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Chapter: Clinical Pharmacology: Gastrointestinal drugs

Dietary fiber and related bulk-forming laxatives

A high-fiber diet is the most natural way to prevent or treat consti-pation. Dietary fiber is the part of plants not digested in the small intestine.

Dietary fiber and related bulk-forming laxatives

 

A high-fiber diet is the most natural way to prevent or treat consti-pation. Dietary fiber is the part of plants not digested in the small intestine.

 

Bulking up

 

Bulk-forming laxatives, which resemble dietary fiber, containnatural and semisynthetic polysaccharides and cellulose. These laxatives include:

 

·                 methylcellulose

 

·                 polycarbophil

 

·                 psyllium hydrophilic mucilloid.

 

Pharmacokinetics

Dietary fiber and bulk-forming laxatives aren’t absorbed systemi-cally. The polysaccharides in these drugs are converted by intesti-nal bacterial flora into osmotically active metabolites that draw water into the intestine.

Excretion

 

Dietary fiber and bulk-forming laxatives are excreted in stool.

Pharmacodynamics

Dietary fiber and bulk-forming laxatives increase stool mass and water content, promoting peristalsis.

Pharmacotherapeutics

 

Bulk-forming laxatives are used to:

 

§    treat simple cases of constipation, especially constipation re-sulting from a low-fiber or low-fluid diet

§    aid patients recovering from acute myocardial infarction (MI) or cerebral aneurysms who need to avoid Valsalva’s maneuver (forced expiration against a closed airway) and maintain soft stool

§    manage patients with IBS and diverticulosis.

Drug interactions

 

Decreased absorption of digoxin, warfarin, and salicylates occurs if these drugs are taken within 2 hours of taking fiber or bulk-forming laxatives. (See Adverse reactions to dietary fiber and re-lated bulk-forming laxatives.)

 

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Clinical Pharmacology: Gastrointestinal drugs : Dietary fiber and related bulk-forming laxatives |


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