DISEASE & PRODUCT

KNOWLEDGE
 Functions of the COLON
(1) Absorption of water
and sodium
(2) Allows bacterial
degradation of
undigested nutrients
such as dietary fiber
(3) Mixes contents
(4) Storage of feces
(5) Propels the contents
toward the anus

https://www.healthline.com/human-body-maps/descending-colon
Normal Bowel Movement

https://www.youtube.com/watch?v=6CoIDScAzog
 What is Constipation?
Definition & Relevant Facts
Abnormal Digestive System – with
• From Latin word: “constipare” to Constipation
crowd together

• Also called Delayed Bowel

Movement

• A symptom not a disease

• Episode that occurs when the normal

muscle actions in the colon/large
intestine, fail to work properly.
Therefore, contents cannot be
eliminated normally.

Sources: Healthcarewall.com, Dulcolax.com, US Department of Health: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation

 What is Constipation?
Symptoms According to ROME III Criteria
A person is clinically constipated if s/he has experienced at least 2 of the
ff. symptoms in 25% of the defecations:

• Less than 3 bowel movements per

week
• Passage of unduly hard, dry, painful
stools
• Strong pressing is needed
• Feeling of incomplete emptying
• Feeling of anal blockade
• Manual maneuver is needed
 The Heavy Burden of Constipation
For Consumers
Incidence :
• 15% of the adult population in western
countries
• Two to three times more frequent in women
• 5% of the male and 15% of the female
population
• Infrequent bowel movement (e.g., once a
week) are reported almost exclusively by
women.
• More frequent with increasing age, this trend
being continuous in women and more marked
in men older than 60 years.
Source: A. WALD, et al. The burden of constipation on quality of life: results of a multinational survey. 2007 Aliment Pharmacol Ther
26, 227–236 and Sleisenger & Fordtran’s Gastrointestinal & Liver Disease. 9th ed.
 Constipation Risk Factors
Physical Causes:
 Pregnancy, advancing age
 Sudden changes in the diet
 Reduced fiber/water
 Prolonged bed rest, lack of
exercise
 Bad bowel habits
Psychological
Certain diseases and medications Causes:
(Secondary causes)  Stress
 Pain-killers, antacids, anti-  Travel
depressants & blood-pressure meds.
 Hypo- & hyperthyroidism, Diabetes,
Irritable Bowel Syndrome (IBS),
Parkinson's disease, Stroke, Pelvic
floor abnormalities, Chronic
Idiopathic Constipation

Sources: Dulcolax.com, www.gastro.org/patient-center/digestive-conditions/constipation, Kamm MA. Constipation and its management. British Medical Journal 2003;327:460-462
 What Are The Types of Constipation?
Duration of Constipation
Acute Constipation Chronic
• Temporary, occurs suddenly Constipation
• Happens when: • Constipation persists for a
 Change in diet / lifestyle occurs longer time
 Taking medication with side
• Sufferers are advised to
effects
 Hormonal changes: consult a physician to
Pregnancy/menopause understand cause
• Sufferers are easily treated

Sources: Healthcarewall.com, Dulcolax.com, US Department of Health: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation

 Constipation Management
Non-Pharmacologic Treatment
HEALTHY DIET & INCREASED PHYSICAL GOOD TOILET HABITS
FLUID INTAKE ACTIVITY Unhurried & regular time
High fiber diet Regular exercise
(20-25g/day)

1.5-2 liters/day of water

Straightening of anorectal angle

Sources: Sleisenger & Fordtran’s Gastrointestinal & Liver Disease. 9th ed. And WGO Global Guideline Constipation 8 © World Gastroenterology
Organisation, 2010
 Non-Pharmacologic Treatment
Home Remedies Not Enough for Relief
TREATMENT METHOD EVIDENCE
Unhurried defecation,
Psychosocial reassurance, Lacking
psychological support

May be effective in
mild to moderate but
Diet High fibre- 20-25g/day
not in severe
constipation.

No effect unless
Hydration 1.5-2.0L/day
dehydrated
Physical Increase in sedentary
Contradicting
activity lifestyle

Sources: Sleisenger & Fordtran’s Gastrointestinal & Liver Disease. 9th ed. And WGO Global Guideline Constipation 8 © World Gastroenterology
Organisation, 2010
Pharmacologic Treatments
Comparison
 TM
= Kontra-Constipation Expert

No. 1 OTC Laxative Range Worldwide1

 Rated Class 1 (Safe & Effective) by US FDA2
Tried & Trusted for over 60 years

Sources: 1. Nicholas Halls 2018 DB6 2. Federal Register/ Vol. 67, No. 90/ Thursday May 9, 2002
 Bisacodyl

Derivatives from diphenyl methane but differ in

the active metabolite
 Dual Action: Stimulates & Softens

• Dual Action supports the body’s natural mechanism

Stimulates involuntary muscle movements (Peristalsis) of the
colon
Promotes accumulation of water & electrolytes
Dulcolax® has a Complete Range
for different Consumer Needs

DULCOLAX TABLETS DULCOLAX SUPPOSITORIES

Bisacodyl Bisacodyl
6-12 hours onset of action 10-30 mins. onset of action

FEATURES & BENEFITS FEATURES & BENEFITS

• Small size that’s easy to • Special Torpedo shape for
take even among kids easy insertion
• Special comfort coating
that dissolves only in the
colon
WHO CAN BENEFIT WHO CAN BENEFIT
Consumers who are looking for Consumers looking for fast &
on-the-go & convenient relief immediate relief
Dulcolax® has a Complete Range
for different Consumer Needs

DULCOLAX TABLETS DULCOLAX SUPPOSITORIES

Bisacodyl Bisacodyl
INDICATION:
For patients suffering from constipation
For preparation of diagnostic procedures, in pre- and post-operative
treatment and in conditions which require defecation to be facilitated

5mg Bisacodyl Adult: 10mg Bisacodyl

Infant: 5mg Bisacodyl
DOSAGE & INTAKE DOSAGE & INTAKE
Kids 4-10 yrs.: 1 tab Kids 4-10 yrs: 1 infant
Kids & Adults >10 yrs.: 1-2 tabs suppository
Kids & Adults >10 yrs.: 1 adult
Preferably to be taken at night. suppository
Not to be taken with antacids, milk
or PPI’s
GAME
Drinking lots of water and eating lots of high-fiber
foods like papaya & vegetables are enough.

While home remedies like drinking

lots of water and eating high-fiber
foods may help prevent
constipation, they are not enough
to relieve you of the symptoms.
When constipated, it is
recommended to take a laxative in
addition to your healthy diet &
lifestyle.

If symptoms persist, consult your doctor.

Sources: Data on File. Basis Text 10/2014
Not all “natural/herbal” laxatives like Senna
are proven safe.
While Senna is being
advertised to be safe and
natural, it is still classified
under US FDA as Category III
with safety profile under
evaluation.
Unlike Bisacodyl / SP, there
are only a limited no. of
clinical studies available to
support Senna’s safety.
If symptoms persist, consult your doctor.
Sources: Data on File. Basis Text 10/2014
It is normal for stimulant/contact laxatives like (Biscacodyl)
Dulcolax® and Senna to cause cramps.

• Stomach discomfort, faintness or

cramps are occasionally
reported. These side effects are
common among contact
laxatives like Bisacodyl/SP or
Senna.

• Taking Dulcolax® Tablets less

than one hour after taking
antacids or consuming dairy
products such as milk and
yoghurt can result in a less acidic
stomach and therefore in
stomach discomfort and/or
cramps.

If symptoms persist, consult your doctor.

Sources: Data on File. Basis Text 10/2014
Dulcolax is not recommended for nursing
mothers.

Long experience has

shown no evidence of
undesirable or damaging
effects during pregnancy.
However, Dulcolax®
should only be taken
during pregnancy upon
doctor’s advice.

Dulcolax® CAN BE used

by breastfeeding mothers.
If symptoms persist, consult your doctor.
Sources: Data on File. Basis Text 10/2014