AskDefine | Define purgation

Dictionary Definition

purgation

Noun

1 purging the body by the use of a cathartic to stimulate evacuation of the bowels [syn: catharsis, katharsis]
2 a ceremonial cleansing from defilement or uncleanness by the performance of appropriate rites [syn: purification]
3 the act of clearing yourself (or another) from some stigma or charge [syn: purge, purging]

User Contributed Dictionary

English

Noun

purgation
  1. the act of purging, especially by the use of a purgative
  2. cleansing from sin or guilt

Extensive Definition

Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. Certain stimulant, lubricant, and saline laxatives are used to evacuate the colon for rectal and bowel examinations, and may be supplemented by enemas in that circumstance. Sufficiently high doses of laxatives will cause diarrhea. Laxatives only work to hasten the elimination of undigested remains of food in the large intestine and colon.
There are several types of laxatives, listed below. Some laxatives combine more than one type of active ingredient to produce a combination of the effects mentioned. Laxatives may be oral or in suppository form.
Constipation with no known organic cause, i.e. no medical explanation, exhibits gender differences in prevalence: females are more often affected than males. Not surprisingly, some advertisers promote their brands as being more feminine and thereby tailor their message to the market. The way laxatives function in males and females, however, does not exhibit significant differences.

Vegetables and foods

Some vegetables and foods can be eaten to cure constipation and act as laxatives, although the effectiveness may vary. These include:

Bulk-producing agents

Also known as bulking agents or roughage, these include dietary fiber. Bulk-producing agents cause the stool to be bulkier and to retain more water, as well as forming an emollient gel, making it easier for peristaltic action to move it along. They should be taken with plenty of water. Bulk-producing agents have the gentlest of effects among laxatives and can be taken just for maintaining regular bowel movements.

Stool softeners / Surfactants

  • Site of Action: Small and large intestine
  • Onset of Action: 12 - 72 hours
  • Examples: docusate (Colace, Diocto)
These cause water and fats to penetrate the stool, making it easier to move along. Many of these quickly produce a tolerance effect and so become ineffective with prolonged use. Their strength is between that of the bulk producers and the stimulants, and they can be used for patients with occasional constipation or those with anorectal conditions for whom passage of a firm stool is painful.

Lubricants / Emollient

  • Site of Action: Colon
  • Onset of Action: 6 - 8 hours
These simply make the stool slippery, so that it slides through the intestine more easily. An example is mineral oil, which also retards colonic absorption of water, softening the stool. Mineral oil may decrease the absorption of fat-soluble vitamins and minerals.

Hydrating agents (osmotics)

These cause the intestines to hold more water within, softening the stool. There are two principal types, saline and hyperosmotic.

Saline

Saline laxatives attract and retain water in the intestinal lumen, increasing intraluminal pressure and thus softening the stool. They will also cause the release of cholecystokinin, which stimulates the digestion of fat and protein. Saline laxatives may alter a patient's fluid and electrolyte balance.
Sulfate salts are considered the most potent.

Hyperosmotic agents

Lactulose works by the osmotic effect, which retains water in the colon, lowering the pH and increasing colonic peristalsis. Lactulose is also indicated in Portal-systemic encephalopathy. Glycerin suppositories work mostly by hyperosmotic action, but also the sodium stearate in the preparation causes local irritation to the colon.
Solutions of polyethylene glycol and electrolytes (sodium chloride, sodium bicarbonate, potassium chloride, and sometimes sodium sulfate) are used for whole bowel irrigation, a process designed to prepare the bowel for surgery or colonoscopy and to treat certain types of poisoning. Brand names for these solutions include GoLytely, GlycoLax, CoLyte, NuLytely, and others.

Effectiveness

For adults, a randomized controlled trial found PEG [MiraLax or GlycoLax] 17 grams once per day better than tegaserod 6 mg twice per day. A randomized controlled trial found greater improvement from 2 sachets (26 grams) of PEG versus or 2 sachets (20 grams) of lactulose . 17 grams/day of PEG has been effective and safe in a randomized controlled trial for six months. Another randomized controlled trial found no difference between sorbitol and lactulose .
For children, PEG was found to be more effective than lactulose.

Stimulant / Irritant

  • Site of Action: Colon
  • Examples:
These stimulate peristaltic action and can be dangerous under certain circumstances. Long term use can lead to 'cathartic colon'. Stimulant laxatives act on the intestinal mucosa, or nerve plexus; they also alter water and electrolyte secretion. They are the most severe among laxatives and should be used only in extreme conditions. Castor oil may be preferred when more complete evacuation is required.

Castor oil

  • Site of Action: Small intestine
Castor oil acts directly on intestinal mucosa or nerve plexus and alters water and electrolyte secretion. It is converted into ricinoleic acid (the active component) in the gut.

Serotonin agonist

Tegaserod is a motility stimulant that works through activation of 5-HT4 receptors of the enteric nervous system in the gastrointestinal tract. However caution must be taken due to potentially harmful cardiovascular side-effects.

Uses

Bowel Prep. Chronic constipation. Chronic immobility.

Problems with use

Laxative Abuse

Laxative abuse is potentially serious since it can lead to intestinal paralysis, Irritable Bowel Syndrome (IBS), pancreatitis, renal failure, and other problems.

Laxative gut

Physicians generally warn against the chronic use of stimulant laxatives due to concern that chronic use causes the colonic tissues to get worn out over time and not be able to expel feces due to long term overstimulation. The evidence for this was never too strong, and it was always unclear whether the elongated and poorly moving colon of a patient with chronic constipation was a result of or was just a cause for patients' use of stimulant laxatives. A common finding in patients who have used stimulant laxatives is a brown pigment deposited in the intestinal tissue, known as Melanosis coli.

Eating Disorders

Laxatives are often used by people with an eating disorder. In many cases of bulimia nervosa the patient will abuse laxatives in an attempt to purge themselves of food in the intestines before it becomes digested. Frequently, patients with eating disorders had chronic digestive problems in childhood and found laxatives an effective treatment. The laxative use later may substitute of more appropriate treatment such as a better diet. Treatment of patients with eating disorders and gastrointestinal illnesses can be challenging.

References

See also

purgation in Czech: Laxativum
purgation in German: Abführmittel
purgation in Spanish: Laxante
purgation in French: Laxatif
purgation in Croatian: Laksativi
purgation in Indonesian: Laksatif
purgation in Dutch: Laxeermiddel
purgation in Japanese: 瀉下薬
purgation in Norwegian: Avføringsmiddel
purgation in Polish: Środki przeczyszczające
purgation in Portuguese: Laxante
purgation in Russian: Слабительное
purgation in Simple English: Laxative
purgation in Slovak: Preháňadlo
purgation in Finnish: Laksatiivi
purgation in Swedish: Laxermedel
purgation in Thai: ยาระบาย
purgation in Chinese: 泻药

Synonyms, Antonyms and Related Words

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