May
10
23:01
Gastroenterology

Overview of drugs for the treatment of constipation

Constipation called systematically inadequate, difficult, slow gastric emptying.According to statistics, this problem is present in 10-20% of the population of different age groups.Constipation can occur for various reasons, its clinical manifestations are also varied.Treatment of this condition requires a doctor exclusively individual approach and includes a range of activities: a special diet, a change in image and style of life of the patient, drug therapy.This article will be discussed preparations which can be used by doctors in the treatment of constipation.

Content

  • 1 classification of drugs used to treat constipation
  • 2 drugs that increase the motility of the gastrointestinal tract, or prokinetic
    • 2.1 itopride hydrochloride (Ganaton, Zirids,Itomed, Primer)
  • 3 Drugs that regulate intestinal motility
    • 3.1 Tegaserod (fractal)
  • 4 Laxatives
  • 5 Myotropic antispasmodics
    • 5.1 Mebeverin (Duspatalin,Meverin, Mebsin retard)
    • 5.2 Otiloniya bromide (Spazmomen)
  • 6 preparations for correction of the microbial environment of the intestine, or bacterial preparations
  • 7 Microclysters

drugs used for the correction of thestates have different mechanisms of action, depending on which are combined in the following pharmacological group:

This group includes several well-known medicines: domperidone (Motorikum) mosaprid (Mosid) metoklopromid (Reglan) and itopride hydrochloride (Primer), however,to treat constipation is usually applied only to one of them, the last one.

Since the drug acts not only on upper digestive tract but also in the intestine, increasing its motility, it is widely used for the treatment of constipation.The mechanism of action is due to its specific receptor blockade - D2-dopaminergic, and the stimulation of the synthesis of hormones motillina and somatostatin.

Overview of drugs for the treatment of constipation itopride well and rapidly absorbed in the digestive tract, the maximum concentration in the blood was within 30-45 minutes after the first dose.Active distributed in tissue into breast milk.It penetrates through the blood-brain barrier in a minor amount.The half-life of the drug is 6 hours.Because the body is released mainly in the urine.

not an independent means of treatment of constipation, and is used in the complex treatment of this condition.

issued in the form of tablets containing 50 mg of active substance.

recommended to take 1 tablet before meals three times a day.The duration of treatment is 4-6 weeks.

itopride contraindicated in case of individual intolerance of the organism of the patient, the gastro-intestinal bleeding, obstruction (blockage of the lumen) of the intestine or perforation (perforation) of its wall.During pregnancy and lactation take the drug is not recommended.

While taking the drug may develop the following adverse effects:

Drugs in this group have an effect on serotonin receptors type 4, are their agonists.One of the effects of serotonin is its involvement in the regulation of intestinal secretion, visceral sensitivity and intestinal motility and serotonin receptors type 4 contribute to maintaining normal function of the gastrointestinal tract.Among the drugs with a similar action, the special role belongs to the drug tegaserod (fractal).

This compound is a partial agonist of serotonin receptors type 4, ie, connecting with them is their physiological response.As a result, activates the production of digestive juices, improves skin tone and motility of the gastrointestinal tract: reduced transit time of the food through the intestines, and reduces the strain during defecation.The number of bowel movements increased consistency of the stool becomes softer, reduced pain and discomfort in the abdomen.

When ingestion absorbed only partially.The maximum concentration in the blood was 1 hour after a single dose.Return with urine and feces.

issued in the form of tablets of 6 mg.

recommended to take 1 tablet inside before a meal twice a day for 1-1.5 months.Improving the condition of the patient it is noted at the end of the first week of regular drug administration and continued for 3 months after its cancellation.Fractal

not used in children under the age of 18 years, in the case with a history of bowel obstruction, when adhesive disease, severe liver and kidney disease, clinically significant diseases of the gallbladder.

While taking the drug occasionally appear its side effects, such as:

no data on the safety of receiving tegaserod in these categories of patients, such as pregnant and lactating women, so they take the drug is not recommended.

Preparations of this group are also classified according to their mechanism of action.

1. Drugs that increase the volume of intestinal contents. This is a group of drugs which absorb a lot of water, so that bowel movements become very bulky and softer, activated intestinal peristalsis, and speed the passage of stool through it increases.

These medications include:

2. Laxatives, stool softener .Preparations of this group contribute to the evacuation of feces solid consistency, softening it.These include mineral and vegetable oils.Because of the possibility of malabsorption of fat-soluble vitamins, lower rectal sensitivity and the likelihood of spontaneous expiration of intestinal contents from the anus, these drugs do not accept for a long time and is prescribed only for short periods.It can be taken orally or used in the form of oil enemas.

3. Osmotic laxatives. retained in the intestines of the water, increasing its content in the stool, which accelerates and improves the process of defecation.As a rule, long-term treatment of constipation are not applied, and used prior to the radiological or endoscopic examination of the colon with a view to a thorough, complete bowel movement for better visualization of changes in the investigated organ.

4. nonabsorbable (not soaked), di- and polysaccharides. main drugs of this group are preparations based on lactulose.They exhibit an osmotic laxative properties (i.e. gut delays in water) in combination with prebiotic properties (i.e., their "feed" beneficial gut bacteria).Security.Can be assigned a long time.They are used in pregnant women.

Overview of drugs for the treatment of constipation lactulose (Normase, Dufalak, Laktulaks, Laktuvit, Normolak) - a synthetic disaccharide that is not absorbed by the intestinal wall.After ingestion reaches the ileum in an unmodified form, there intestinal microflora cleaved to form acids, which leads to acidification of the intestinal contents and increase the osmotic pressure, and thus increase the mass of feces and stimulation of intestinal motility.Also, in the processing of the drug bacteria produced an excessive amount of gas, which leads to bloating.It is recommended to take 1-3 tablespoons (15-45 ml) before meals three times a day.The duration of treatment is 1-1.5 months.

5. Contact or irritant laxative. drugs in this group are characterized by rapid (within 6-10 hours) and the onset of the effect of the elimination of painful sensations filled intestines.Their mechanism of action is due to stimulation of specific receptors of the intestinal mucosa, provoking propulsive contraction of the muscles of the colon.Also contact laxatives increase intestinal secretion and reduce the absorption fluid from the intestine into the blood.

Due to their positive properties of these drugs are widely used by patients for self-medication, but it is not recommended to get involved in them: their metabolic products have a damaging effect on the gut epithelium, which will eventually lead to violations of the processes of absorption and secretion, and impair bowel motility.Because of these negative effects should not take long stimulant laxatives.In addition, chronic administration may develop tolerance to the treatment, and also appear cramping abdominal pain and false urge to defecate.

Once in the body, these drugs trigger a number of mechanisms that result in reduced contraction of muscle fibers.They are used in the complex treatment of constipation, since the latter usually accompanied by pain in the lower abdomen.
best-known drugs of this class are mebeverin and otiloniya bromide.

eliminates spasms of smooth muscles of the intestine, without affecting peristalsis (does not reduce the muscle tone of the gastrointestinal tract).It is recommended to take the drug and 1 tablet (135 mg) three times a day, or 1 capsule (200 mg) twice a day for 2-4 weeks.Take preferably 20-30 minutes before meals.

During pregnancy and breastfeeding should not be treated mebeverin because his research on these categories of patients have not been conducted.

Has expressed antispastic effect on the smooth muscles of the digestive tract.
recommended to be taken orally 1 tablet (40 mg) 2-3 times a day.Tablets are taken 20 minutes before a meal, do not chew, drink plenty of water.

During pregnancy and lactation with caution.

independently for the treatment of constipation do not apply, but in combination with drugs that improve intestinal motility, their use is completely appropriate.

These drugs increase the amount of beneficial microflora in the gut, which improves digestion and helps to activate the motor function of the colon.When combined with the reception of bacterial preparations with dietary fibers, which are prebiotics, the effectiveness of the treatment will be much higher.

take probiotics courses for 2-4 weeks.

should also be said about the drugs used in the dosage form.The most famous among them is docusate sodium (Norgalaks).

When administered into the rectum active ingredient helps soften the stool and initiates reflex defecation.The effect observed after 5-20 minutes after administration.

As a rule, used in the preparation for endoscopy lower parts of the colon, and in the absence of defecation in puerperas within 3 days.

Using a special tube-cannula gel injected into the rectum.If necessary, repeat the procedure the next day.

use of this drug is contraindicated during exacerbation of hemorrhoids, hemorrhagic colitis and proctitis, in the case of anal fissures.

So modern pharmacological industry offers a huge number of drugs that can help the patient to cope with such a sensitive issue as constipation, but please note that they must appoint a doctor!