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Table 3 Laxative compounds commonly used to treat chronic constipationá…ź

From: Chronic constipation in the elderly: a primer for the gastroenterologist

Type Laxative agent Mechanism of action Possible side effects
Bulking forming laxatives Natural fibres (e.g., psyllium) Intraluminal H2o binding, bulk forming and decrease stool consistency Bloating, flatulence
Semi-synthetic fibres (es. methylcellulose)
synthetic fibres (e.g., Polyethylene glycol polycarbophil: Macrogol)
Osmotic laxatives Magnesium hydroxide, magnesium citrate, magnesium sulfate, sodium phosphate. Interstitial H2o binding hydroelectrolytic alterations
Disaccharides and alditols Lactulose, sorbitol. Interstitial H2o binding Bacterial fermentation with bloating and flatulence (low efficacy in slow transit constipation)
Emollients laxatives Paraffin oil, docusate sodium Intraluminal H2o binding, bulk forming and decrease stool consistency Discomfort, abdominal pain, cramping
Stimulant laxatives diphenylmethane derivatives (bisacodyl, sodium picosulfate) Stimulating action on enteric nerves with decrease in peristaltic contractions. Discomfort, abdominal pain, cramping
Anthraquinones (senna, aloe, cascara) Decrease in colic absorption of H2o and electrolytes
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