Fitting Degrees of Cathartic Colon Animal Models with Disease Characteristics of Western Medicine and Syndrome Characteristics of Traditional Chinese Medicine / 中国实验方剂学杂志

Cathartic colon （CC） is a common and refractory digestive system disease， with the pathogenesis not fully clarified. The effective therapies other than laxatives and surgery remain to be developed for CC. Therefore， establishing the CC animal models that fit the disease characteristics of western medicine and syndrome characteristics of traditional Chinese medicine （TCM） is an important link to promote the research on this disease. The fitting degree of animal models with the latest Chinese and western medical diagnostic criteria is an indicator to assess the effectiveness of the animal models in simulating the disease characteristics of western medicine and syndrome characteristics of TCM. The literature review showed that the model animals， drugs and their dosage forms， doses， administration methods， and modeling period of CC varied in different studies， and the available CC animal models presented different fitting degrees with the disease characteristics of western medicine and syndrome characteristics of TCM. Rats were the preferred animals for the modeling of CC. Rhei Radix et Rhizoma preparations were commonly used for model inducing， which， however， may cause water electrolyte disorders， decreased immunity， and even death of animals at the late stage of modeling. The animals were modeled by gradually increasing the starting dose， while the starting dose and increasing dose varied. The maintenance dose was determined based on 50% of the animals having loose stools， and the end for a cycle was determined as the time when loose stools disappeared in 80% of animals. The modeling always lasted for 2-3 cycles， approximately 2-4 months. The CC models established with Rhei Radix et Rhizoma granules and rhein had high fitting degrees with the disease and syndrome characteristics. In addition， the CC animal models of TCM syndromes were still in the exploration stage. There were only the animal models of four TCM syndromes： liver depression and spleen deficiency， both Qi and Yin deficiency， Qi stagnation and blood stasis， and spleen and kidney deficiency. Efforts should be made to establish the animal models that meet the characteristics of disease of western medicine and syndromes of TCM， so as to facilitate the research on CC mechanism and drug development.

Avaliação de soluções eletrolíticas e vias da administração sobre o teor de umidade das fezes de equinos desidratados experimentalmente / Evaluation of electrolyte solutions and administration routes on the moisture content of feces of experimentally dehydrated horses

A ocorrência de processos fisiopatológicos que cursam com desidratação da ingesta no trato gastrointestinal dos equinos é comum na rotina clínica. Fatores como diminuição da motilidade intestinal e sobrecarga intraluminal de conteúdo desidratado podem levar a compactação em segmentos como estômago, ceco e cólons. Este estudo objetivou realizar a comparação entre soluções eletrolíticas enterais hipotônica (SeHIPO) e isotônica (SeISO) e a solução Ringer com lactato de sódio (RL IV) sobre o teor de umidade das fezes de equinos submetidos a um período de desidratação experimental (PD). Foram utilizados seis equinos adultos, todas fêmeas com idades entre 10 e 15 anos, média de 440 kg de peso corpóreo. O PD constou de 36 horas de jejum hídrico e alimentar associadas a duas administrações intravenosas de furosemida, sendo a primeira imediatamente no início (T-36) e a segunda 12 horas após o início do PD. Os tratamentos utilizados foram: SeHIPO e SeISO, ambas administradas por via nasogástrica em fluxo contínuo (HETfc), e RL IV administrada pela via intravenosa. Todos os tratamentos foram administrados a uma taxa de infusão contínua de 15mL kg-1 h-1 durante 8 horas consecutivas. O delineamento experimental utilizado foi o crossover6x3, onde cada animal foi submetido, em sistema de rodízio, aos três tratamentos em momentos distintos. As soluções eletrolíticas enterais demonstraram maior eficácia na recomposição do teor de umidade das fezes quando comparadas à terapia RL IV. A hidratação enteral com soluções isotônicas e hipotônicas administrada em fluxo contínuo são eficazes em restaurar o teor de umidade das fezes, podendo ofertar uma opção econômica, segura e eficiente na reidratação de pacientes e nas afecções que cursam como obstruções intraluminais simples.

The occurrence of pathophysiological processes that curse with digesta dryness in the gastrointestinal tract of horses is common in clinical routine, factors such as decreased intestinal motility and intraluminal overload of dry content can lead to compaction in segments such as cecum and colon. This study aimed to compare a hypotonic enteral solution (SeHIPO), an isotonic enteral solution (SeISO) and a Ringer with sodium lactate solution (RL IV) over the moisture content of equine feces submitted to an experimental dehydration protocol. Six adult horses were used, all females aged between 10 and 15 years, average body weight of 440 kg. The PD consisted of a 36 hours period of water and food fasting associated with two intravenous administrations of furosemide, the first immediately at the beginning (T-36) and the second 12 hours after the beginning of the PD. The treatments used were: SeHIPO (hypotonic enteral solution administered via nasogastric), SeISO (enteral isotonic solution administered via nasogastric) and RL IV (Ringer's solution with sodium lactate administered intravenously), all treatments were administered by continuous infusion at a rate of 15mL kg-1 h-1 for 8 consecutive hours. The experimental design used was the 6x3 crossover, where each animal is submitted, in a rotation system, to the three treatments at different times. Enteral fluid therapy with isotonic and hypotonic solutions administered in continuous flow are effective in restoring the moisture content of feces, and may offer an economical, safe, and efficient option for rehydrating patients and in conditions that progress as simple intraluminal obstructions.

Intoxicación por leche magnesia en una paciente pediátrica con constipación crónica: a propósito de un caso / Milk of magnesia intoxication in a pediatric patient with chronic constipation: case report

Resumen Las intoxicaciones accidentales siguen siendo un problema importante que genera gran cantidad de casos de autopsia médico legal, sobre todo cuando ocurren en pacientes pediátricos donde se deben descartar otras causas de muerte y que no se trate de un homicidio. La intoxicación con leche magnesia es un diagnóstico poco frecuente por lo que se hace necesario conocer sus características, evolución y las alteraciones metabólicas por las que se produce la muerte. La hipermagnesemia constituye una condición iatrogénica, generalmente secundaria a la administración de fármacos que contienen magnesio, entre ellos laxantes en pacientes con estreñimiento crónico, en muchas ocasiones sin supervisión médica; que puede producir depresión respiratoria, hipotensión, paro cardiorrespiratorio y la muerte. El diagnóstico de intoxicación con leche magnesia es clínico y se correlaciona con la concentración de magnesio detectada en análisis de muestras de sangre. A continuación se presenta un caso de intoxicación por leche magnesia en una paciente en edad pediátrica con antecedente de parálisis cerebral infantil y constipación crónica que desarrolló una hipermagnesemia posterior a la administración de dicho laxante por parte de sus padres.

Abstract Accidental intoxications continue to be an important problem in the Forensic Pathology field, mostly when they occur in pediatric patients where it is necessary to dismiss other causes of death and to rule out homicide. Milk of magnesia intoxication is a rare diagnosis, therefore it is important to know it´s characteristics, evolution and the metabolic disorders that lead to death. Hypermagnesemia is an iatrogenic condition, usually caused by the administration of medications that contain magnesium, such as laxatives in patients with chronic constipation, without medical supervision; that can lead to respiratory distress, hypotension, cardiac arrest and death. The diagnosis of milk of magnesia intoxication is clinical and can be correlated to the levels of magnesium found in blood sample analysis. We present a case of milk of magnesia intoxication in a 6-year-old girl with cerebral palsy and chronic constipation that was given laxatives by her parents and developed a fatal hypermagnesemia.

The effect of Hylocereus polyrhizus (red dragon fruit) on whole gut transit time of young Malaysian adults

@#Introduction: The red dragon fruit (Hylocereus polyrhizus) is a popular fruit, not only where it originated from, in Central America, but across the world including in Asia. It contains healthy minerals, vitamins and antioxidants, and has been shown to have gut motility action in animals. Methods: To determine the effect of red dragon fruit on whole gut transit time, a cross-sectional study of whole gut transit time using two different stool markers was conducted among 128 young Malaysian adults. Results: Red dragon fruit, in a half fruit serving of 225±25 grams, reduced mean whole gut transit time from 26.0±12.9 hours to 21.9±12.8 hours (p<0.001) when colour change in stools was used as an indicator. The tests also showed that 14.8-17.3% of individuals had whole gut transit time ≥40 hours with carbon as a stool marker compared to only 7.8-8.6% when red dragon fruit was consumed and used as a marker. Conclusion: This study demonstrated a laxative effect of red dragon fruit among young adults.

Organ specific differences in alteration of aquaporin expression in rats treated with sennoside A, senna anthraquinones and rhubarb anthraquinones / 中国药理学与毒理学杂志

OBJECTIVE Senna and rhubarb are classified as stimulative laxatives, and known to have similar effec?tive constituents, the anthraquinones. Being protected by theβ-glucoside bond, the anthraquinones can reach the intes?tines where they are degraded into complex metabolites by enzymes secreted from the intestinal microbiome. It is these complex metabolites that produce the laxative effects. Then the similarities and differences of action between the anthra?quinones require further elucidation. METHODS Here, we studied metabolites of senna anthraquinones (SAQ), rhubarb anthraquinones (RAQ) and their chemical marker, sennoside A (SA), in a rat diarrhea model. In the in vitro biotransfor?mation experiments, SAQ, RAQ and SA were incubated with rat fecal flora solution and the metabolites produced were analyzed using HPLC. In the in vivo studies, the same compounds were investigated for purgation induction, with mea?surement of histopathology and multiple aquaporins (Aqps) gene expression in six organs. RESULTS SAQ and RAQ had similar principal constituents but could be degraded into different metabolites. A similar profile of Aqps down-regula?tion for all compounds was seen in the colon, suggesting a similar mechanism of action for purgation. However, in the kidneys and livers of the diarrhea-rats, down-regulation of Aqps was found in the RAQ-rats whereas up-regulation of Aqps was seen in the SAQ-rats. Furthermore, the RAQ-rats showed lower aquaporin 2 (Aqp2) protein expression in the kidneys, whilst the SA-rats and SAQ-rats had higher Aqp2 protein expression in the kidneys. This may have implications for side effects of SAQ or RAQ in patients with chronic kidney or liver diseases. CONCLUSION SAQ and RAQ showed similar laxative actions with a similar mechanism, they could display different actions in rat kidneys and livers. We suggest that the clinical usage of senna or rhubarb products should be clarified for patients having chronic kidney or liver diseases.

Cassia Fistula: Botany, Phytochemistry And Pharmacological Leverages-A Review

Cassia fistula Linn. is also called a “golden shower”. It is aboriginal to India, Sri Lanka and diffused in various countries, including Mexico, China, Mauritius, East Africa, South Africa, and West Indies. Plant and its parts, such as bark, fruit, leaves, and seeds, are used traditionally to cure diseases. Traditionally the plant possesses hepatoprotective, antipyretic, anti-inflammatory, leukotriene inhibition, antitussive activity, antioxidant, wound healing, hypo-lipidemia, anticancer, antidiabetic, central nervous system activity, antiulcer, antibacterial, antifertility, larvicidal and ovicidal, antifeedant, laxative, anti-epileptic, antimicrobial, urease inhibition, antifungal, anti-tobacco mosaic virus activities. The review contains botanical information, constituents and pharmacological leverages of the plant. The review draws attention towards the traditional, phytochemical and pharmacological knowledge accessible on Cassia fistula Linn, which would be beneficial for research scholars to develop novel chemical entities. This review article is written after studying most of the journal’s articles, which were published between 1998 to 2019.

In Vivo Study on Laxative Effect of Prunus amygdalus Oil

Objective: In this study, we assessed the laxative effects of Prunus amygdalus oil (PAO) in constipation model of mice. Method: The animals were divided into 6 groups and Prunus amygdalus oil was orally administered in two dose-strengths (3.0 ml/kg/day and 6.0 ml/kg/day) in mice. Group one was administered with Lactulose (30 ml/kg/day) as standard. Understandings of the possible mechanism of laxative action 2 groups of animals were pretreated with atropine (10 ml/kg/day) that moderately inhibit the laxative activity of Prunus amygdalus oil. Results: Results of our study revealed that treatment of PAO was effective in increasing the fecal number and fecal weight and this increase was very close to standard drug Lactulose, which indicate the laxative activity of oil. Those groups of animals which were previously administered with atropine partially inhibit the laxative activity of Prunus amygdalus oil, specifying that laxative action is mainly facilitated through muscarinic receptors activation and indicated the occurrence of Acetylcholine like component. Conclusion: Our study results revealed the laxative activity of PAO mediated mainly with the cholinergic pathway. This study provides a basis for beneficial use of Prunus amygdalus oil in constipation.

Regulation of gastrointestinal hormones during laxative activity of gallotannin-enriched extract isolated from Galla Rhois in loperamide-induced constipation of SD rats / 한국실험동물학회지

Regulation of gastrointestinal hormones have been reported in animal models for constipation undergoing laxative therapy when administered herbal products. We undertook to investigate whether the laxative activity of gallotannin-enriched extracts isolated from Galla Rhois (GEGR) affects the regulation of gastrointestinal hormones, by examining the concentration of four hormones and the activation of their receptors in the loperamide (Lop)-induced constipation model. Stool parameters, including number, weight and water content, were significantly recovered in the Lop+GEGR treated group, relative to the Lop+vehicle treated group; however, food intake and water consumption were maintained at a constant level. Also, a similar recovery was detected for thickness of mucosa, muscle and flat luminal surface in the Lop+GEGR treated group. Furthermore, concentration of the four gastrointestinal hormones evaluated, namely, cholecystokinin (CCK), gastrin (GAS), somatostatin (SS) and motilin (MTL), were lower in the Lop+vehicle treated group than the No treated group, but were remarkably enhanced in the Lop+GEGR treated group. Moreover, the downstream signaling pathway of MTL and SS receptors were recovered after GEGR administration. Results of the present study therefore indicate that the laxative effects of GEGR treatment may be tightly related with the regulation of gastrointestinal hormones in the Lop-induced constipation model.

Laxative Function of Shutong Digestion Powder in Mice / 中国药师

Objective:To observe laxative function of Shutong digestion powder in mice with constipation by experimental means to provide reference for clinical research. Methods:ICR mice were used as the research objects,and the mice model of constipation was induced by oral administration of loperamide hydrochloride. Totally 120 ICR mice were divided into two groups(experimental group 1 and experimental group 2) with 60 in each,and each group was divided into 6 subgroups by random number:the normal control group, the model control group,the positive control group(mosapride citrate tablets,2.25×10 -3g·kg-1),Shutong digestion powder group respectively at low(1 g·kg-1),medium(3 g·kg-1) and high dose(9 g·kg-1) with 10 ones in each. Drugs were given by intra-gastric administration,once a day,for 7 days. In the first experiment group,mice were subjected to defecation test,and the stool traits and the time of first defecation in each group were observed and recorded. In the experimental group 2,small intestine motility test was conducted to observe and record the ink advancing rate in intestine. Results:Compared with the model control group,there was no sig-nificant difference in the body weight of mice in each Shutong digestion powder group(P>0.05),and the time for the first row of me-lena significantly decreased(P<0.05 or P<0.01). The rate of small intestine propulsion increased except for Shutong digestion pow-der group at low dose,and the other groups had significant differences (P<0.05 or P<0.01). Compared with the positive control group,there was no significant difference in the body weight and the first defecation time between Shutong digestion powder groups and the control group (P>0.05). The ink advancing rates of Shutong digestion powder groups were lower than that of the positive control group (P<0.05 or P <0.01). Conclusion:Shutong digestion powder has good promotion function for defecation and intestinal peri-stalsis.

LAXATIVE EFFECT OF RHEUM UNDULATUM L. EXTRACT ON LOPERAMIDE INDUCED CONSTIPATION IN WISTAR RATS / Монголын эм зүй, эм судлал

Introduction: Constipation is highly prevalent, often chronic gastrointestinal disorder that affects adults. The treatment with classic drugs did not cut, in one hand with the inadequate relief of bloating and other symptoms, and with the luck of efficacy in relieving constipation. Therefore, the search for novel safe laxative drugs seems, inevitable. Rheum undulatum L. was traditionally used in constipation, thus we have attempted to evaluate the laxative effect of Rheum undulatum L. Purpose: The laxative effect of Rheum undulatum L. was evaluated against loperamide induced constipated rats. Methodology: Fifteen male normal rats were used in this study. Fifteen male constipated wistar albino rats weighing 180-250 g were also used for the study and randomized into three groups (n=5) in each of the experiments. Constipated control group rats oral administrated distilled water. Constipated rats (treatment groups) were treated with 4.1 mg/kg dose body weight /day of the preparation for one day and also Laxing a standard drug was used for the reference group. The fecal weight, the fecal humidity laxative activity were monitored in experimental rats.Results: Constipation was successfully induced in the rats by loperamide as seen in the elevated fecal properties compared to the control rats. The Rheum undulatum L. compounds preparation administered orally produced significant laxative activity and reduced loperamide induced constipation in dose dependent manner as seen in the increase of fecal output. The same doses of the Rheum undulatum L. compounds preparation produced a significant increase (P<0.05) fecal weight, the faeces humidity. The effect of the compounds preparation compares favourably well with Laxing, a standard laxative drug. Conclusion: The results of this study justify the use of Rheum undulatum L. compounds preparation as a laxative in traditional medicine. The produced significantly increase in fecal output of rats and the stimulation of gastrointestinal motility. Keywords: Laxative, gastro intestinal motility, loperamide, constipated

Laxative effect of Rheum undulatum L. Extract on loperamide induced constipation in wistar rats / Монголын эм зүй, эм судлал

Introduction@#Constipation is highly prevalent, often chronic gastrointestinal disorder that affects adults. The treatment with classic drugs did not cut, in one hand with the inadequate relief of bloating and other symptoms, and with the luck of efficacy in relieving constipation. Therefore, the search for novel safe laxative drugs seems, inevitable. Rheum undulatum L. was traditionally used in constipation, thus we have attempted to evaluate the laxative effect of Rheum undulatum L.@*Purpose@#The laxative effect of Rheum undulatum L. was evaluated against loperamide induced constipated rats.@*Methodology@#Fifteen male normal rats were used in this study. Fifteen male constipated wistar albino rats weighing 180-250 g were also used for the study and randomized into three groups (n=5) in each of the experiments. Constipated control group rats oral administrated distilled water. Constipated rats (treatment groups) were treated with 4.1 mg/kg dose body weight /day of the preparation for one day and also Laxing a standard drug was used for the reference group. The fecal weight, the fecal humidity laxative activity were monitored in experimental rats.@*Results@#Constipation was successfully induced in the rats by loperamide as seen in the elevated fecal properties compared to the control rats. The Rheum undulatum L. compounds preparation administered orally produced significant laxative activity and reduced loperamide induced constipation in dose dependent manner as seen in the increase of fecal output. The same doses of the Rheum undulatum L. compounds preparation produced a significant increase (P<0.05) fecal weight, the faeces humidity. The effect of the compounds preparation compares favourably well with Laxing, a standard laxative drug. @*Conclusion@#The results of this study justify the use of Rheum undulatum L. compounds preparation as a laxative in traditional medicine. The produced significantly increase in fecal output of rats and the stimulation of gastrointestinal motility.

Correlation between laxative effects of uridine and suppression of ER stress in loperamide induced constipated SD rats / 한국실험동물학회지

A correlation between endoplasmic reticulum (ER) stress and laxative effects was first reported in a constipation model treated with an aqueous extract of Liriope platyphylla (AEtLP) roots. To investigate the correlation between the laxative effect of uridine (Urd) and ER stress response, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with Urd. The efficacy of the laxative effect of Urd was notable on the symptoms of chronic constipation, including alteration of stool parameters and structure of the transverse colon, in Lop induced constipated SD rats. In the PERK/eIF2-ATF4 pathway of ER stress response, the levels of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and DNA damage-inducible protein (GADD34) transcripts were significantly enhanced in the Lop+Vehicle treated group. However, the levels were restored in the Lop+Urd treated group, although few differences were detected in the decrease rate. Similar changes were observed for levels of inositol-requiring enzyme 1 beta (IRE1β) phosphorylation and X-box binding protein 1 (XBP-1) transcript in the IRE1α/XBP pathway. Furthermore, the number of ER stress-induced apoptotic cells and Bax and Bcl-2 expression were recovered in the Lop+Urd treated group compared to the Lop+Vehicle treated group. The results of the present study therefore provide first evidence that the laxative effects of Urd may be tightly correlated with the recovery of ER stress response in constipation models.

Operculina macrocarpa: chemical and intestinal motility effect in mice

ABSTRACT Operculina macrocarpa (L.) Urb., Convolvulaceae, is used by the population as a laxative. In this work we described the isolation of the three phenolic acids present in the hydroethanolic extract of the O. macrocarpa roots. The quantification of the caffeic, chlorogenic acids and of the new caffeic dimer in the hydroethanolic and infusion extracts was performed by high-performance liquid chromatography coupled photodiode array detector. These analyses showed the higher content of the chlorogenic, caffeic and the new 3,4'-dehydrodicaffeic acid in hydroethanolic and hydroethanolic extracts without resin in which infusion. The acid found in greater quantity is caffeic acid followed by the 3,4'-dehydrodicaffeic acid. The laxative activity was evaluated by different experimental models of intestinal transit with the hydroethanolic and infusion extracts, and the resin fraction, caffeic, chlorogenic and ferulic acids. The results showed all extracts and compounds tested had significant activity in the experimental model tested. These results obtained are essential for the future development of a pharmaceutical product with safety and efficacy.

Optimization of integration of field processing and processing crude drugs of Polygoni Multiflori Radix / 中草药

Objective: To optimize a technology of integration on field processing and processing crude drugs of Polygoni Multiflori Radix (PMR) and to provide the scientific evidence for the integration of PMR. Methods: Orthogonal test was used to optimize the integration technology on primary processing and reprocessing with two major characteristic components (stilbene glucoside and combined anthraquinone). To compare the differences between the integration technology and traditional technology on pharmacological activity by models of constipation and swelling of ear in mice with Various index (small intestinal propulsion rate, first defecation time, fecal water content, swelling degree of ear, and inflammatory factors). Results: The results showed that the integration technology of 50℃, 16 h was better, and there was significant difference in chemical composition and Laxative effect between the integration technology and traditional technology. The anti-inflammatory effect of the integrated process was better than that of the traditional technology. Conclusion: The technology of integration of field processing and processing crude drugs is feasible and the operation is good.

Pharmacoepidemiological Examination for the Safety of the Oral laxatives in the Elderly Patients / 医薬品情報学

<b>Objective: </b>Many of the elderly patients are suffering from constipation, are using the oral laxative.  However the risk assessment of the oral laxative is not performed.  Therefore, we used Japanese Adverse Drug Event Report database (JADER) and examined for the safety of the oral laxative in the elderly patients.<br><b>Methods: </b>Since the analysis target medicines; 12 oral laxatives and target ADEs; “digestive disorders” and “electrolyte abnormality,” the JADER database for April 2004 to January 2015 were analyzed in adults of age exceeds 60.  We used the reporting odds ratio for a safety index of drugs, using reporting odds ratio, when the Lower bound of the 95% two-sided confidence interval exceeds 1, it is the signal detection of ADE.<br><b>Results: </b>The oral laxatives detected the signal of “digestive disorders” were three medicines, and “electrolyte abnormality” were five medicines.  Especially, for electrolyte abnormalities not only increases the blood magnesium values as magnesium oxide, that there is also affect other electrolyte revealed.<br><b>Conclusion: </b>Some oral laxatives were also intended to signal detections of the adverse events that are not listed in the attached document, it is necessary to pay attention to the use of them for the elderly patients.

Laxative effects of Liriope platyphylla are tightly correlated with suppression of endoplasmic reticulum stress in loperamide-induced constipation of SD rats / 한국실험동물학회지

A dysfunction of endoplasmic reticulum (ER) stress response can result in various diseases, including cancer, inflammation, diabetes and neurodegenerative disorders. To investigate whether ER stress response can play an essential role in the induction and treatment of chronic constipation, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with aqueous extracts of Liriope platyphylla (AEtLP), which has been shown to have a laxative effect. Symptoms of chronic constipation including alteration of stool parameters and the transverse colon's structure were successfully induced by Lop treatment. Laxative effects such as enhancement of stools parameters, recovery of the mucosa thickness, increased muscle thickness and recovery of flat luminal surface were also observed in the Lop+AEtLP treated group. Furthermore, enhancement of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and inositol-requiring enzyme 1 beta (IRE1β) expression, key indicators for ER stress, that were observed in the Lop+vehicle treated group were significantly recovered in the Lop+AEtLP treated group, although the phosphorylation level of c-Jun N-terminal protein kinase (JNK) remained constant. Moreover, alterations in the transcription level of the marker genes X-box binding protein 1 (XBP-1) and growth arrest and DNA damage-inducible protein (GADD34) were similar to those of eIF2α and IRE1β. However, their level was slightly or completely recovered after AEtLP treatment. Overall, this study provides the first evidence that ER stress response may be tightly correlated with chronic constipation induced by Lop treatment, as well as the laxative effects of AEtLP.

Prospective, randomized trial comparing a salt laxative solution with use water enema for colonoscopy preparation / Монголын Анагаах Ухаан

INTRODUCTION:Colonoscopy is the current standard method for evaluation of the colon. Diagnostic accuracy andtherapeutic safety of colonoscopy depends on the quality of the colonic cleansing or preparation.Thepreparation also would not cause any patient discomfort and would be inexpensive.GOAL:To compare two bowel preparation regimens for colonoscopy in terms of result of preparation.MATERIALS AND METHODS:A total 100 patients underwent colonoscopy were randomized to two bowel preparation regimens: A saltlaxative solution (n=50) oruse water enema (n=50). In group A, patients were consuming up to 5 L of saltlaxative solution at 8:00 an examination.Second groupB, patient received 6-9 L water enema the eveningbefore the colonoscopy, and the morning of the examination. Associated with the bowel preparationsuch as duration of examination, used volume of fluid, quality of bowel preparation was good (availabilitydetection of polyps greater than 5 mm), poor (inadequate cleansing).Data were entered into computer database using SPSS 20.0. The one simple test was used for analysisof categorical and ordinal variables. A Ð value of less than 0.05 was considered statistically significant.RESULTS:Using oral salt laxatives andwater enema preparation were decreased duration of examination, patientsatisfaction, successful cleaning of colon mucosa for both diasnostic and treatment procedure, decreasedtime for patient preparation.CONCLUSION:This randomized trial, salt laxative solution achieved better bowel preparation for colonoscopy than waterenema.

Does hypokalemia contribute to acute kidney injury in chronic laxative abuse?

Prolonged hypokalemia from chronic laxative abuse is recognized as the cause of chronic tubulointerstitial disease, known as "hypokalemic nephropathy," but it is not clear whether it contributes to acute kidney injury (AKI). A 42-year-old woman with a history of chronic kidney disease as a result of chronic laxative abuse from a purging type of anorexia nervosa (AN-P), developed an anuric AKI requiring hemodialysis and a mild AKI 2 months later. Both episodes of AKI involved severe to moderate hypokalemia (1.2 and 2.7 mmol/L, respectively), volume depletion, and mild rhabdomyolysis. The histologic findings of the first AKI revealed the remnants of acute tubular necrosis with advanced chronic tubulointerstitial nephritis and ischemic glomerular injury. Along with these observations, the intertwined relationship among precipitants of recurrent AKI in AN-P is discussed, and then we postulate a contributory role of hypokalemia involved in the pathophysiology of the renal ischemia-induced AKI.

Laxative effect of peanut sprout extract

Certain phenolic compounds are known to exhibit laxative properties. Seed sprouts, such as those of peanut, are known to promote de novo biosynthesis of phenolic compounds. This study was conducted to examine the potential laxative properties of 80% (v/v) ethanolic extract of peanut sprout (PSE), which contains a high concentration of phenolic compounds such as resveratrol. For this, SD rats were orally administered PSE while a control group was incubated with saline. Laxative effects were examined in both groups of rats. Constipation induced by loperamide in SD rats was improved by administration of PSE. Constipated rats showed increased intestinal movement of BaSO4 upon administration of PSE compared to the control, and the groups administered 100 or 1,000 mg PSE/kg bw were not significantly different in transit time of the indicator. However, colon length was not statistically different among the experimental groups, although it was longer in the group incubated with 1 g PSE/kg bw compared to other groups. Further, there was no significant difference in stool number among the experimental groups. Taken together, these findings show that PSE has a laxative effect in a rat model of loperamide-induced constipation.

Manejo del paciente con constipación / Managing the constipated patient

El estreñimiento es un problema común. La mayoría de las personas resolverá el problema por si mismo, sin embargo hay un porcentaje que no lo logran y requieren de ayuda médica. Sigue siendo un reto para el médico seleccionar quienes se beneficiarán de estudios para excluir enfermedad orgánica, de estudios específicos para evaluar el mecanismo fisiopatológico implicado, y cuál es el mejor tratamiento para cada paciente. En este capítulo se revisan los aspectos más relevantes para el manejo de pacientes con estreñimiento funcional.

Constipation is a common problem. Most people solve the problem by itself, but there is a percentage who do not succeed and require medical help. It remains a challenge for the physician to select those who will benefit from studies to exclude organic disease, specific studies to evaluate the physiological mechanism involved, and what is the best treatment for each patient. In this chapter we review the most relevant aspects for the management of patients with functional constipation.