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Running Head: CONSTIPATION AND DIARRHEA.

Pharmacology for Issues Regarding Constipation and Diarrhea Michelle O'laires, Phyu Aung, Emilydee Nguyen, Gamaliel Vo, Darren Li West Coast University

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Constipation and Diarrhea Constipation is defined as a decrease in the frequency of bowl movements (Adams & Holland, 2011). The decrease in bowel movements causes a higher reabsorption rate of water from the stool than a normal bowel movement would provide. A small and hard stool can result from this improper amount water reabsorption. The reabsorption of water in the large intestines occurs within the colon. If unrelieved constipation is prolonged impaction can occur. Impaction is the complete collection of harden feces that is wedged into the rectum, of which a patient is unable to defecate. There are many causes for constipation such as insufficient amount exercise, irregular bowel habits, low fiber diet, low fluid intake, anxiety, age, and medications (Perry & Potter, 2009). Medications can cause changes in the normal function of stool motility through the intestines. Classifications such as Opiods, anticholinergics, antihistamines, antacids, and iron supplements are all able to cause symptoms of constipation. Laxatives are drugs that promote bowel movements (Adams & Holland, 2011). Before drugs are used to promote bowel movements, other strategies to promote bowel movements should be attempted firsts. Lifestyle modifications such as fiber intake, fluid intake, and physical activity should be modified before any medication should be a consideration. Laxatives are used as a prophylaxis to constipation. Many of these laxatives are provided as over -the-counter drugs to be used as self treatment (Adams & Holland, 2011). Laxatives are used especially in surgeries in the vicinity of the abdomen. For example, a patient with a need of a appendectomy could be approved for a laxative. The laxative will allow the patient to have more comfort when defecating because they will require less "bearing down." Cathartic drugs are

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used in diagnostics testing of the colon such as a colonoscopy. The use of laxatives does come with its adverse effects. The most frequent complaint with laxatives are abdominal distention and cramping. Excessive use of laxatives can result to diarrhea. However, if laxatives are taken in prescribed amounts there are very few adverse effects. There are five main primary classifications of laxatives. First off, the preferred choice of chronic constipation treatment is the use of Bulkforming laxatives such as calcium polycarbophil, methylcellulose, and psyllium mucilloid (Adams & Holland, 2011). Caution should be taken with these laxatives as esophageal and gastrointestinal obstruction can result if not taken with the appropriate amount of fluids. Bulkforming laxatives are not use for cases that require rapid bowel evacuation ( Patrick &Norman, 2011). Surfactant laxatives, of which are also known as stool softeners, are used as for patients who have recently had surgery. Stool softeners, like docusate, work by causing more water and fat to be reabsorbed into the stool. The adverse effects of stool softeners are abdominal cramping and diarrhea. There are no severe adverse effects to using stool softeners. Stimulant laxatives are used to promote peristalsis and are used for clients and situations that would require a fast acting results. Adverse effects for stimulant laxatives include nausea, fainting, and diarrhea. Saline cathartics like magnesium hydroxide create a more watery stool. These agents should not be used often as they are fast acting and put the patient at risk of electrolyte depletion. Herbal agents like sennosides promotes peristalsis by irritating the bowel. It is used as a self treatment and can be purchase as an over-the-counter product. Lastly is the Miscellaneous agents such as mineral oil and lubitprostone, of which act by lubricating the stool and the colon mucosa. Adverse effects of miscellaneous agents such as mineral oil and lubiprostone include nausea, headache, dysphea, and diarrhea. Severe adverse effects include allergic reactions and nutritional deficiencies, and

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aspiration pneumonia. Alongside of constipation is the direct opposite diarrhea, of which not enough water is being reabsorbed into the intestines.

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References Adams, M.P., Holland, L.N. (2011). Pharmacology for nurses: a pathological approach, Pearson. 3rd edition. Potter, P.A., Perry, A.G. (2009). Fundamentals of nursing, Mosby Elsevier, 7th edition.