatic and lienal flexures (2/12), dolichocolon (2/12), and dolichosigma (2/12); 10 of 12 children had symptoms characteristic of irritable colon syndrome. It seems that clinical symptoms accompanying these abnormalities begin to manifest mainly in girls during adolescence because at that time the final length of the colon is established, the transit time reaches its maximal value, and the shape of the pelvis becomes characteristic for this gender. These abnormalities are rather constitutional than acquired since previously it has been reported that the vertical ptosis of the kidney(s) occurs also mainly in adolescent girls.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14593959&dopt=Abstract

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Anal incontinence and constipation are not only physically and psychologically disabling symptoms but also a significant social and public health problem. The epidemiology of anal incontinence and constipation from community-bases remains largely unknown, especially in Asian women. This study is a continuation of a previous survey taken on the epidemiology of urinary incontinence and overactive bladder in Taiwanese women by using a second questionnaire (correlation coefficient for symptoms, r=0.87; P<0.05). We evaluated the prevalence and potential risk factors associated with anal incontinence and constipation in the general population. Of the 1,584 (2.92%) women sampled, 1,253 (79.1%) were successfully interviewed at home. The prevalence of fecal incontinence and flatus incontinence was 35 (2.8%) and 107 (8.6%), respectively. There were 306 (24.5%) participants who reported constipation. However, according to the current medical criteria for constipation, the prevalence of constipation was only 2.7%. The prevalence of anal incontinence did not increase after the age of 65 years (9.7%, including 3.5% of elderly women with fecal incontinence and 6.2% of elderly women with flatus incontinence). The prevalence of constipation significantly increased in the women aged 65 years and over (self-reported prevalence: 32.4%, fitted in medical criteria for constipation: 8.3%). Our results demonstrated that constipation shares some of the same risk factors, namely, symptoms of uterovaginal prolapse, prior gynecologic surgery, and overactive bladder that predispose women to the occurrence of anal incontinence. The questionnaire needs a higher discriminatory capacity, and a longitudinal study should be conducted to clari

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