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Background: The prompt development of obesity/constipation is the most serious problem for both children and adults. Limited studies suggested an association between them but lacked preclinical studies. This study allows to evaluate their crosslink and to compare the aqueous extracts laxative actions of two edible wild fruits of Arbutus unedo (AUAE) and Crataegus monogyna (CMAE) in constipated high-fat diet (HFD) rats., Methods: Wistar rats were divided into experimental groups for 13 weeks: standard (SD) and HFD groups. SD-rats were randomly redivided into 2 groups: SD and SD + Loperamide (LOP, 3 mg/kg, b.w.). HFD-rats were randomly reseparated into HFD-group, (HFD + LOP)-group, [HFD + Yohimbine (YOH, 2 mg/kg, b.w.)]-group, [HFD+ LOP]-groups+ various doses of AUAE or CMAE (75, 150, and 300 mg/kg, b.w.). Diversified indicators were investigated to achieve the expected objectives, including; fecal parameters, gastrointestinal transit (GIT), gastric emptying (GE), oxidative stress-(OxS), blood biochemical analysis, and accompanied small/large bowel histological modification., Key Results: The liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS) analysis of AUAE and CMAE allowed the identification of 11 and 6 phenolic compounds, respectively. In HFD-rats, the subsequent dysregulation of GI motility was markedly aggravated. More importantly, with the same way (CMAE and AUAE)-treated groups showed alleviated outcomes for the following: most stool parameters, GIT, and GE were remarkably recovered; a similar recovery pattern was observed in the histopathological structure, OxS, and blood biochemical indicators., Conclusions & Inferences: Our results experimentally confirmed the crosslink between overweight and constipation and both fruits have potential as functional foods to reduce metabolic risk of the obesity associated with bowel dysmotility., (© 2024 The Author(s). Neurogastroenterology & Motility published by John Wiley & Sons Ltd.)

Ethnopharmacological Relevance: Rosmarinus officinalis L. (Rosemary) is a popular herb with reported effectiveness against diarrhea, anxiety and constipation, albeit with limited pharmacological evidence., Aim of the Study: The current study was aimed at evaluating the therapeutic potential, possible pharmacological mechanisms of action and active constituents of hydro-ethanolic extract of rosemary (Rs.Cr), as potential anti-diarrheal, laxative and anxiolytic agent., Method: Rs.Cr was analyzed through reverse-phase high pressure liquid chromatography (RP-HPLC). Laxative, antidiarrheal, and anxiolytic activities were assessed using in vivo models. Spasmogenic and spasmolytic mechanisms were studied on isolated guinea pig ileum and rabbit jejunum tissues, respectively. Possible role of diosmetin, one of the active constituents of Rs.Cr was also evaluated., Results: RP-HPLC analysis revealed presence of diosmetin, rutin and apigenin in Rs.Cr. Laxative effect was seen at low doses, which was partially reversed in atropinized mice. The spasmogenic mechanism was mediated by cholinergic and histaminergic receptors stimulation. At higher doses, antidiarrheal activity was evident, with reduction in gastrointestinal motility and secretions using charcoal meal and enteropooling assays, respectively. Rs.Cr also showed dose-dependent anxiolytic effect. The antispasmodic mechanisms were mediated by anti-muscarinic and K + channel opening-like effect (predominant K ATP -dependent). Diosmetin exhibited antidiarrheal and antispasmodic activities, but spasmogenic effect was not seen., Conclusion: Rosemary leaves have dual antidiarrheal and laxative effects, and as well as anxiolytic activity. In addition, the possible modulation of muscarinic and histaminergic receptors, and K ATP channels show it as potential herb to be explored for irritable bowel syndrome. Diosmetin is possibly one of its constituents that contributes to its antidiarrheal activity., Competing Interests: Declaration of competing interest The authors declare no competing interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Polyethylene glycol (PEG), bisacodyl, and prucalopride have been reported to be more effective than placebo in treating patients with constipation but about 50% of the patients still do not respond to these medications. Only bisacodyl and prucalopride are expected to directly stimulate the colonic motility in humans in vivo. As no previous study has done this, the aim of the study was to investigate the effect of PEG, bisacodyl, and prucalopride as compared to placebo on colonic motility assessed by means of the high-resolution manometry (HRM) in healthy subjects., Methods: Ten healthy subjects have been enrolled in an acute, open label, randomized, reader-blinded, crossover study and requested to undergo a colonoscopy-assisted HRM measuring their colonic motility before and after oral administration of 13.8 g (two doses) PEG, 10 mg bisacodyl, 2 mg prucalopride, and placebo., Key Results: In the human prepared colon, oral administration of PEG significantly increases the number of low-amplitude long distance propagating contractions (p = 0.007 vs placebo) while bisacodyl significantly increases the number of high-amplitude propagating contractions (HAPCs) (all p < 0.01 vs PEG, prucalopride, and placebo). Prucalopride has no major effect on the number of propagating contractions but increases HAPCs amplitude (p = 0.01)., Conclusions & Inferences: In humans, PEG, prucalopride, and bisacodyl have distinct effects on colonic motility. This information has clinical implication, as it indicates that the combination of prucalopride and bisacodyl, normally not considered in clinical practice, could be effective in treating patients with constipation refractory to single medications., (© 2020 John Wiley & Sons Ltd.)

Ethnopharmacological Relevance: Sjögren's syndrome (SS) is an autoimmune disease and can cause gastrointestinal disorders such as constipation and intestinal inflammation. As a kind of medicinal material, Paeonia lactiflora Pall has a variety of pharmacological effects, and it is also an indispensable component in many pharmaceutical preparations, which has been widely concerned by the medical and pharmaceutical circles. Total glucosides of paeony (TGP) is a mixture of biologically active compounds extracted from the root of Paeonia lactiflora Pall and has therapeutic effects on a variety of autoimmune diseases., Aim of the Study: To investigate the therapeutic effect of TGP on constipation and intestinal inflammation in mice modeled by SS, and to provide a basis for clinical research., Materials and Methods: The SS model was set up by submandibular gland (SMG) immune induction method and then treated with TGP for 24 weeks. The fecal characteristics were observed and the fecal number and moisture content were measured. Colonic pathology was observed by H&E staining. The levels of serum P substance (SP), vasoactive intestinal peptide (VIP), interleukin (IL)-1β, tumor necrosis factor (TNF)-α, nuclear factor (NF)-κB, nitric oxide (NO), and nitric oxide synthase (NOS) were determined by enzyme linked immunosorbent assay (ELISA) and microplate method, respectively. Reverse transcription polymerase chain reaction (RT-PCR) was employed to analyze the mRNA expression of c-kit and stem cell factor (SCF) in colon., Results: Compared with the model group, the dry and rough condition of the feces was improved, and the fecal gloss, number and moisture content significantly increased after the administration of TGP capsules. Meanwhile, TGP treatment improved colonic pathological damage, inhibited the serum concentrations of NO, NOS, IL-1β, TNF-α, NF-κB and SP, increased serum VIP concentration, and up-regulated mRNA expression of SCF and c-kit in colon., Conclusions: TGP could obviously attenuate SS-mediated constipation and intestinal inflammation in mice by acting on some intestinal motility related factors and inflammatory factors., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Colonic manometry with intraluminal bisacodyl infusion can be used to assess colonic neuromuscular function in children with treatment-refractory constipation. If bisacodyl does not induce high-amplitude propagating contractions (HAPCs), this can be an indication for surgical intervention. A detailed characterization of the colonic response to intraluminal bisacodyl in children with constipation may help to inform clinical interpretation of colonic manometry studies., Methods: Studies were performed in five pediatric hospitals. Analysis included identification of HAPCs, reporting HAPCs characteristics, and an area under the curve (AUC) analysis. Comparisons were performed between hospitals, catheter type, placement techniques, and site of bisacodyl infusion., Results: One hundred and sixty-five children were included (median age 10, range 1-17 years; n = 96 girls). One thousand eight hundred and ninety-three HAPCs were identified in 154 children (12.3 ± 8.8 HAPCs per child, 0.32 ± 0.21 HAPCs per min; amplitude 113.6 ± 31.5 mm Hg; velocity 8.6 ± 3.8 mm/s, propagation length 368 ± 175 mm). The mean time to first HAPC following bisacodyl was 553 ± 669 s. Prior to the first HAPC, there was no change in AUC when comparing pre- vs post-bisacodyl (Z = -0.53, P = .60). The majority of HAPCs terminated in a synchronous pressurization in the rectosigmoid. Defecation was associated with HAPCs (χ 2 (1)=7.04, P < .01). Site of bisacodyl administration, catheter type, and hospital location did not alter the response., Conclusions and Inferences: Intraluminal bisacodyl induced HAPCs in 93% of children with treatment-refractory constipation. The bisacodyl response is characterized by ≥1 HAPC within 12 minutes of infusion. The majority of HAPCs terminate in a synchronous pressurization in the rectosigmoid. Optimal clinical management based upon colonic manometry findings is yet to be determined., (© 2020 John Wiley & Sons Ltd.)

Background: There are numerous medicinal plants including the leaves of Grewia ferruginea used as traditional medicine for the treatment of constipation. This study was conducted to evaluate the laxative activity of the leaves of G ferruginea ., Methods: The laxative activity of the leaves of G ferruginea was tested using 3 models: laxative activity, gastrointestinal motility, and gastrointestinal secretion tests. The effect of the plant extract on mean number of feces, fecal water content, ratio of intestinal distance traveled by the charcoal meal and intestinal fluid accumulation were evaluated and analyzed., Results: Significant increase was observed in the mean weight of wet fecal matter at 200 (1.00 ± 0.03 g, P < .05) and 400 mg/kg (1.01 ± 0.02 g, P < .01), relative to loperamide constipated negative control group. Similarly, percent fecal water content was significantly improved in extract treated groups at 100 mg/kg (52.10% ± 2.04%, P < .05), 200 mg/kg (54.02% ± 2.15%, P < .01), and 400 mg/kg (54.25% ± 2.50%, P < .01) compared with the negative control group. The gastroinestinal transit ratio was also significantly increased with 200 mg/kg ( P < .01) and 400 mg/kg ( P < .001) of the extract relative to the constipated negative control. The crude extract showed significant increase in intestinal fluid accumulation at 200 mg/kg (0.48 ± 0.07 g, P < .05) and 400 mg/kg (0.51 ± 0.08 g, P < .01) compared with the negative control., Conclusion: The results of the present study indicated that 80% methanol extract of the leaves of G ferruginea possessed significant laxative activity. As such, this study corroborates the traditional claim of using G ferruginea in the treatment of constipation.

The prokinetic effects of 5-HT 4 receptor (5-HT 4 R) agonists have been utilized clinically for almost three decades to relieve symptoms of constipation. Surprisingly, the mechanism(s) of action of these compounds is still being debated. Recent studies highlight luminal 5-HT 4 Rs as an alternative and effective target for these prokinetic agents. These include the study by Shokrollahi et al (2019, Neurogastroenterol Motil, e13598) published in the current issue of Neurogastroenterology and Motility, who found that activation of mucosal 5-HT 4 Rs by intraluminal prucalopride, significantly enhanced propulsive motor patterns in rabbit colon. The authors highlight the idea that development of agonists targeting luminal 5-HT 4 Rs in the colonic mucosa might be more effective and safer in achieving prokinetic effects on intestinal motility. The purpose of this mini-review is to discuss the evidence for luminal 5-HT 4 Rs as an emerging target for prokinetic agents in facilitating propulsive motor patterns in the colon., (© 2019 John Wiley & Sons Ltd.)

Hippophae rhamnoides (Family; Elaeagnaceae) fruit extract was investigated for prokinetic and gut excitatory effects to rationalize its therapeutic utility in gastrointestinal complaints like delayed gastric emptying and constipation. The fruit extract of Hippophae rhamnoides (Hr.Cr) prepared in hydro-methanol (30:70) was verified for flavonoids, tannins, coumarins and terpenes as plant constituents. In mice, Hr.Cr administration caused an increased in faecal production and charcoal meal transport (50-300mg/kg, per-oral.), similar to activity pattern of carbamylcholine (1 mg/kg). Laxative and prokinetic effects of Hr.Cr were found partially atropine-sensitive. On challenge with isolated intestinal tissues, Hr.Cr charged a dose-dependent spasmogenic effect on jejunum (0.01-1mg/mL) preparations of rabbit and in ileal tissues (guinea-pig) at the dose range of 0.03 to 3mg/mL, following predominant relaxing impact at increased concentrations. Unlike carbamylcholine, stimulant effect of Hr.Cr was partly antagonized in atropine incubated tissues. These data attest the laxative, prokinetic and gut excitatory activities of Hippophae rhamnoides probably mediated through partial activation of muscarinic receptors. Further in agreement of the current findings with earlier reports on gastric emptying effects of Hippophae rhamnoides seed oil, this is the first study of its kind providing insight into mechanism to the laxative potential of Hippophae rhamnoides fruit, thus rationalizing its medicinal use in constipation.

Royal jelly (RJ) is widely used as a cosmetic or dietary supplement to relieve various health disorders, such as dry skin, fatigue, and menopause. RJ has been recommended to improve constipation on a commercial basis. However, the detailed mechanisms by which RJ influences intestinal motility and whether RJ improves constipation remain unclear. Therefore, we investigated the effects of RJ on the motility of mouse ileum both in vitro and in vivo . Using myograph methods, RJ dose-dependently induced contractions of isolated ileal segments, which were inhibited by treatment with atropine. Eserine sulfate, a cholinesterase inhibitor, enhanced the RJ-induced contractions, whereas RJ treated with acetylcholinesterase did not result in ileum contraction. RJ-induced contractions were not affected by N G -nitro-l-arginine methyl ester, a nitric oxide synthase inhibitor, although nicotine-induced contractions were significantly enhanced. In contrast, in a gastrointestinal (GI) transit model, single oral administration of 300 mg/kg RJ did not affect GI transit in both normal mice and the loperamide-induced constipation model mice. These results demonstrate that acetylcholine in RJ directly acted on the muscarinic receptors of the mouse intestinal smooth muscle, causing it to contract in vitro . In contrast, single oral administration of RJ did not improve constipation. This study is the first to evaluate the effects of RJ on the motility of mouse ileum in in vitro and in vivo experiments for the validation of application of RJ as a gentle laxative.

Background: Stimulant laxatives are widely used to treat constipation. We investigated in human small and large intestinal preparations the effects of bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM), the active metabolite of the laxatives bisacodyl and sodium picosulfate on smooth muscle tone and epithelial secretion., Methods: Circular and longitudinal muscle tone of small or large intestinal preparations were recorded with isometric force transducers. Epithelial ion flux (I SC ) and tissue resistance was measured with Ussing chamber technique after apical and basolateral BHPM application to large intestinal mucosa/submucosa preparations. Studies were performed in macroscopically normal specimens from 79 patients., Key Results: BHPM concentration-dependently (0.5-5 μM) increased the tone of circular and longitudinal muscle from small to large intestine. The effect was strongest in large intestinal longitudinal muscle and smallest in small intestinal circular muscle. Increase in muscle tone was prevented by the L-type Ca ++ channel blocker nifedipine but insensitive to the nerve blocker tetrodotoxin. Apical or basolateral BHPM concentration-dependently decreased or increased I SC , respectively. The K C a 1.1 (BK) channel blocker iberiotoxin reversed apical I SC decrease whereas tetrodotoxin reversed basolateral I SC increase. BHPM had no effect on tissue resistance or nerve-mediated secretory or muscle response with one exception: at the highest concentration basolateral BHPM reduced nerve-mediated secretion., Conclusions and Interferences: BHPM enhanced mucosal secretion and muscle contractility. Results suggested that the laxative effect of BHPM was a consequence of the increase in muscle tone as well as an increased K + secretion when acting luminally and a nerve-driven Cl - and HCO 3 - secretion once acting basolaterally after absorption., (© 2018 John Wiley & Sons Ltd.)

In this studied, extracts of black garlic on the improvement of gastrointestinal function, antioxidant activity, total polyphenols, total flavonoids and total polysaccharides were evaluated. Results showed that the black garlic n-butanol fraction extract (BA) had significantly increased effect within small intestine in vitro, while the ethyl acetate fractions had no significant effect on small intestine in vitro. Increase of 5-HT 4 content effectively stimulated the gastrointestinal peristalsis, which enhanced its gastrointestinal tract emptying, and promoted defecation. As for antioxidant activity test, the water extract was more effective in SOD activity test, DPPH radical scavenging rates, ferric reducing antioxidant power and reducing power. In addition, the water fraction was simulated by gastric acid digestion and hydrolysis, and the small intestine was isolated after acid hydrolysis (AW). It was found that the water fraction extract after acid hydrolysis did significantly improve the intestinal contraction rate. In short, extract of black garlic could effectively promote gastrointestinal motility and promote defecation. The active compounds were highly polar ingredients since water extract of black garlic exhibits most significant effect on improving gastrointestinal function., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Ethnobotanical Relevance: Bambusa arundinacea (Retz.) Willd., commonly known as Kanta Bans, plays an important ethnobotanical role, especially in Asia. In traditional medicine it has reportedly been used for the treatment of constipation, blood-diseases, leucodema, inflammation and urinary discharges. A number of ethnomedicinal records exist regarding the use of B. arundinaceae shoots as a laxative, however, there are no scientific studies reported on its laxative activity. Therefore, the aim of this present study was to evaluate the laxative activity of an ethanolic B. arundinaceae shoot extract in mice., Materials and Methods: B. arundinacea shoots were collected from Dhaka, Bangladesh in July 2015. An ethanolic shoot extract was obtained and its laxative activity was evaluated by faecal consistency, gastrointestinal transit and entero-pooling assays in a mouse model. Furthermore, a phytochemical investigation of the extract was conducted by UHPLC-ESI-QqQ MS and UHPLC-ESI-Orbitrap MS analysis., Results: The ethanolic shoot extract of B. arundinacea showed significant laxative activity in our mouse model, with significant increases in (i) the amount of wet faeces, with the maximum effect at 2h for 500mg/kg (47.92%), (ii) gastrointestinal transit (67.18% and 60.03% for doses of 250 and 500mg/kg, respectively), and (iii) small intestine content at the test doses of 250 and 500mg/kg p.o. Phytochemical investigation identified a total of thirty compounds in the ethanolic shoot extract of B. arundinacea using UHPLC-ESI-QqQ MS and UHPLC-ESI-Orbitrap MS analysis., Conclusions: The results of this study provide support for the traditional use of B. arundinacea shoot as a laxative., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Intestinal dysmotility is a major problem in critically ill patients. This report describes the successful treatment of intestinal dysmotility with rhubarb as a laxative in six critically ill patients on mechanical ventilation. Bowel movement and defecation occurred in all patients an average of 1.8 days after the administration of powdered rhubarb. In 4 patients who also had gastric reflux, the reflux volume via nasal tube was decreased an average of 3.5 days after the initiation of rhubarb treatment, and enteral nutrition was able to be started. Rhubarb may be useful for the treatment of incompetent gastric and intestinal motility in critically ill patients.

Background: This study compared prucalopride, a selective, prokinetic, 5-HT4 receptor agonist, with polyethylene glycol 3350 + electrolytes (PEG3350), an osmotic laxative, on colonic motility parameters, primarily high-amplitude propagating contractions (HAPCs) in patients with chronic constipation., Methods: This randomized, cross-over, reader-blinded study was conducted at a single site in the USA. The study was open to men and women aged 18-75 years who met study inclusion criteria. Colonic manometry catheters were inserted the day before investigation. On the investigation days, patients received oral 2 mg prucalopride or 2 × 13.8 g PEG3350 in solution. The primary endpoint was HAPC count (threshold: mean amplitude ≥100 mmHg, propagation ≥20 cm [HAPC1 ]) in the 12 h after treatment administration. Analyses were also conducted at two co-primary thresholds: mean amplitude ≥75 mmHg, propagation ≥20 cm (HAPC2 ); and mean amplitude ≥75 mmHg, propagation ≥10 cm (HAPC3 ). Secondary endpoints included HAPC area under the curve (AUC), contraction force, amplitude, duration, and propagation velocity., Key Results: Thirteen women were enrolled, with 12 completing the study. Significantly more HAPC1 (8.7 ± 2.06 vs 2.9 ± 2.06; p = 0.012) and HAPC2 (9.0 ± 2.11 vs 3.3 ± 2.11; p = 0.017) were observed in the 12-h periods with prucalopride than with PEG3350. Prucalopride significantly increased mean propagation distance and velocity (HAPC2 ) and mean AUC, force, and amplitude (HAPC3 ) compared with PEG3350. Adverse events were mild or moderate., Conclusions & Inferences: Prucalopride was superior to PEG3350 in inducing HAPCs in patients with chronic constipation. ClinicalTrials.gov number NCT01707667., (© 2016 Shire Development LLC Neurogastroenterology & Motility Published by John Wiley & Sons Ltd.)

Introduction: Gastrointestinal dysmotility and constipation are common problems in intensive care patients. The majority of critical care patients are sedated with opioids to facilitate tolerance of endotracheal tubes and mechanical ventilation, which inhibit gastrointestinal motility and lead to adverse outcomes. Methylnaltrexone is a peripheral opioid antagonist that does not cross the blood-brain barrier and can reverse the peripheral side effects of opioids without affecting the desired central properties. This trial will investigate whether methylnaltrexone can reverse opioid-induced constipation and gastrointestinal dysmotility., Methods: This is a single-centre, multisite, double-blind, randomised, placebo-controlled trial. 84 patients will be recruited from 4 intensive care units (ICUs) within Imperial College Healthcare NHS Trust. Patients will receive intravenous methylnaltrexone or placebo on a daily basis if they are receiving opioid infusion to facilitate mechanical ventilation and have not opened their bowels for 48 hours. All patients will receive standard laxatives as per the clinical ICU bowel protocol prior to randomisation. The primary outcome of the trial will be time to significant rescue-free laxation following randomisation. Secondary outcomes will include tolerance of enteral feed, gastric residual volumes, incidence of pneumonia, blood stream and Clostridium difficile infection, and any reversal of central opioid effects., Ethics and Dissemination: The trial protocol, the patient/legal representative information sheets and consent forms have been reviewed and approved by the Harrow Research Ethics Committee (REC Reference 14/LO/2004). An independent Trial Steering Committee and Data Monitoring Committee are in place, with patient representation. On completion, the trial results will be published in peer-reviewed journals and presented at national and international scientific meetings., Trial Registration Number: 2014-004687-37; Pre-results., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Joannesia princeps is a plant commonly used in folk medicine as laxative for menstrual discomfort and as antihelminthic and antimicrobial to reduce edema and improve tissue healing. The seeds are used in many regions of Brazil as laxative; however, studies are needed to confirm its effectiveness and safety. Thus, the aim of this study was to evaluate the effects of using seeds of this plant on intestinal motility of Wistar rats, evaluate the effects and acute toxicity of its management, as well as determine its phytochemical profile. The evaluation of the effect on the intestinal motility was performed according to the model described by Michelin and Salgado (2004) with modifications. For the evaluation of acute toxicity, we used the model described by Craveiro et al. (2008) and Goloni et al. (2005), and for the analysis of the presence of alkaloids, flavonoids, anthraquinones, steroids, and other components, we used the method described by Carvalho et al. (2006). The results showed that J. princeps exhibits laxative effects similar to those of Senna species such as Cassia angustifolia and the phytochemical analysis of ethanol and aqueous extracts showed the presence of alkaloids, triterpenes, and/or steroids compounds. Acute toxicity showed in the first 12 h: piloerection, contortion, decreased respiratory rate, diarrhea, and weight loss. After this period, these changes were no longer observed. It was concluded that the seeds of this plant have potential laxative activity, confirming the popular use and that the dose of 5 g/kg can be considered safe for consumption.

Background: Fumaria parviflora Linn. (Fumariaceae), is a small branched annual herb found in many parts of the world including Saudi Arabia and Pakistan. This study was designed to provide pharmacological basis for the medicinal use of Fumaria parviflora in gut motility disorders., Methods: The in-vivo prokinetic and laxative assays were conducted in mice. Isolated intestinal preparations (ileum and jejunum) from different animal species (mouse, guinea-pig and rabbit) were separately suspended in tissue baths containing Tyrode's solution bubbled with carbogen and maintained at 37°C. The spasmogenic responses were recorded using isotonic transducers coupled with PowerLab data acquisition system., Results: The aqueous-methanol extract of Fumaria parviflora (Fp.Cr), which tested positive for the presence of alkaloids, saponins, tannins and anthraquinones showed partially atropine-sensitive prokinetic and laxative activities in the in-vivo in mice at 30 and 100 mg/kg. In the in-vitro studies, Fp.Cr (0.01-1 mg/ml) caused a concentration-dependent atropine-sensitive stimulatory effect both in mouse tissues (jejunum and ileum), and rabbit jejunum but had no effect in rabbit ileum. In guinea-pig tissues (ileum and jejunum), the crude extract showed a concentration-dependent stimulatory effect with higher efficacy in ileum and the effect was partially blocked by atropine, indicating the involvement of more than one types of gut-stimulant components (atropine-sensitive and insensitive). This could be a plausible reason for the greater efficacy of Fp.Cr in gut preparations of guinea-pig than in rabbit or mouse., Conclusions: This study shows the prokinetic, laxative and spasmodic effects of the plant extract partially mediated through cholinergic pathways with species and tissue-selectivity, and provides a sound rationale for the medicinal use of Fumaria parviflora in gut motility disorders such as, indigestion and constipation. This study also suggests using different species to know better picture of pharmacological profile of the test material.

Objectives: To evaluate the in-vitro antitumour properties, and the in-vivo laxative and toxicological effects of the methanolic extract of the aerial parts of Mitracarpus frigidus (MFM)., Methods: The in-vitro antitumour activity of MFM was evaluated against three human tumour cell lines: Jurkat, HL60 and MCF-7. The laxative activity and the effect of MFM on intestinal motility were evaluated in rats at the doses of 100, 300 and 1000 mg/kg. Acute oral toxicity was performed at 10, 100, 1000 and 2000 mg/kg and subchronic toxicity was evaluated at 100, 300 and 1000 mg/kg of MFM during a 42-day period. After subchronic administration of MFM the biochemical, haematological and histopathological parameters were analysed. Also, the total content of anthraquinones was determined., Key Findings: MFM was cytotoxic only against HL60 and Jurkat cells with 89 and 83% growth inhibition, respectively. The laxative activity of MFM was similar to bisacodyl. Regarding the effect on intestinal motility, MFM showed a significant increase in the pathway of charcoal compared with the group treated with saline. Furthermore, MFM showed no in-vivo toxicity at the doses tested. Free and anthraquinone C- and O-glycosides were detected in MFM., Conclusions: MFM showed significant antitumour activity for leukaemic cells. Moreover, it presented laxative potential and no in-vivo toxicity., (© 2011 The Authors. JPP © 2011 Royal Pharmaceutical Society.)

Several species of Senna are well known for their therapeutic properties, being used in folk medicine to treat throat inflammation and constipation. In this regard, the anti-inflammatory, laxative and intestinal motility effects of different extracts of Senna macranthera (Colladon) H. Irwin and Barneby leaves were determined. The hexane extract significantly reduced carrageenan-induced paw oedema in rats in a manner similar to that of sodium diclofenac. A laxative effect was observed for the methanolic and hexane extracts comparative to the standard drug bisacodyl; however, only the hexane extract increased the intestinal motility in the studied period. Moreover, the extracts were evaluated for their antioxidant activity and the ethyl acetate extract presented a pronounced activity comparable to the standard rutin. Phytochemical screening was also performed and phenolic compounds like flavonoids, tannins and coumarins were observed in all extracts except for the hexane extract, which instead presented anthrones, triterpenes and steroids in its composition. The HPLC profile showed the presence of the anthraquinone emodine in all tested extracts.

Aim of the Study: To provide ethnopharmacological basis for the medicinal use of Lepidium sativum seeds in indigestion and constipation., Materials and Methods: The in vivo studies were conducted in mice, while isolated tissues of mouse, guinea-pig and rabbit were suspended in tissue bath to measure isotonic contractions., Results: The aqueous-methanolic extract of Lepidium sativum seeds (Ls.Cr) at 30 and 100mg/kg showed atropine-sensitive prokinetic and laxative activities in mice, which were partially sensitive to atropine. In isolated gut preparations of mouse and guinea-pig, Ls.Cr (0.1-1mg/mL) caused a concentration-dependent stimulatory effects both in jejunum and ileum, which was blocked in the presence of atropine. In rabbit jejunum, the stimulant effect of Ls.Cr remained unchanged in the presence of atropine, pyrilamine or SB203186, while in rabbit ileum, the stimulatory effect was partially blocked by atropine. The Ls.Cr was more efficacious in gut preparations of rabbit than in guinea-pig or mouse. The phytochemical analysis of the plant extract detected alkaloids, saponins and anthraquinones as plant constituents., Conclusion: This study showed the prokinetic and laxative effects of Lepidium sativum in mice, which were partially mediated through a cholinergic pathway. The in vitro spasmodic effect of the plant extract mediated through a similar mechanism with species and tissue-selectivity, provides a rationale for the medicinal use of the seeds of Lepidium sativum in indigestion and constipation, and suggests studying the plant extracts on more than one species to get the wider picture., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background and Aim: Fecal soiling is a challenging problem in some children after pull-through surgery for Hirschsprung disease (HSCR). The prevailing perception is that soiling results from overflow incontinence; however, its treatment with laxatives yields mixed results. Colonic manometry studies are reported to be normal in most patients in this population. The interpretation of these findings does not support the physiology of fecal overflow incontinence in these children. The aim of the present study was to define the physiology underlying daily, frequent fecal soiling in children after surgery for HSCR using manometric techniques., Patients and Methods: Four pediatric motility centers in the United States participated in the study; medical records and manometric tracings (anorectal and colonic) of children (n = 59; 6.5 years; 48 boys) who had pull-through surgery for HSCR and presented with daily, frequent fecal soiling were examined. Children referred for evaluation of constipation who had normal colonic manometry served as controls (n = 25; 6.7 years; 12 boys). The patients with HSCR were divided into 2 groups (Hirschsprung disease groups 1 and 2 [HD1, HD2]) based on the absence or presence of high-amplitude propagated contractions (HAPCs). A control group that included children with chronic constipation was also studied. We compared the mean HAPC frequency between the HD2 and control groups., Results: HD1 included 21 patients who had no HAPCs in fasting or postprandial periods. HD2 included 38 patients who had an average of 0.07 HPACs/min while fasting and 0.13/min in the postprandial state. In this subset the number of HAPCs in the fasting state (P = 0.04) and the postprandial state (P < 0.001) was greater when compared with controls. Additionally, there was a significant increase in HAPCs/min from the fasting to the postprandial state (P = 0.01). In the HD2 group 40% had colonic hyperactivity., Conclusions: Daily, frequent fecal soiling after pull-through surgery for HSCR may be due to colonic hyperactivity in some children. It is imperative that this unique subset be identified because the management strategy would include avoidance of laxatives, contrary to standard current practice.