Laxatives

[Guest guest]

,

You wrote, " Is Miralax over the counter or do you have to have a script?

Because of the MS Contin I have big time trouble with constipation. Awhile back

an ER doc gave me a script for a stool softener, but my doc wouldn't write

me a script for it when I ask him about it! "

Unfortunately, Miralax is not OTC. IT is an excellent bowel manager. I say

that because if I have diarrhea it seems to stabilize that and if am

constipated, it stabilizes that. That is odd that a doctor would not be willing

to

write a script for something for constipation. The reality is probably that the

doctor did not know what to write. When you go look for something OTC, it is

very confusing.

Laxatives are divided into groups consisting of

Stimulant laxatives, such as senna and cascara, encourage bowel movements by

increasing the muscle contractions that move along the stool mass.

Bulk-forming laxatives, such as psyllium and other fiber supplements, are

not digested but absorb liquid in the intestines and swell to form a soft,

bulky stool. The bowel is then stimulated normally by the presence of the bulky

mass.

Stool softeners encourage bowel movements by helping liquids mix into the

stool and prevent dry, hard stool masses. This type of laxative has been said

not to cause a bowel movement but instead allows the patient to have a bowel

movement without straining.

Stool softeners soften stools, making them easier to pass.

Lubricant laxatives, such as mineral oil or glycerin suppository, are

different from stool softener. Lubricants encourage bowel movements by coating

the

bowel and the stool mass with a waterproof film. This keeps moisture in the

stool. The stool remains soft and its passage is made easier.

Hyperosmotic laxatives encourage bowel movements by drawing water into the

bowel from surrounding body tissues. This provides a soft stool mass and

increased bowel action.

There are three types of hyperosmotic laxatives taken by mouth—the saline,

the lactulose, and the polymer types. The saline type is often called

''salts.'' They are used for rapid emptying of the lower intestine and bowel.

The

lactulose type is a special sugar-like laxative that works the same way as the

saline type. However, it produces results much more slowly and is often used

for long-term treatment of chronic constipation. The polymer type is a

polyglycol (polyethylene glycol), a large molecule that causes water to be

retained

in the stool; this will soften the stool and increase the number of bowel

movements.

Karyn E. , RN

Executive Director, PAI

Indianapolis, Indiana