There is a wide range of laxatives, and how to use them wisely is a big question. Will use, it is medicine, can relieve or cure constipation. Will not use, it is poison, will damage the intestinal tract, aggravate constipation. The premise of reasonable use is to know yourself and your enemy, “yourself” is to understand the characteristics of the drug and the scope of application, “his” is the type and severity of constipation. Then the right medicine will be prescribed, so that we can get twice the result with half the effort. Let’s first “know yourself”. According to the mechanism of action can generally be divided into six categories, namely contact, swelling, lubricating, enterokinetic drugs, proprietary Chinese medicine and probiotics. Contact laxatives, formerly known as stimulant laxatives, are the most familiar type of laxatives. Because of the quick effect and easy to take, many constipation patients first choice after the disease is this type of medicine. These ingredients can also be found in many laxative Chinese medicines and in weight loss, beauty and detoxification products. The clinical category is divided into two categories: anthraquinones, including rhubarb, senna, cassia and aloe vera, rhamnolipid and rhamnolipid. These drugs are decomposed into anthraquinones by bacteria in the large intestine after oral administration, and most of them reach the large intestine directly without absorption because of the protection of the sugar group, and are decomposed into glycosides and sugars by bacterial enzymes in the intestine. The glycosides stimulate the mucous membrane of the large intestine and inhibit the absorption of sodium ions from the intestinal lumen, which increases water in the large intestine and causes diarrhea due to hyper-peristalsis. It is often used for acute and chronic constipation. Rhubarb, senna, cassia and aloe all belong to Chinese medicine, we are already familiar with, here no longer introduced. The bark is a small to medium-sized tree that grows along the Pacific coast, in Washington, Oregon and California. It was first used by the North Indians who considered it a sacred herb and recommended it to Spanish explorers, and then to Europe, where it is now a popular laxative. It stimulates the lining of the upper intestinal tract, thus promoting normal bowel function and enhancing the contraction of the large intestinal muscles (peristalsis), and is effective in treating chronic constipation. Diphenylmethane class Representative drugs include phenolphthalein, bixacodyl (poo stop), sodium picosulfate, etc. Phenolphthalein is the fruit-conducting tablets that many constipation patients have eaten. After oral administration, it meets with alkaline intestinal fluid in the intestine to form soluble sodium salts, which can promote colon peristalsis. It is suitable for chronic constipation because of its mild effect and soft stool discharge in 6-8 hours after taking the drug. Bisacodyl can be used for chronic constipation or for endoscopy or preoperative bowel cleansing. These drugs are mainly used for temporary laxation and should not be used continuously for more than half a month. If taken for a long time, some of the following adverse reactions can occur: (1) Serious drug dependence can occur, and the dosage of the drug can become increasingly large, even damaging the peripheral nerves and muscle tissues of the intestinal wall, causing weakness of the large intestinal muscles and developing from a functional lesion to an organic constipation that is difficult to treat. (2) rhubarb, senna, cassia, etc. contain “anthracene” compounds, which will be deposited in the intestinal mucosa over time, so that the intestinal surface becomes black and melanosis, this change may increase the risk of colon cancer. (3) In addition, the intestinal ecological environment will be damaged, the balance of bifidobacteria and other beneficial bacteria will be imbalanced, the normal pH value in the intestinal cavity will be changed, and a large amount of water secreted by the intestine will be lost, resulting in dehydration symptoms. Swelling laxatives are also called volumetric laxatives, or osmotic laxatives. These drugs are not absorbed by the stomach and small intestine, but can absorb water in the large intestine, soften the stool, increase the volume of stool, and expand in the intestine to stimulate intestinal peristalsis, thus enabling laxation. Representative drugs include: salts (magnesium sulfate, sodium sulfate), alcohols (sorbitol, mannitol), disaccharides (lactulose, dulcolax), and fosone (polyethylene glycol 4000), mannitol, food cellulose, glycerin, etc. Salts and alcohols Strongly acting laxatives, effective 1-3 days after administration, mainly used for human detoxification and bowel preparation before colonoscopy. Rarely used to routinely treat constipation, long use can cause electrolyte disorders, such as high magnesium, high potassium, hypernatremia and hypocalcemia. Magnesium sulfate, sodium sulfate can also cause reflex pelvic congestion and water loss, menstruation, pregnant women and the elderly use with caution. Lactulose and dulcolax of disaccharides These two drugs are not absorbed by hydrolysis in the small intestine, and their permeability keeps water and electrolytes in the intestinal lumen, and bacteria in the colon decompose them into lactic acid and acetic acid, which further increases the intestinal osmotic pressure, increases the volume of stool, stimulates intestinal peristalsis, produces a gentle diarrheal effect, and also facilitates the excretion of ammonia and other nitrogenous substances. It takes effect 24-48 hours after oral administration. It is especially suitable for the elderly, pregnant women, children and those with post-operative constipation. The disadvantage is that it produces gas by fermentation under the action of bacteria, causing abdominal distension and other discomfort. Fosamax Its chemical name is polyethylene glycol 4000, which differs from other osmotic laxatives in that it retains water in the colonic lumen and the stool is softened by the increased water content, resulting in a smoother transit through the colon. It does not overstimulate the intestinal tract, does not affect the integrity of the intestinal mucosa, and does not interfere with the absorption of vitamins, minerals and other nutrients. Small doses open the bowels and large doses cleanse the intestines. Lactulose, dulcolax and fosone are the most commonly used laxatives today. Food-based cellulose and other substances Food cellulose includes natural and semi-synthetic polysaccharides and cellulose derivatives such as methyl cellulose and carboxymethyl cellulose in vegetables and fruits are not absorbed by the intestine, increase intestinal volume and keep stools wet and soft, with good laxative effect. It can prevent and control functional constipation. Glycerin, the main component of Cesarean, is injected into the rectum through the anus, which stimulates the intestinal wall to cause defecation due to high osmotic pressure and has a local lubrication effect, causing defecation within a few minutes. It is suitable for children and the elderly. Lubricating laxatives, also known as stool softeners, are not absorbed in the intestine after oral administration, and impede the absorption of water, so it has the effect of softening the stool and lubricating the intestinal wall. Commonly used drugs are liquid paraffin, commonly used amount of 5 to 15 ml / time. As well as fire hemp seeds, almonds, etc. It is suitable for hemorrhoids, hypertension, post-surgery, constipation in the elderly and children. Disadvantages are poor taste, weak action, long-term application will prevent the absorption of fat-soluble vitamins AD, K, as well as calcium and phosphorus, so it should not be used for a long time. Intestinal motility drugs can increase the rate of transmission of the whole digestive tract, increase the number of bowel movements, and improve the sensitivity of the rectum to dilation. But often need to be used in combination with other drugs. Representative drugs are cisapride, mosapride, prilocarbital succinate tablets (Lilo), etc.. The use of such drugs should exclude organic lesions of the intestinal tract. Proprietary Chinese medicines Representative medicines include Ma Ren Wan, Liou Wei An Xie Capsules, Si Mo Tang, Ma Ren Zhi Shen Wan, Fang Feng Tong Sheng Wan, Gardenia Jin Hua Wan, Niu Huang Shang Qing Wan, Shu Secret Capsules, etc.. When using, you should read the instructions carefully and control the amount and time of taking the medicine to prevent adverse reactions. Probiotics: Bifidobacterium, Pepcid, Intestinal Health, and Meconium. It can supplement the intestinal beneficial bacteria, soften the stool and promote intestinal peristalsis. After understanding the various medications for constipation, we also need to remind you that you should not rely solely on medication, but also start with lifestyle changes, good lifestyle habits, moderate exercise, and eat more food rich in plant fiber. Psychotherapy, including biofeedback therapy, is often more effective for constipated patients suffering from irritable bowel syndrome. For some long-term constipation with a variety of drugs is still not effective, you can also consider surgery.