Tuesday, December 18, 2012

Stool Softeners

Stool softeners

How do they act?
They soften the stool material by permitting water and lipids to penetrate

Emollient laxatives lubricate the intestinal walls and soften the stool, thereby enhancing passage of fecal material
Some stool softeners like liquid paraffin are also known to lubricate the hard scybali by coating them

"Emollients, stool softeners, surface-acting drugs, lubricants, stool surfactant agents" are the many names used to describe these drugs @_@
According to me, there is no need to distinguish between the different terms used as most books consider them to be the same
In one of the books I read, it said that the difference between emollient laxatives and fecal softeners is that the emollient laxatives do not promote the retention of water in the stool

We'll just call them "Stool softeners" ^__^

They take 1-2 days to act
Mineral oil is preferably given on an empty stomach in the evening or bed time

Examples: Mineral oil, docusate (oral or enema), glycerin suppository, liquid paraffin

When are they used?
They are used when straining at stools is to be avoided such as hernia, cardiovascular diseases, eye surgery and perianal afflicitions (piles, fissures, anal surgery)
It is also used to prevent and treat fecal impaction in young children and debilitated adults
(May be given prior to administration of other laxatives in treating fecal impaction)

Adverse effects

Docusates by itself are relatively non toxic but when taken with other laxatives increase their absorption and may lead to liver toxicity
It disrupts the mucosal barrier and increases the absorption of many non absorbable drugs, liquid paraffin should not be combined with it

Mineral oil may impair gastrointestinal absorption of fat soluble vitamins like vitamin A, D, E and K (Avoid long term use)
Larger doses may leak out the anal sphincter and cause physical and social discomfort
Paraffin taken orally over long periods, especially at night, may be aspirated and cause chronic lipoid pneumonia
It may be carried from the intestine to the lymph nodes to produce foreign body granulomas in the intestinal mucosa, mesenteric lymph nodes, liver and spleen

Did you know?
An unusual case of lipid pneumonia resulted from attempts by a patient, an amateur singer, to lubricate his larynx with liquid paraffin

That's all for today :)

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