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Drug Safety

, Volume 10, Issue 1, pp 47–65 | Cite as

Adverse Effects of Drugs Used in the Management of Constipation and Diarrhoea

  • Jenny M. Gattuso
  • Michael A. Kamm
Review Article Drug Experience

Summary

Most laxatives, if used intermittently in the absence of contraindications, are relatively safe. Bulking agents may diminish absorption of some minerals and drugs, but this is not usually clinically significant. Ispaghula can cause serious allergic reactions. The chronic ingestion of stimulant laxatives has been blamed for the development of the ‘cathartic colon’, but there are no definitive studies which have demonstrated this. Dantron (danthron) preparations should only be used in older patients and the terminally ill because of the risk of hepatotoxicity with this drug. Oral oxyphenisatine should no longer be used. Senna would appear to be the stimulant laxative of choice during pregnancy and lactation. Bisacodyl is the polyphenolic derivative of choice. Lactulose, sorbitol and lactilol rarely cause significant adverse effects. Magnesium salt laxatives and phosphate enemas can cause serious metabolic disturbances in babies and young children. Liquid paraffin is contraindicated if there is any risk of aspiration. Interference with the absorption of fat soluble vitamins would not appear to be clinically significant. Docusate sodium may potentiate the hepatotoxicity of other drugs, but reports of this are rare. The role of cisapride in constipation has not been established.

Antidiarrhoeal drugs are second line drugs whose use is aimed at minimising inconvenience and discomfort. No antidiarrhoeals can be recommended for children under 4 years of age. Loperamide is the drug of choice in older children and adults. The atropine component of diphenoxylate/atropine combinations can cause significant adverse effects. Bismuth salicylate is an inconvenient treatment for travellerss’ diarrhoea as large frequent doses of the liquid formulation are needed. Some bismuth can be absorbed and there is the potential to cause encephalopathy. Octreotide, methysergide and cholestyramine have a role for specific causes of diarrhoea only. Octreotide is effective in high output states from the small or large bowel, with few adverse effects. Clonidine and lidamidine may have a role in the treatment of chronic diabetic diarrhoea. The role of lidamidine in nondiabetic chronic diarrhoea has not been established.

Keywords

Lactulose Loperamide Bisacodyl Analgesic Nephropathy Codeine Phosphate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Abramowiecz M (Ed.). Safety of stool softeners. Medical Letter on Drugs and Therapeutics 19: 45–46, 1977Google Scholar
  2. Alestig K, Trollfors B, Stenqvist K. Acute non-specific diarrhoea. Studies on the use of charcoal, kaolin-pectin and diphenoxylate. Practitioner 222: 859–860, 1979PubMedGoogle Scholar
  3. Alison LH, Bulugahapitiya D. Laxative induced magnesium poisoning in a 6 week old infant. British Medical Journal 300: 125, 1990PubMedGoogle Scholar
  4. Allen MD, Greenblatt DJ, Harmatz JS, Smith TW. Effect of magnesium-aluminium hydroxide and kaolin-pectin on absorption of digoxin from tablets and capsules. Journal of Clinical Pharmacology 21: 26–30, 1981PubMedGoogle Scholar
  5. Allison MC, Sercombe J, Pounder RE. A double-blind crossover comparison of lidamidine, loperamide and placebo for the control of chronic diarrhoeas. Alimentary Pharmacology and Therapeutics 2: 347–351, 1988PubMedGoogle Scholar
  6. Angelides A, Fitzgerald JF. Pharmacologic advances in the treatment of gastrointestinal diseases. Pediatric Clinics of North America 28: 95–112, 1981PubMedGoogle Scholar
  7. Armstrong RD, Crisp AJ, Grahame R, Woolf DL. Hypertrophie osteoarthropathy and purgative abuse. British Medical Journal 282: 1836, 1981PubMedGoogle Scholar
  8. Ashton MR, Sutton D, Nielsen M. Severe magnesium toxicity after magnesium sulphate enema in a chronically constipated child. British Medical Journal 300: 541, 1990PubMedGoogle Scholar
  9. Aucamp AK, Achtebergh van SM, Theron E. Potential hazard of magnesium sulphate administration. Lancet 2: 1057, 1981PubMedGoogle Scholar
  10. Baldwin WF. Clinical study of senna administration to nursing mothers: assessment of effects on infant bowel habits. Canadian Medical Association Journal 89: 566–568, 1963PubMedGoogle Scholar
  11. Bardy J-D, Malo J-L, Sequin P, Ghezzo H, Desjardins J, et al. Occupational asthma and IgE sensitization in a pharmaceutical company processing psyllium. American Review of Respiratory Diseases 135: 1033–1038, 1987Google Scholar
  12. Barker P, Hanning C, Trotter T. A study of the effect of picolax on body weight, cardiovascular variables and haemoglobin concentration. Annals of the Royal College of Surgeons of England 74: 318–319, 1992PubMedGoogle Scholar
  13. Barrett KE, Dharmsathaphorn K. Pharmacological aspects of therapy in inflammatory bowel diseases: antidiarrheal agents. Journal of Clinical Gastroenterology 10: 57–63, 1988PubMedGoogle Scholar
  14. Barth JH, Reshad H, Darley CR, Gibson JR. A cutaneous complication of dorbanex therapy. Clinical and Experimental Dermatology 9: 95–96, 1984PubMedGoogle Scholar
  15. Bateman DN, Smith JM. A policy for laxatives. British Medical Journal 298: 188, 1989Google Scholar
  16. Bateman DN. Adverse reactions to gastrointestinal drugs. Update 43: 707–712, 1991Google Scholar
  17. Bell AM. Colonic perforation with a phosphate enema. Journal of the Royal Society of Medicine 83: 54–55, 1990PubMedGoogle Scholar
  18. Bennett JR. Can Fybogel sachets (ispaghula husk) be taken indefinitely? British Medical Journal 293: 1222, 1986Google Scholar
  19. Bernier J-J, Ls’Hirondel Ch, Bretagne J-F. Cell loss under laxatives in human jejunum. Abstract. Gastroenterology 76: 1099A, 1979Google Scholar
  20. Beuers U, Spengler U, Pape GR. Hepatitis after chronic abuse of senna. Lancet 337: 372–373, 1991PubMedGoogle Scholar
  21. Bhutta TI, Tahir KI. Loperamide poisoning in children. Lancet 335: 363, 1990PubMedGoogle Scholar
  22. Binder HJ, Dobbins JW, Whiting DS. Evidence against importance of altered mucosal permeability in ricinoleic acid induced fluid secretion. Abstract. Gastroenterology 72: 1029A, 1977Google Scholar
  23. Binder HJ, Donowitz M. A new look at laxative action. Gastroenterology 69: 1001–1005, 1975PubMedGoogle Scholar
  24. Bingham E. Carcinogenicity of mineral oils. Annals of the New York Academy of Sciences 534: 452–458, 1988PubMedGoogle Scholar
  25. Bockus HL, Willard JH, Bank J. Melanosis coli. Journal of the American Medical Association 101: 1–6, 1933Google Scholar
  26. Boulos PB, Karamanolis DG, Salmon PR, Clark CG. A rapid bowel preparation without colonic washout for colonoscopy. Coloproctology 84: 158–159, 1984Google Scholar
  27. Bowyer RC, Urquhart J. Faecal peritonitis induced by picolax. British Medical Journal 295: 1413, 1987Google Scholar
  28. Bradshaw MJ, Harvey RF. Antidiarrhoeal agents: clinical pharmacology and therapeutic use. Drugs 24: 440–451, 1982PubMedGoogle Scholar
  29. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain, London, 1992Google Scholar
  30. Brown AT, Campbell WAB. Hazards of hypertonic magnesium enema therapy. Archives of Disease in Childhood 53: 920, 1978PubMedGoogle Scholar
  31. Brown DD, Juhl RP. Decreased bioavailability of digoxin due to antacids and kaolin-pectin. New England Journal of Medicine 295: 1034–1037, 1976PubMedGoogle Scholar
  32. Buckley P, Larkin C, Os’Callaghan E. Psychosis following use of proprietary antidiarrhoeal medicines. British Journal of Psychiatry 157: 758–759, 1990PubMedGoogle Scholar
  33. Casdorph HR. Safe uses of cholestyramine. Annals of Internal Medicine 72: 759–760, 1970PubMedGoogle Scholar
  34. Chow CB, Li SH, Leung NK. Loperamide associated necrotising enterocolitis. Acta Paediatrica Scandinavica 75: 1034–1036, 1986PubMedGoogle Scholar
  35. Claeson ME, Clements ML. Ridding the world of hydroxyquinolones. British Medical Journal 299: 527–528, 1989PubMedGoogle Scholar
  36. Costello AMdeL, Bhutta TI. Antidiarrhoeal drugs for acute diarrhoea in children. None work, and many may be dangerous. British Medical Journal 304: 1–2, 1992PubMedGoogle Scholar
  37. Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ. Variation of bowel habit in two population samples. British Medical Journal 2: 1095–1099, 1965PubMedGoogle Scholar
  38. Courtney SP, Wightman JAK. Urethral calculi caused by cholestyramine. British Journal of Urology 68: 654, 1991PubMedGoogle Scholar
  39. Cox NH, Vickers CFH. A cutaneous complication of dorbanex therapy. Correspondence. Clinical and Experimental Dermatology 9: 624, 1984PubMedGoogle Scholar
  40. Davies RF, Eichner JM, Bleyer WA, Okamoto G. Hypocalcaemia, hyperphosphataemia, and dehydration following a single hypertonic phosphate enema. Journal of Pediatrics 90: 484–485, 1977Google Scholar
  41. Dodson ME. Picolax bowel preparation. British Journal of Anaesthesia 66: 664, 1991Google Scholar
  42. Donowitz M, Binder HJ. Dioctyl sodium sulfosuccinate (DSS) stimulates large intestinal water and electrolyte secretion: mechanism of laxative action? Abstract. Gastroenterology 66: 838A, 1974Google Scholar
  43. Douthwaite AH, Goulding R. Action of senna. British Medical Journal 14: 1414–1415, 1957Google Scholar
  44. Dudl RJ, Forsythe AB, Ziegler MG, Os’Dorisio TM. Treatment of diabetic diarrhea and orthostatic hypotension with somatostatin analogue SMS 201-995. American Journal of Medicine 83: 584–588, 1987PubMedGoogle Scholar
  45. Dufour P, Gendre. Long term mucosal alterations by sennosides and related compounds. Pharmacology 36(Suppl. 1): 194–202, 1988PubMedGoogle Scholar
  46. Dwyer JT, Goldin B, Gorbach S, Patterson J. Dietary fiber and fiber supplements in the therapy of gastrointestinal disorders. Journal of the American Medical Association 69: 51–62, 1978Google Scholar
  47. Eastwood MA, Passmore R. Dietary fibre. Lancet 2: 202–205, 1983PubMedGoogle Scholar
  48. Editorial. In Dialogue on diarrhoea, No. 43, pp. 4-5, AHRTAG, London, 1990Google Scholar
  49. Editorial. Laxative jaundice. British Medical Journal 1: 325, 1972Google Scholar
  50. Editorial. Trifyba — an improved bulk laxative? Drug and Therapeutics Bulletin 30: 63-64, 1992Google Scholar
  51. Elkington SE. Progress report. Lactulose. Gut 11: 1043–1048, 1970PubMedGoogle Scholar
  52. Elliot D, Glover GR. Large bowel perforation due to excessive bran ingestion. British Journal of Clinical Practice 37: 32–33, 1983PubMedGoogle Scholar
  53. Fedorak RN, Field M, Chang EB. Treatment of diabetic diarrhea with Clonidine. Annals of Internal Medicine 102: 197–199, 1985PubMedGoogle Scholar
  54. Fioramonti J, Bueno L. Mechanisms of action of laxatives. In Kamm & Lennard-Jones (Eds) Gastrointestinal transit, pp. 187–194, Wrightson Biomedical Publishing Ltd, Petersfield, 1991Google Scholar
  55. FitzGerald O, Redmond J. Anthraquinone induced clubbing associated with laxative abuse. Irish Journal of Medical Sciences 152: 246–247, 1985Google Scholar
  56. Freese B, Medawar C, Herxheimer A. No more loperamide for infants. Lancet 2: 816–817, 1981PubMedGoogle Scholar
  57. Friedman LS. Somatostatin therapy for Aids diarrhea: muddy waters. Gastroenterology 101: 1446–1447, 1991PubMedGoogle Scholar
  58. Frier BM, Scott RDM. Hypertrophic osteoarthropathy and purgative abuse. British Medical Journal 283: 439, 1981PubMedGoogle Scholar
  59. Gaginella TS, Chadwick VS, Debongnie JC, Lewis JC, Phillips SF. Perfusion of rabbit colon with ricinoleic acid: dose-related mucosal injury, fluid secretion, and increased permeability. Gastroenterology 73: 95–101, 1977PubMedGoogle Scholar
  60. Garcia-Webb P, Bhagat C, Oh T, Hart G, Thompson W. Hypermagnesaemia and hypophosphataemia after ingestion of magnesium sulphate. British Medical Journal 288: 759, 1984PubMedGoogle Scholar
  61. Garrett JM, Sauer WG, Moertel CG. Colonie motility in ulcerative colitis after opiate administration. Gastroenterology 53: 93–100, 1967PubMedGoogle Scholar
  62. Gascoigne EW, Reyntjens A, Huijghebaert S. World-wide experience with loperamide in acute diarrhoea. In Dupont HL (Ed.) Acute infectious diarrhoea: role of drug therapy, Janssen Pharmaceutical Ltd, Wantage, 1987Google Scholar
  63. German K, Chandiramani VJ, Stephenson TP. A study of the effect of Picolax on body weight, cardiovascular variables and haemoglobin concentration. Annals of the Royal College of Surgeons of England 75: 70, 1993PubMedGoogle Scholar
  64. Gillespie BF, Rathbun FJ. Adverse effects of psyllium. Canadian Medical Association Journal 146: 16–17, 1992PubMedGoogle Scholar
  65. Gilman AG, Rall TW, Nies AS, Taylor P. (Eds). Goodman and Gilmanss’ The pharmacological basis of therapeutics, Pergamon Press, New York, 1990Google Scholar
  66. Gjone E, Blomhoff JP, Ritland S, Elgio K, Husby G. Laxative-induced chronic liver disease. Scandinavian Journal of Gastroenterology 7: 395–402, 1972PubMedGoogle Scholar
  67. Godding EW. Hazards of multilaxative mixtures. British Medical Journal 1: 838, 1976aPubMedGoogle Scholar
  68. Godding EW. Therapeutics of laxative agents with special reference to the anthraquinones. Pharmacology 14(Suppl.): 78–101, 1976bPubMedGoogle Scholar
  69. Goff JS. Diabetic diarrhea and lidamidine. Annals of Internal Medicine 101: 874–875, 1984PubMedGoogle Scholar
  70. Gorbach SL. Bismuth therapy in gastrointestinal diseases. Gastroenterology 99: 863–875, 1990PubMedGoogle Scholar
  71. Gorden P, Comi RJ, Maton PN, Go VLW. Somatostatin and somatostatin analogue (SMS 201-995) in treatment of hormonesecreting tumors of the pituitary and gastrointestinal tract and non-neoplastic diseases of the gut. Annals of Internal Medicine 110: 35–50, 1989PubMedGoogle Scholar
  72. Grace R, Hale M. Faecal peritonitis induced by picolax. British Medical Journal 295: 1413, 1987Google Scholar
  73. Greenhalf JO, Leonard HSD. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 210: 259–263, 1973PubMedGoogle Scholar
  74. Gussin RZ. Withdrawal of loperamide drops. Lancet 335: 1603–1604, 1990PubMedGoogle Scholar
  75. Harvey RF, Read AE. Saline purgatives. Lancet 2: 185–187, 1973PubMedGoogle Scholar
  76. Hasking GJ, Duggan JM. Encephalopathy from bismuth subsalicylate. Medical Journal of Australia 10: 167, 1982Google Scholar
  77. Heaton KW, Leaver JV, Barnard D. Osteomalacia associated with cholestyramine therapy for postileectomy diarrhea. Gastroenterology 62: 642–646, 1972PubMedGoogle Scholar
  78. Hendrickse RG, Woolridge MAW, Russell A. Loperamide in acute diarrhoea in childhood: results of a double blind, placebo controlled multicentre clinical trial. British Medical Journal 289: 1263–1267, 1984Google Scholar
  79. Honig PJ, Holtzapple PG. Hypocalcemic tetany following hypertonic phosphate enemas. Clinical Pediatrics 678-679, 1975Google Scholar
  80. Hool GJ, Bokey EL, Pheils MT. Enema-nozzle injury of the rectum. Medical Journal of Australia 1: 364–365, 1980PubMedGoogle Scholar
  81. Hoyle CHV. Effect of long-term treatment with senna on neuromuscular transmission in the large intestine of the rat. In Kamm & Lennard-Jones (Eds) Gastrointestinal transit, pp. 195–208, Wrightson Biomédical Publishing Ltd, Petersfield, 1991Google Scholar
  82. Hughes K, Mann S, Cooke MBD, James WB. A new oral bowel evacuant (picolax) for colon cleansing. Clinical Radiology 34: 75–77, 1983PubMedGoogle Scholar
  83. Hughes S. Acute secretory diarrhoeas. Drugs 26: 80–90, 1983PubMedGoogle Scholar
  84. Hughes S. Antimotility drugs in the treatment of acute diarrhoea. Biochemical Society Transactions 12 (604th Meeting): 202–205, 1984PubMedGoogle Scholar
  85. Jenkins JA, Jenkins AL. The clinical implications of dietary fiber. Advances in Nutritional Research 6: 169–202, 1984PubMedGoogle Scholar
  86. Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. Journal of Clinical Gastroenterology 11: 525–536, 1989PubMedGoogle Scholar
  87. Kachel G, Ruppin H, Hagel J, Barina W, Meinhardt M, et al. Human intestinal motor activity and transport: effects of a synthetic opiate. Gastroenterology 90: 85–93, 1986PubMedGoogle Scholar
  88. Karaus M, Sarna SK, Ammon HV, Weinbeck M. Effects of oral laxatives on colonic motor complexes in dogs. Gut 28: 1112–1119, 1987PubMedGoogle Scholar
  89. Kaupke C, Sprague T, Gitnick GL. Hypernatremia after administration of lactulose. Annals of Internal Medicine 86: 745–746, 1977PubMedGoogle Scholar
  90. Kendall AC. Fatal case of encephalitis after Phenolphthalein ingestion. British Medical Journal 2: 1461–1462, 1954PubMedGoogle Scholar
  91. Khan MA, Hasan SB. Drugs and diarrhoea. Journal of the Indian Medical Association 87: 125–126, 1989PubMedGoogle Scholar
  92. Krishnamurthy S, Schuffler MD, Rohrmann CA, Pope CE. Severe idiopathic constipation is associated with a distinctive abnormality of the colonie myenteric plexus. Gastroenterology 88: 26–34, 1985PubMedGoogle Scholar
  93. Kronborg IJ, Howard A. Diarrhoea: causes and specific treatment. Drugs 21: 62–68, 1981PubMedGoogle Scholar
  94. Kune GA, Kune S, Field B, Watson LF. The role of chronic constipation, diarrhea, and laxative use in the etiology of large-bowel cancer. Diseases of the Colon and Rectum 31: 507–512, 1988PubMedGoogle Scholar
  95. Kutt E, Hall MJ, Booth A, Virjee J. Barium enemas are a headache. Clinical Radiology 39: 9–10, 1988PubMedGoogle Scholar
  96. Ladefoged K, Christensen KC, Hegnhoj J, Jarnum S. Effect of a long acting somatostatin analogue SMS 201-995 on jejunostomy effluents in patients with severe short bowel syndrome. Gut 30: 943–949, 1989PubMedGoogle Scholar
  97. Lantner RR, Baltazar RE, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. Journal of the American Medical Association 264: 2534–2536, 1990PubMedGoogle Scholar
  98. Lawrance J, Massoud T, Shatwell W, Mason A, Creasy T, et al. Picolax, hydration and fluid replacement. European Society of Gastrointestinal Radiologists, 2nd Annual Meeting, William Cook Europe Ltd, 1991Google Scholar
  99. Lederle FA, Busch DL, Mattox KM, West MJ, Aske DM. Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose. American Journal of Medicine 89: 597–601, 1990PubMedGoogle Scholar
  100. Leibach JR, Sninsky CA, Justus PG, Riley RL, Mathias JR. Lidamidine HCL: a new drug for the treatment of diarrheal disorders. Abstract. Gastroenterology 80: A1207, 1981Google Scholar
  101. Leng-Peschlow E. Senna and its rational use. Pharmacology 44(Suppl. 1): 1–52, 1992Google Scholar
  102. Levine D, Goode AW, Wingate DL. Purgative abuse associated with reversible cachexia, hypogammaglobulinaemia, and finger clubbing. Lancet 1: 919–920, 1981PubMedGoogle Scholar
  103. Levitt M, Gessert C, Finberg L. Inorganic phosphate (laxative) poisoning resulting in tetany in an infant. Journal of Pediatrics 82: 479–481, 1973PubMedGoogle Scholar
  104. Lee JR, Ferrando JR. Variables in the preparation of the large intestine for double contrast barium enema examination. Gut 25: 69–72, 1984PubMedGoogle Scholar
  105. Lish PM. Some pharmacologie effects of dioctyl sodium sulfosuccinate on the gastrointestinal tract or the rat. Gastroenterology 41: 580–584, 1961PubMedGoogle Scholar
  106. Loon van FPL, Bennish ML, Speelman P, Butler C. Double blind trial of loperamide for treating acute watery diarrhoea in expatriates in Bangladesh. Gut 30: 492–495, 1989PubMedGoogle Scholar
  107. Lowney ED, Baublis JV, Kreye GM, Harrell ER, McKenzie AR. The scalded skin syndrome in small children. Archives of Dermatology 95: 359–369, 1967PubMedGoogle Scholar
  108. Ludan AC. Current management of acute diarrhoeas. Use and abuse of drug therapy. Drugs 36(Suppl. 4): 18–25, 1988PubMedGoogle Scholar
  109. Ludever JR, Demers LM, Nomides CT. Mechanism of action of castor oil: a biochemical link to the Prostaglandins. Advances in Prostaglandin Thromboxane and Leukotriene Research 8: 1633–1634, 1980Google Scholar
  110. Machado L, Stalenheim G. Respiratory symptoms in ispaghula-allergic nurses after oral challenge with ispaghula suspension. Allergy 39: 65–68, 1984PubMedGoogle Scholar
  111. Machado L, Zetterstrom O, Fagerberg E. Occupational allergy in nurses to a bulk laxative. Allergy 34: 51–55, 1979PubMedGoogle Scholar
  112. Mader TM, Stulting RD. Keratoconjunctivitis sicca caused by diphenoxylate hydrochloride with atropine sulphate (lomotil). American Journal of Ophthalmology 111: 377–378, 1991PubMedGoogle Scholar
  113. Malmquist J, Hulten-Nosslin MB, Ericsson B, Jeppsson J-O. Finger clubbing and aspartylglucosamine excretion in a laxative-abusing patient. Postgraduate Medical Journal 56: 862–864, 1980PubMedGoogle Scholar
  114. Martindale. In Reynolds (Ed.) The extra pharmacopoeia, 1073–1112, 1057–1058, The Pharmaceutical Press, London, 1989Google Scholar
  115. McArthur KE, Anderson DS, Durbin TE, Orloff MJ, Dharmsathaphorn K. Clonidine and lidamidine to inhibit watery diarrhoea in a patient with lung cancer. Annals of Internal Medicine 96: 323–325, 1982PubMedGoogle Scholar
  116. McConnochie K, Edwards JH, Fifield R. Ispaghula sensitization in workers manufacturing a bulk laxative. Clinical and Experimental Allergy 20: 199–202, 1990PubMedGoogle Scholar
  117. McCormick PA, Os’Donoghue D, Brennan N. Diphenoxylate and pancreatitis. Lancet 1: 752, 1985PubMedGoogle Scholar
  118. McDonagh AJG, Singh P, Pilbrow WJ, Yopungs GR. Safety of picolax (sodium picosulphate-magnesium citrate) in inflammatory bowel disease. British Medical Journal 299: 776–777, 1989PubMedGoogle Scholar
  119. Meisel JL, Bergman D, Graney D, Saunders DR, Rubin CE. Human rectal mucosa: protoscopic and morphological changes caused by laxatives. Gastroenterology 72: 1274–1279, 1977PubMedGoogle Scholar
  120. Minton NA, Smith PGD. Loperamide toxicity in a child after a single dose. British Medical Journal 294: 1383, 1987PubMedGoogle Scholar
  121. Moriarty KJ. Laxatives-use and abuse. Gastroenterology in Practice Oct/Nov: 15-24, 1987Google Scholar
  122. Morton AR, Bailie GR. Severe hypermagnesaemia after magnesium sulphate enemas. British Medical Journal 291: 516, 1985Google Scholar
  123. Mori H, Sugie S, Niwa K, Takahashi M, Kawai K. Induction of intestinal tumours in rats by chrysazin. British Journal of Cancer 52: 781–783, 1985PubMedGoogle Scholar
  124. Mori H, Sugie S, Niwak K, Yoshimi N, Tanaka T, Hirono I. Carcinogenicity of chrysazin in large intestine and liver of mice. Japanese Journal of Cancer Research 77: 871–876, 1986PubMedGoogle Scholar
  125. Muhlendahl von KE, Bunjes R, Krienke EG. Loperamide-induced ileus. Lancet 1: 209, 1980Google Scholar
  126. Müller-Lissner SA, Bavarian constipation study group. Treatment of chronic constipation with cisapride and placebo. Gut 28: 1033–1038, 1987PubMedGoogle Scholar
  127. Müller-Lissner S. Nebenwirkungen von Laxantien. Zeitschrift für Gastroenterologie 30: 418–427, 1992PubMedGoogle Scholar
  128. Nakamura GJ, Schneiderman LJ, Klauber MR. Colorectal cancer and bowel habits. Cancer 54: 1475–1477, 1984PubMedGoogle Scholar
  129. Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. DrugNutrient Interactions 5: 67–69, 1987Google Scholar
  130. Olm M, Gonzalez FJ, Garcia-Valdecasas JC, Fuster F, Bertran A, et al. Necrotising colitis with perforation in diarrhoic patients treated with loperamide. European Journal of Clinical Pharmacology 40: 415–416, 1991PubMedGoogle Scholar
  131. Outerbridge EW, Papageorgiou A, Stern L. Magnesium sulfate enema in a newborn. Fatal systemic magnesium absorption. Journal of the American Medical Association 224: 1392–1393, 1973PubMedGoogle Scholar
  132. Oxnard SC, Os’Bell J, Grupe WE. Severe tetany in an asotemic child related to a sodium phosphate enema. Pediatrics 53: 105–106, 1974PubMedGoogle Scholar
  133. Palmer KR, Corbett CL, Holdsworth CD. Double-blind cross-over study comparing loperamide codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology 79: 1272–1275, 1980PubMedGoogle Scholar
  134. Paraskevaides EC. Fatal lipid pneumonia and liquid paraffin. British Journal of Clinical Practice 44: 509–510, 1990PubMedGoogle Scholar
  135. Patel PM, Selby PJ, Deacon J, Chilvers C, McElwain TJ. Anthraquinone laxatives and human cancer: an association in one case. Postgraduate Medical Journal 65: 216–217, 1989PubMedGoogle Scholar
  136. Pattison M, Lee SM. Life-threatening metabolic acidosis from cholestyramine in an infant with renal insufficiency. American Journal of Diseases of Children 141: 479–480, 1987PubMedGoogle Scholar
  137. Pearson AJG, Scheuer PJ, Grainger JM, McIntyre N. Jaundice due to oxyphenisatin. Lancet 1: 994–996, 1971PubMedGoogle Scholar
  138. Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 335: 416, 1990PubMedGoogle Scholar
  139. Phillips SF. A further look at laxatives. Gastroenterology 70: 464–465, 1976PubMedGoogle Scholar
  140. Phipps RF, Fraser S. Faecal peritonitis induced by picolax. British Medical Journal 295: 1027, 1987PubMedGoogle Scholar
  141. Portnoy BL, Dupont HL, Pruitt D, Abson JA, Rodriguez JT. Antidiarrheal agents in the treatment of acute diarrhea in children. Journal of the American Medical Association 236: 844–846, 1976PubMedGoogle Scholar
  142. Preston DM, Butler MG, Smith B, Lennard-Jones JE. Neuropathology of slow transit constipation. Abstract. Gut 24: A997, 1983Google Scholar
  143. Prior J, White I. Tetany and clubbing in patient who ingested large quantities of senna. Lancet 2: 947, 1978PubMedGoogle Scholar
  144. Qvitzau S, Matzen P, Madsen P. Treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium. Scandinavian Journal of Gastroenterology 23: 1237–1240, 1988PubMedGoogle Scholar
  145. Reedy JC, Zwiren GT. Enema-induced hypocalcaemia and hyperphosphatemia leading to cardiac arrest during induction of aneasthesia in an outpatient surgery center. Anesthesiology 59: 578–579, 1983PubMedGoogle Scholar
  146. Reynolds TB, Peters RL, Yamada S. Chronic active and lupoid hepatitis caused by a laxative oxyphenisatin. New England Journal of Medicine 285: 813–820, 1971PubMedGoogle Scholar
  147. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin. Lancet 338: 706, 1991PubMedGoogle Scholar
  148. Riemann JF, Schmidt H. Ultrastructural changes in the gut autonomic nervous system following laxative abuse and in other conditions. Scandinavian Journal of Gastroenterology 17(Suppl. 71): 111–124, 1982Google Scholar
  149. Rieman JF, Schenk J, Ehler R, Schmidt H, Koch H. Ultrastructural changes of colonic mucosa in patients with chronic laxative misuse. Acta Hepato-Gastroenterologica 25: 213–218, 1978Google Scholar
  150. Rohack JJ, Mehta BR, Subramanyam K. Hyperphosphatemia and hypocalcemic coma associated with phosphate enema. Southern Medical Journal 78: 1241–1242, 1985PubMedGoogle Scholar
  151. Rohde JE, Cash RA, Guerrant RL, Mahalanabis D, Molla AM, et al. Therapeutic interventions in diarrhea. Diarrhoea and Malnutrition: Interactions, Mechanisms and Interventions, pp. 287–295, Plen Press, New York, 1983Google Scholar
  152. Salim A, Tariq B, Tariq M. Effect of magnesium trisilicate and kaolin-pectin on the bioavailability of trimethoprim. Research Communications in Chemical Pathology and Pharmacology 40: 165–167, 1983Google Scholar
  153. Sandler RS, Drossman DA. Bowel habits in young adults not seeking health care. Digestive Diseases and Sciences 32: 841–845, 1987PubMedGoogle Scholar
  154. Sarner M. Problems caused by laxatives. Practitioner 216: 661–664, 1976PubMedGoogle Scholar
  155. Saunders DR, Sillery J, Rachmilewitz D. Effect of dioctyl sodium sulfsuccinate on structure and function of rodent and human intestine. Gastroenterology 69: 380–386, 1975PubMedGoogle Scholar
  156. Savin JA. Current causes of fixed drug eruptions. British Journal of Dermatology 83: 546–549, 1970PubMedGoogle Scholar
  157. Scheel PJ, Baughman K, Whelton A, Watson A. Cholestyramine related hyperchloremic metabolic acidosis. Journal of Clinical Pharmacology 31: 860, 1991Google Scholar
  158. Schindler AM. Isolated neonatal hypomagnesaemia associated with maternal overuse of stool softner. Lancet 2: 822, 1984PubMedGoogle Scholar
  159. Schiller LR, Santa Ana CA, Morawski G, Fordtran JS. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology 86: 1475–1480, 1984PubMedGoogle Scholar
  160. Scott RS. Management of constipation in obstetrics: a clinical report on 592 cases. Western Medicine 6: 342–344, 1965Google Scholar
  161. Shelton MG. Standardized senna in the management of constipation in the puerperium. South African Medical Journal 57: 78–80, 1980PubMedGoogle Scholar
  162. Siegers C-P. Anthranoid laxatives and colorectal cancer. Trends in Pharmacological Sciences 13: 229–231, 1992PubMedGoogle Scholar
  163. Siegers C-P, Hertzberg-Lottin E, Otte M, Schneider B. Anthranoid laxative abuse - a risk for colorectal cancer? Gut 34: 1099–1101, 1993PubMedGoogle Scholar
  164. Silk DBA, Gibson JA, Murray CRH. Reversible finger clubbing in a case of purgative abuse. Gastroenterology 68: 790–794, 1975PubMedGoogle Scholar
  165. Smith DF, Smith CC, Douglas JG, Reid TMS, Gould IM. Severe salmonellosis related to oral adminstration of anti-diarrhoeal drugs. Scottish Medical Journal 35: 176–177, 1990PubMedGoogle Scholar
  166. Smith MS, Feldman KW, Furukawa CT. Coma in an infant due to hypertonic sodium phospate medication. Journal of Pediatrics 82: 481–482, 1973PubMedGoogle Scholar
  167. Smith B. Effect of irritant purgatives on the myenteric plexus in man and the mouse. Gut 9: 139–143, 1968PubMedGoogle Scholar
  168. Smith B. Pathology of cathartic colon. Proceedings of the Royal Society of Medicine 65: 288–291, 1972PubMedGoogle Scholar
  169. Smith B, Pathologic changes in the colon produced by anthraquinone purgatives. Diseases of the Colon and Rectum 16: 455–458, 1973PubMedGoogle Scholar
  170. Sotos JF, Cutler EA, Finkel MA, Doody D. Hypocalcemic coma following two pediatric phosphate enemas. Pediatrics 60: 305–307, 1977PubMedGoogle Scholar
  171. Souter WA. Bolus obstruction of gut after use of hydrophilic colloid laxatives. British Medical Journal 1: 166–168, 1965PubMedGoogle Scholar
  172. Speare GS. Melanosis coli. American Journal of Surgery 82: 631–637, 1951PubMedGoogle Scholar
  173. Spinrad S, Grosskopf Y, Blum I, Sztern M, Graff E. Treating constipation with phosphate enema: an unnecessary risk. Israel Journal of Medical Sciences 25: 237–238, 1989PubMedGoogle Scholar
  174. Steer HW, Colin-Jones DG. Melanosis coli: studies of the toxic effects of irritant purgatives. Journal of Pathology 115: 199–205, 1975PubMedGoogle Scholar
  175. Steingrub JS, Lopez T, Teres D, Steingart R. Amniotic fluid embolism associated with castor oil ingestion. Critical Care Medicine 16: 642–643, 1988PubMedGoogle Scholar
  176. Taylor TV, Lambert ME, Torrance HB. Value of bile-acid binding agents in post-vagotomy diarrhoea. Lancet 1: 635–636, 1978PubMedGoogle Scholar
  177. Thompson WG. Laxatives: clinical pharmacology and rational use. Drugs 19: 49–58, 1980PubMedGoogle Scholar
  178. Tolman KG, Hammar S, Sannella JJ. Possible hepatotoxicity of doxidan. Annals of Internal Medicine 84: 290–292, 1976PubMedGoogle Scholar
  179. Tremaine WJ. Diarrhea and constipation therapy. Current Opinion in Gastroenterology 8: 60–63, 1992Google Scholar
  180. Umeki S. Does bismuth subnitrate normalize intestinal conditions in patients with chronic diarrhea. Archives of Internal Medicine 148: 2073, 1988PubMedGoogle Scholar
  181. Verbov J. Laxative eruption. Correspondence. Clinical and Experimental Dermatology 9: 435, 1984PubMedGoogle Scholar
  182. Verhaeren EHC, Geboes K, Lemli J. The morphological alterations of guinea pig colonic mucosa following short term administration of high doses of 1-8 dihydroxyanthraquinone. Colo-Proctology 7: 205–208, 1985Google Scholar
  183. Wainscoat JS, Finn R. Possible role of laxatives in analgesic nephropathy. British Medical Journal 4: 697–698, 1974PubMedGoogle Scholar
  184. Walley T, Milson D. Loperamide related toxic megacolon in Clostridium difficile colitis. Postgraduate Medical Journal 66: 582–584, 1990PubMedGoogle Scholar
  185. Ware S. Drugs for diarrhoea in small children. Lancet 1: 252–253, 1977PubMedGoogle Scholar
  186. Watson JS, Ebert WR. Lactulose: a new bowel regulator. Clinical Medicine (July): 24-26, 1969Google Scholar
  187. Weaver LT, Richmond SWJ, Nelson R. Loperamide toxicity in severe protracted diarrhoea. Archives of Diseases in Childhood 58: 568–569, 1983Google Scholar
  188. Weller MPI. Neuropsychiatrie symptoms following bismuth intoxication. Postgraduate Medical Journal 64: 308–310, 1988PubMedGoogle Scholar
  189. Wittoesch JH, Jackman RJ, McDonald JR. Melanosis coli: general review and a study of 887 cases. Diseases of the Colon and Rectum 1: 172–180, 1958PubMedGoogle Scholar
  190. World Health Organisation. Rational use of drugs in the management of acute diarrhoea in children. World Health Organisation, Geneva, 1990Google Scholar
  191. Wright RA. Lactulose-induced megacolon. Gastrointestinal Endoscopy 34: 489–490, 1988PubMedGoogle Scholar
  192. Wynne HA, Edwards C. Laxatives. Pharmaceutical Journal 248: 17–19, 1992Google Scholar
  193. Yam LT, Oropilla SB. Octreotide for diarrhea in amyloidosis. Annals of Internal Medicine 115: 577, 1991PubMedGoogle Scholar
  194. Ziegenhagen DJ, Tewinkel G, Kruis W, Herrmann F. Adding more fluid to wheat bran has no significant effects on intestinal functions of healthy subjects. Journal of Clinical Gastroenterology 13: 525–530, 1991PubMedGoogle Scholar
  195. Zimmerman AL, Gupta JK, Ingegno AP. Pneumatosis coli following treatment with lactulose. New York State Journal of Medicine 79: 1896–1899, 1979PubMedGoogle Scholar

Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Jenny M. Gattuso
    • 1
  • Michael A. Kamm
    • 1
  1. 1.The Sir Alan Parks Physiology UnitSt Marks’s HospitalLondonEngland

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