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Isphagula, sterculia, and sterculia/frangula
These laxatives are effective in simple constipation arising from a low fibre, low fluid diet. They increase the faecal bulk by directly increasing the volume of faecal material, which stimulates peristalsis.
Contraindications:
- Intestinal obstruction
- Atonic colon
- Faecal impaction
Side effects:
- Flatulence and abdominal distension.
Nursing points:
- Take with water. Additional fluid of 2.0-3.0 litres per day is essential.
- Not to be taken before going to bed in order to reduce the risk of obstruction.
- May reduce appetite.
- May take up to 3 days to have an effect.
Osmotic laxatives and rectal preparations
Lactulose, lactitol, magnesium
hydroxide
These products retain fluid in the large intestine by osmosis, causing intestinal distension and eventual peristalsis.
Contraindications
- Intestinal obstruction
- Lactulose is contraindicated in galactosaemia.
Side effects
- Cramps, flatulence and general abdominal discomfort.
Nursing points
- Lactulose and lactitol are best administered with either water or fruit juice and require regular dosing. They may take up to 3 days to have any effect and therefore are not suitable for rapid relief.
- Magnesium hydroxide, generally used prior to surgery, should be shaken well before use and then taken with a full glass of water. This product will take 1-2 hours to have an effect.
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