Laxatives are drugs that are given for initialing bowel movement or for loosening stools. Laxative are available in various different forms such as liquids, pills, enemas, foods etc. This usually has a short term impact on patient’s body. Doctors make use of this drug for preparing patients body before colonoscopy, in which it is a must that the colon of the patient is completely empty for better examination. Let’s take a look on the best laxative most suited for patients undergoing colonoscopy.
What Is The Best Laxative To Take Before A Colonoscopy?
According to FDA i.e. Food and Drug Administration a balanced combination of magnesium oxide, anhydrous citric acid and sodium picosulfate is perfect colon cleaner, which is required as preparation before colonoscopy. The combination is approved based on the following criteria:
Efficacy – The efficacy of all the three components i.e. magnesium oxide, anhydrous citric acid and sodium picosulfate was done in two ways. In the first trial, all the three components were given to patient in split-dose pattern and in the second trail the combination was given following the day before pattern. In both the trails the combination was testes with polyethylene glycol plus and bisacodyl tablets. The interesting thing is that in both the cases magnesium oxide, anhydrous citric acid and sodium picosulfate were found non-inferior from the comparator.
Safety – After laxative is given to patient for cleaning the colon, some of the after effects such as bloating, abdominal cramps, diarrhea or distension are not considered as side effects. Instead, some of the severe side effects that were observed by giving magnesium oxide, anhydrous citric acid and sodium picosulfate were:
In some rare cases patients may also experience renal impairment and cardiac seizures. Around twenty percent of the patients suffer orthostatic changes after taking magnesium oxide, anhydrous citric acid and sodium picosulfate.
If the combination of magnesium oxide, anhydrous citric acid and sodium picosulfate is given in addition with some other laxatives, then there is a very high possibility that the patient may suffer from ischemic colitis. This is a severe problem and requires hospitalization for proper treatment. This is one of the prime reasons why doctors strictly say no to take any medication on the date of colonoscopy. This is a precautionary measure to avoid adverse interaction of two medicinal components.
Dosing- After Efficacy and safety the third important criteria is the dose. As mentioned about the combination is effective only when it is given in an approximate combination, before use the components in powder form is mixed with cold water. There are two different dosing patterns followed by doctors, first is the split-dose and second is the day before pattern. In the split-dose pattern half of the dose is given to patient at evening before the test and the second half of the dose is given at around five to six hours before the screening test but with minimum fluid. In the second pattern i.e. Day–before pattern the first dose if given to patient in the afternoon before the test and the second dose is given after six hours of the first dose. Both the dosages should be given with minimum fluid.
Laxative abuse usually occur when patient make alteration in the dosage i.e. either takes more than recommended or more frequently than recommended. This is a very serious problem as it can lead to many health complications and can be lethal. According to FDA i.e. Food and Drug Administration one should always take doctor prescribed laxatives and not over the counter one, because over the counter laxative can have serious affects even when taken properly as per the instructions. At times intake of laxative cause weight loss but some people consider it as a weight loss medication which is wrong. In fact, intake of laxative regularly or frequently can be very dangerous. Hence, it is better to follow doctor’s instructions carefully and take the drug accordingly without any alteration.