medicine and drugs constipation (constipation)
Depending on the
food - and life can vary the frequency of bowel movements very much. Between three times a day three times a week and can meet the standard. The average is once a day. Only when the bowel movement less than three times per week is possible, it is in the medical sense to constipation. The frequently encountered fear that a less frequent bowel movements to poison the body by so-called metabolic waste from the intestine is unjustified, because a normal liver function, all controlled substances can be absorbed into the blood, not the case.
Blutreinigungstee , which usually also contain laxatives (see below) make so much sense.
Getting to the meal, the chewed food down the esophagus into the stomach first, where the chyme
hydrochloric acid and the proteolytic enzyme pepsin be added. Then it goes further into the duodenum and then into the actual small intestine where carbohydrates, proteins and fats are broken down enzymatically
and can pass the derived
nutrients in the blood. The leached chyme finally reaches the large intestine, where it is most of the water withdrawn. The remainder is excreted through the anus (bowel movement).
Source: http://www.trennkost-regensburg.de happens, the transport of the chyme by a wavelike contraction and relaxation of intestinal muscles (peristalsis
) and is controlled by the autonomic nervous system reflexes which is caused by a strain of the intestinal wall with good filling.
The bowel is thus promoted by a diet adequate in fiber, which are difficult to digest plant fibers cellulose contains, to fill the colon so far are that
transport reflexes triggered reliably. The fiber can also be bound by
water swelling and prevent an excessive
thickening and hardening of the
chair in the large intestine. That is why it is so important to drink enough, because so very often a blockage can be prevented.
A first group of laxatives are the source
- and
filler, which is vegetable fiber, which are indigestible, wander through the entire intestine and prevent large quantities of water itself and in the gut retention. They swell up and cause transport reflexes. The source
- and
fillers include, for example Wheat bran, linseed
, psyllium and
carboxymethylcellulose (CMC
). When taking these supplements
must necessarily sufficient to
hydration be respected, because otherwise lumps may form a tough, clogging up the intestines. In extreme cases, threatened with a life-threatening
intestinal obstruction !
Certain salts such as sodium sulfate
(
Glauber's salt) and magnesium sulfate
(Epsom salt) also act as a laxative, when dissolved in drinking water. The
sulfate is not absorbed through the intestinal wall into the blood (
absorbed ) and remains with his back
water solution in the gut and will increase the fill volume
, which in turn causes the already-known transport reflexes. If the gut is not enough water is available, through the
sulfate additional water from the blood drawn in the intestine (
osmosis). One therefore speaks of osmotically active laxatives.
mannitol, sorbitol
and
lactulose also belong in this group.
A second group of laxative effect of irritation of the intestinal mucosa. This irritation triggers a reflex that triggers bowel movements or at least reinforced, leading to increased water transfer in the gut, with significantly reduced
absorption of water from the intestine. For the longer-term use but causes significant losses of sodium and potassium. Potassium deficiency reduces but again the excitability of the intestinal muscles, so that
needed correspondingly more of the laxative. A vicious cycle can begin and lead to laxative abuse.
The very unpleasant taste of castor oil
has been in the small intestine, while the other laxatives in this group exert their effect only in the large intestine. These include the
anthraquinones, for example, in
senna are included, and synthetic fabrics such as
bisacodyl (Dulcolax
®) and sodium picosulfate
(
Laxoberal ®). All these substances are subject to a distinct so-called enterohepatic
circuit between intestine and liver.
The active ingredient is absorbed from the intestine and passes (via the portal vein ) in the liver. There the drug by enzymes chemically modified (oxidized), where he is a little water and creates an additional binding site. It is then conjugated that is coupled to a really good water-soluble molecule. As a result excretion by the kidneys is possible. A large part of the active ingredient get back into the intestine, however, is decoupled again and converted back to its original form (reduced), the additional binding site is removed again wird.Das accomplished in enzymatic way through the intestinal bacteria. The cycle is closed. A pronounced enterohepatic circuit delays the excretion of the drug thus extending the duration ( liver = liver, kidney = kidney, GIT = gastrointestinal tract, biliary secretion = secretion of Gallenflüssigkit, renakl excretion = excreted from the kidneys, ingestion = nutrition) Source: http:// www.uwgi.org/gut/liver_05.asp Finally, there is a third group of laxatives which soften hard stool and to increase its lubricity
in the colon. Mention here should be
docusate sodium (
Norgalax ®) and paraffin oil
. The extended use of paraffin oil
however, is very problematic since the
absorption of fat-soluble vitamins is prevented in the intestine. Affected are the vitamins A (retinol
visual pigments ), D3 (Cholecalciferol
for
Knochenauffbau ) and K1 (
phytomenadione for
clotting).
If you are healthy and receiving enough fiber in the form of vegetables, fruits and grain products and also drink enough yet, generally requires no laxative!
Jens Christian Heuer Sources: Color Atlas of Pharmacology, Heinz Lüllmann and Klaus Mohr drug reactions, Ernst Mutschler including Wikipedia ( http://de.wikipedia.org/wiki/Verdauung )
