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At least 19 recordsLinked to original sources
PubMed1981

Saline cathartics and saline cathartics plus activated charcoal as antidotal treatments.

The results of this experimental study indicate that Na2SO4 reduces the gastrointestinal absorption of aspirin, but not that of pentobarbital, chlorpheniramine, or chloroquine. Activated charcoal (AC) and the combination of AC + Na2SO4 were effective in reducing gastrointestinal absorption of all four test drugs. The combination treatment was more effective than AC treatment in reducing gastrointestinal absorption of aspirin, pentobarbital, and chloroquine. We believe that saline cathartics should not be used in lieu of AC for treatment of poison ingestions, and their routine use to treat poison ingestion should be reevaluated. On the other hand, saline cathartics may be used in conjunction with AC to enhance the antidotal effect of the adsorbent.

Animals↗
PubMed1979

[Cathartic activity of spasmogens in mice, rats and guinea pigs (author's transl)].

To examine the effect of spasmogens on propulsive motility in the intestine, cathartic activity of drugs was investigated. Mice, rats and guinea pigs were individually observed in cages with 20 separate small rooms in which a sheet of filter paper covered the botton of case for observation of feces. The effect was evaluated 1 hr after drug administration. Cathartic activity of spasmogens was the most marked in mice followed by rats, but was rarely observed in guinea pigs. Cholinergic drugs and cholinesterase inhibitors had a cathartic effect in mice and rats, but the activity differed. Drugs such as acetylcholine and physostigmine produced a low cathartic activity even at sublethal and lethal doses. Other drugs as bethanechol, pilocarpine and neostigmine had a dose dependent cathartic effect at doses below lethal ones and were found to be clinically useful for intestinal relaxation after laparotomy. Among autacoids which contract the intestine by direct action on smooth muscles, histamine and bradykinin had no cathartic effect in mice and rats. 5-HT and prostaglandin E2 were dose dependent with a marked cathartic effect in both species. 5-HTP produced the same cathartic activity as that seen with 5-HT in mice, but had no cathartic effect in rats. The cathartic effect of BaCl2 was low, but dose dependent in both species. We recommend this method for the study of the effect of various compounds on the propulsive motility of the intestine.

Amines↗
PubMed1979

[Effect of spasmolytics on cathartic activity of pilocarpine, 5-HT and prostaglandlin E2 in mice (author's transl)].

Effects of autonomic, anti-histaminic, anti-5HT drugs, papaverine and morphine on cathartic activity of spasmogens such as pilocarpine, 5-HT and prostaglandin E2 (PGE2) were tested by giving these drugs to mice subcutaneously. Mice used were male dd strain weighing 20 +/- 2 g and the catharatic effect was evaluated by the all or none method. The cathartic effect by pilocarpine was inhibited markedly by anti-cholinergic drugs such as atropine and diphenhydramine, but not by hexamethonium and methysergide. Therefore, the action of pilocarpine was found to be direct on the acetylcholine receptors. The catharatic effect by 5-HT was inhibited significantly by hexamethonium and methysergide. Atropine inhibited the cathartic effect of 5-HT, but the inhibitory activity was lower by about one hundredth than that on pilocarpine-induced diarrhea. It is suggested that 5-HT has dual sites of actions and there are less cholinergic and specific serotonergic actions. The cathartic effect by PGE2 was inhibited by anticholinergic, anti-5HT and ganglion blocking agents. PGE2 appears to possess the same mode of action as both pilocarpine and 5-HT. Papaverine inhibited little the cathartic effect of all three spasmogens, while morphine had a potent and nonspecific inhibitory effect on the cathartic action of all three spasmogens.

Animals↗
PubMed1997

Position statement: cathartics. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists.

In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not usually considered. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. The Position Statement went through multiple drafts before being approved by the Boards of the two societies and being endorsed by other societies. The Position Statement includes a summary statement for ease of use and is supported by detailed documentation which describes the scientific evidence on which the Statement is based. The administration of a cathartic alone has no role in the management of the poisoned patient and is not recommended as a method of gut decontamination. Experimental data are conflicting regarding the use of cathartics in combination with activated charcoal. No clinical studies have been published to investigate the ability of a cathartic, with or without activated charcoal, to reduce the bioavailability of drugs or to improve the outcome of poisoned patients. Based on available data, the routine use of a cathartic in combination with activated charcoal is not endorsed. If a cathartic is used, it should be limited to a single dose in order to minimize adverse effects.

Animals↗
PubMed1989

[Validity of ano-rectal manometry in the diagnosis of cathartic colon as a cause of chronic pseudo-obstruction of the colon. Considerations on a case].

Cathartic colon is a rare pathology which hits old people and is radiologically characterized by dolichocolon and megarectum. It is nearly sure that the unusual length of the whole colon might be the first source of the cathartic disease. Rectal ampulla dilatation (megarectum) is due to the extended use of laxatives which induce changes in smooth muscle and in the myenteric nervous plexus. The anatomo-pathological changes of the rectum have been proved so far by histological examination of local and deep biopsy; now, in our opinion, they can be shown by manometry. The authors emphasize the possibility that cathartic colon might give episodes of diarrhoea and also recurrent bowel obstructions limited to the colon and so-called "chronic pseudo-obstruction" of the colon. They describe a case of this rare pathology admitted and treated in their ward. Gastric and esophageal motility in the patient was normal as was the motility of the upper rectum. Therefore they think that changes resulted from extended use of cathartics. In both cases patients show low manometric pressure, disordered peristalsis and in particular lack of internal anal sphincter relaxation in response to high balloon distension. As the occlusive status developed in an old patient (the patient was 81 years old), the authors think that the functional disorders were absent at birth. Cathartic colon is, in the authors experience, a cause of chronic pseudo-obstruction of the colon. Rectal manometry makes it possible to avoid surgical treatment. The therapy of pseudo-occlusion, if correctly diagnosed, consists in endoscopic intubation and decompression of the colon.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1980

The effect of cathartic agents on transmucosal electrical potential difference in the human rectum.

Active ion transport in the colon is generating a transmucosal electrical potential difference (PD) of about 40 mV. Cathartic agents inhibit electrolyte and water net-absorption or cause net-secretion which should be reflected in a change of PD. In 83 normal subjects the effect of an isotonic eletrolyte solution (control) and different cathartic agents on rectal PD was tested: Laxatives (bisacodyl, rhein), bile acids (cholic and deoxycholic acid), fatty acids (oleic and ricinoleic acid) and cardiac glycosides (meproscillarin, digitoxin, digoxin). Bisacodyl, deoxycholic acid in high concentration, meproscillarin and digitoxin significantly decreased PD, while the other substances did not. Cathartics act on different transport mechanisms which together with different absorption characteristics of the proximal and distal colon may explain the difference in effecting the PD. Rectal PD measurement provides an easy and convenient tool to document effects of cathartic agents on electrolyte transport, otherwise difficult to obtain, and is applicable for clinical use.

Adult↗
PubMed1985

Gastrointestinal transit times of cathartics combined with charcoal.

Oral activated charcoal usually is administered in toxic ingestions along with a cathartic. A study was done in volunteers to determine the rapidity of gastrointestinal transit when activated charcoal was administered with various cathartics. A control of activated charcoal was compared to the gastrointestinal transit times of activated charcoal plus the cathartics magnesium citrate, magnesium sulfate, or sorbitol. Activated charcoal alone produced a mean transit time of 23.5 hours; magnesium citrate catharsis occurred in 4.2 hours, magnesium sulfate catharsis occurred in 9.3 hours, and sorbitol catharsis occurred in 0.9 hours. Sorbitol clearly was the most rapidly acting cathartic.

Administration, Oral↗
PubMed1994

Study of various rhubarbs regarding the cathartic effect and endotoxin-induced disseminated intravascular coagulation.

Sennoside A content in hot-water extracts from 17 varieties of rhubarb obtained from the market was measured, and their respective cathartic effects were also examined in mice. A positive correlation was confirmed between the sennoside A content and cathartic effects in our experiments. Furthermore, the effects of Shisendaio [symbol: see text], with a higher sennoside A content, and Kinmondaio [symbol: see text], with a lower sennoside A content, exhibited endotoxin-induced disseminated intravascular coagulation (DIC) which related closely to Oketsu symptoms, and these effects were examined in rats. Kinmondaio exhibited weak inhibition on both reducing erythrocyte deformability and prolonging euglobulin lysis time (ELT) in DIC rats. From our results, it is possible to evaluate rhubarb's cathartic effect, one of its main drug effects, by examining the rhubarb's sennoside A content. However, it is difficult to estimate the cathartic effect according to the general market name of Rhubarb. No dramatic effect was found on the experimental models used for Oketsu symptoms such as endotoxin-induced DIC.

Administration, Oral↗
PubMed1998

Studies of aloe. VI. Cathartic effect of isobarbaloin.

The cathartic effect of isobarbaloin, a stereoisomer of barbaloin (compound principally responsible for the cathartic activity of Aloe), was examined in male rats by oral administration. Individual differences in sensitivity in the laxative activity of isobarbaloin and barbaloin was not found. The cathartic activity (ED50) of isobarbaloin in barbaloin positive rats was 19.2 mg/kg, nearly equal to that of barbaloin (19.5 mg/kg). Also, isobarbaloin administered orally was demonstrated to decompose to aloe-emodin-9-anthrone (active metabolite of barbaloin) as well as to barbaloin. Therefore, it is considered that the mechanism underlying the cathartic effect of isobarbaloin is the same as that of barbaloin.

Administration, Oral↗
PubMed1982

Adsorbent and cathartic inhibition of enteral drug absorption.

The effects on absorption of drugs given by mouth of adsorbents (charcoals and resins) and cathartics (osmotic and oil) were studied in vitro and in vivo using acetaminophen (paracetamol) as a test drug. In vitro adsorption isotherms were measured at 37 degrees C in simulated gastric and gastric plus intestinal juices. Maximum binding capacity (MBC) of 16 charcoals and resins varied 30-fold, from 0.36 to 9.32 mol/kg. Dissociation constants varied directly with MBC. In vitro adsorption was little changed by addition of d-mannitol and d-sorbitol, N-acetylcysteine (NAC) or l-methionine. Acetaminophen (0.6 g/kg by orogastric tube) was given to 17 dogs protected by i.v. injections of NAC and methylene blue. One minute later, dogs were given: 1) water; 2) Norit A or Nuchar 1110 charcoal, 3 g/kg; 3) d-mannitol and d-sorbitol, 2 g/kg or castor oil, 3 ml/kg; or 4) both charcoal and either d-mannitol and d-sorbitol or castor oil. Cathartics alone decreased the area under plasma acetaminophen concentrations 15 to 30%. Charcoals alone reduced the area under plasma acetaminophen concentration 93%. Each cathartic diminished the charcoal inhibition of acetaminophen absorption. In mice given acetaminophen by orgastric tube, the acute lethality was decreased more by a new petroleum-based charcoal than by standard wood-based charcoals. Reduction of acetaminophen lethality in mice paralleled the in vitro MBC of adsorbents. Charcoals did not avidly adsorb l-methionine or NAC in vitro. Charcoal did not decrease the l-methionine or NAC protection of acetaminophen-poisoned mice. Charcoals with large MBC diminish absorption and lethality of acetaminophen taken by mouth; cathartics have little effect on acetaminophen absorption.

Acetaminophen↗
PubMed1995

A comparison of cathartics in pediatric ingestions.

OBJECTIVE: To compare the mean time to first stool, number of stools, and side effects of three commonly used cathartics in pediatric ingestions. DESIGN: This prospective clinical trial was a randomized, double-blinded comparison of sorbitol, magnesium citrate, magnesium sulfate, and water, administered with activated charcoal in the treatment of pediatric patients 1 to 5 years of age with acute ingestions. Outcome parameters were mean time to first stool, mean number of stools during 24 hours, and side effects. RESULTS: One hundred sixteen patients completed the study. Significant differences in mean time to the first stool were detected among cathartic agents (F = 9.29), with sorbitol-treated patients having a shortest mean time to the first stool (mean, 8.48 hours). Sorbitol produced a significantly higher number of stools (mean, 2.79) in the 24-hour follow-up period than other cathartics (F = 3.49). The most common side effect of cathartic administration was emesis, which occurred more commonly in sorbitol-treated patients. CONCLUSION: Sorbitol, when administered with activated charcoal in the treatment of children with acute ingestions, produced a shorter time to first stool and more stools than magnesium citrate, magnesium sulfate, or water.

Cathartics↗
PubMed1978

Success of cathartic therapy as a function of patient variables.

Treated sample of 42 patients with cathartic psychotherapy and evaluated differential effectiveness on types of patients. Patients without mental disorders experienced more emotional catharsis than all others, and those with obsessive compulsive personality disorders improved more than all others as a result of emotive treatment. Contrary to popular notions, neither women nor hysterics experienced more catharsis or improved more in cathartic therapy. Although women and hysterics may cry more easily in daily life, obsessives are apparently more able to maintain focus on unhappy experiences and are therefore able to express more emotion in cathartic therapy. Furthermore, it seems that cathartic treatment is beneficial by disrupting long-standing defenses against emotional experiences, rather than by releasing stored-up affects.

Abreaction↗
PubMed1983

Cathartic colon. Reversibility of roentgen changes.

Cathartic colon is an infrequent and severe manifestation of chronic irritant laxative abuse. Little is known of its natural history after cathartics are stopped. Previous reported cases have shown residual roentgen abnormalities on follow-up examinations. A case is presented of cathartic colon caused by more than 70 years of laxative abuse that demonstrated complete reversal of the roentgen changes four months after stopping the medication. Some pathophysiologic correlates of this dramatic reversibility are discussed.

Aged↗
PubMed1998

Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited.

Cathartic colon is a historic term for the anatomic alteration of the colon secondary to chronic stimulant laxative use. Because some have questioned whether this is a real entity, we investigated changes occurring on barium enema in patients ingesting stimulant laxatives. Our study consisted of two parts. In part 1, a retrospective review of consecutive barium enemas performed on two groups of patients with chronic constipation (group 1, stimulant laxative use [n=29]; group 2, no stimulant laxative use [n=26]) was presented to a radiologist who was blinded to the patient group. A data sheet containing classic descriptions of cathartic colon was completed for each study. Chronic stimulant laxative use was defined as stimulant laxative ingestion more than three times per week for 1 year or longer. To confirm the findings of the retrospective study, 18 consecutive patients who were chronic stimulant laxative users underwent barium enema examination, and data sheets for cathartic colon were completed by another radiologist (part 2). Colonic redundancy (group 1, 34.5%; group 2, 19.2%) and dilatation (group 1, 44.8%; group 2, 23.1%) were frequent radiographic findings in both patient groups and were not significantly different in the two groups. Loss of haustral folds, however, was a common finding in group 1 (27.6%) but was not seen in group 2 (p < 0.005). Loss of haustral markings occurred in 15 (40.5%) of the total stimulant laxative users in the two parts of the study and was seen in the left colon of 6 (40%) patients, in the right colon of 2 (13.3%) patients, in the transverse colon of 5 (33.3%) patients, and in the entire colon of 2 (13.3%) patients. Loss of haustra was seen in patients chronically ingesting bisacodyl, phenolpthalein, senna, and casanthranol. We conclude that long-term stimulant laxative use results in anatomic changes in the colon characterized by loss of haustral folds, a finding that suggests neuronal injury or damage to colonic longitudinal musculature caused by these agents.

Aged↗
PubMed1993

Constipation and cathartics as risk factors of colorectal cancer: a meta-analysis.

Since individual case-control studies have failed to resolve the question whether constipation and use of cathartics represent significant risk factors of colorectal cancer, a meta-analysis was performed. The method by Peto was used to calculate pooled odds ratios of the cancer risk among exposed and unexposed subjects. The analysis of 14 previously published case-control studies revealed statistically significant risks for colorectal cancer associated with both constipation and use of cathartics, the pooled odds ratios and their 95 percent confidence intervals being 1.48 (1.32-1.66) and 1.46 (1.33-1.61), respectively. The increased risk applied similarly to both sexes, it was higher in cancer of the colon than rectum. Since constipation and cathartics are associated with much lower odds ratios than various dietary components, such as fat, meat, alcohol, and low-vegetable or low-residue diets, it appears that their risk reflects the confounding influence of underlying dietary habits.

Case-Control Studies↗
PubMed1998

Effect of single dose resin-cathartic therapy on serum potassium concentration in patients with end-stage renal disease.

Hyperkalemia in patients with renal failure is frequently treated with a cation exchange resin (sodium polystyrene sulfonate, hereafter referred to as resin) in combination with a cathartic, but the effect of such therapy on serum potassium concentration has not been established. This study evaluates the effect of four single-dose resin-cathartic regimens and placebo on 5 different test days in six patients with chronic renal failure. Dietary intake was controlled. Fecal potassium output and serum potassium concentration were measured for 12 h. Phenolphthalein alone caused an average fecal potassium output of 54 mEq. The addition of resin caused an increase in insoluble potassium output but a decrease in soluble potassium output; therefore, there was no significant effect of resin on total potassium output. Sorbitol plus resin caused less potassium output than phenolphthalein plus resin. On placebo therapy, the average serum potassium concentration increased slightly (0.4 mEq/L) during the 12-h experiment. This rise was apparently abrogated by some of the regimens that included resin; this may have been due in part to extracellular volume expansion caused by absorption of sodium released from resin. Phenolphthalein regimens were associated with a slight rise in serum potassium concentrations (similar to placebo); this may have been due to extracellular volume contraction produced by high volume and sodium-rich diarrhea and acidosis secondary to bicarbonate losses. None of the regimens reduced serum potassium concentrations, compared with baseline levels. Because single-dose resin-cathartic therapy produces no or only trivial reductions in serum potassium concentration, and because this therapy is unpleasant and occasionally is associated with serious complications, this study questions the wisdom of its use in the management of acute hyperkalemic episodes.

Analysis of Variance↗
PubMed1983

Effects of emetic and cathartic agents on the gastrointestinal tract and the treatment of toxic ingestion.

Emetic drugs and saline cathartics produce direct or reflex changes in gastrointestinal motility. The changes in gastrointestinal smooth muscle function may be important in the rapid oral or rectal expulsion of gastrointestinal contents, effects which serve as a basis for emetic and cathartic drug use in the treatment of toxic ingestion. Because of difficulties in recording gastrointestinal smooth muscle contractile activity from the intact, unanesthetized animal or man, relatively few studies have attempted to characterize the changes in gastrointestinal motility preceding vomiting. Limited results from past studies and the results of more recent studies employing improved technology suggest that pharmacological activation of the emetic reflex is accompanied by characteristic movements of the stomach and small intestine. The gastric response consists of initial muscle relaxation and an expansion of gastric volume. The intestine responds with a contraction, which begins in the distal ileum and migrates orad over the entire small intestine immediately before active retching. The changes in gastric and intestinal motility may be initiated by structures in the central nervous system and may be an important component of the emetic reflex. This article urges more active research to characterize the gastrointestinal emetic response and to investigate more generally the therapeutic value of emesis in the treatment of toxic ingestion. Emphasis should be placed on the clinically important emetic drugs apomorphine and syrup of ipecac. Studies comparing the efficiency of removal of gastrointestinal contents, resultant blood levels of orally administered drugs with and without emesis, differences in the gastrointestinal emetic response between agents and the pharmacology of the gastrointestinal emetic response should be performed. Studies should also be conducted to determine the pharmacology of the emetic sensory receptors in the gastrointestinal tract and the intraluminal physical-chemical or gastrointestinal physiological factors influencing gastrointestinal emetic sensory receptor activation. The results would demonstrate the value of emesis in various poison cases and help establish criteria for use and selection of emetic drugs. No less experimental attention should be devoted to the cathartic drugs.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗