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The essential issues of bioassay methods for quality control of traditional Chinese medicines (TCM) were investigated and discussed through the instantiation of developing the bioassay methods for laxative drugs. For the relatively broad variation of the quality of TCM, which might be influenced much by many factors, the parallel lines model of quantitative response is preferred to control the quality of TCM for its relatively high accuracy. The parallel model of quantal response is alternative while the sample can not meet the reliability standard for quantitative response model. According to the requirement of homogeneity between reference and sample for bioassay, the extract from referenced crude meterial is suitable to be used as reference substance after standardizing and defining by chemical substances, and to give reference to the establishment and reproducibility of authorized standard substance. The results of determination of the purgative biopotency of different species of rhubarb and the compound preparations showed that the bioassay methods and self-made reference substance established in this study could be used to control the quality of laxative medicines.

Allitol, D-talitol and L-iditol are sugar alcohols that are rare in nature. Due to their previous rarity, little is known about the laxative effects of these rare sugar alcohols. Therefore, reliable data on the laxative effect that these sugar alcohols cause in experimental animals could help to evaluate the effectiveness of new monosaccharide laxative drugs. To investigate the laxative effect of rare sugar alcohols, the study was designed to observe the diarrhea that occurred after oral administration of these sugar alcohols in mice. Moreover, to investigate the influence on intestinal function of rare sugar alcohols, the study was designed to examine small intestine transit and the luminal water content. Results indicated that rare sugar alcohols have a laxative effect in mice. Diarrhea started at a dose of 4.95 g/kg of rare sugar alcohols. There was a statistically significant laxative effect for D-talitol and L-iditol at a dose of 9.9 g/kg as compared to vehicle. Moreover, rare sugar alcohols significantly increased the small intestinal transit and the luminal water content of the small intestine and cecum in mice as compared to each vehicle. Overall, L-iditol greatly changes the function of intestine. In conclusion, rare sugar alcohols increase water content in small intestine and accelerate small intestine transit. These results support laxative effect of rare sugar alcohols. Therefore, rare sugar alcohols may be useful as monosaccharide laxatives and may be used to treat constipation.

Aim: To investigate the effects of lubiprostone and Polyethylene Glycol 3350 (PEG) on mucosal barrier repair in ischemic-injured porcine intestine., Methods: Ileum from 6 piglets (approximately 15 kg body weight) was subjected to ischemic conditions by occluding the local mesenteric circulation for 45 min in vivo. Ileal tissues from each pig were then harvested and mounted in Ussing chambers and bathed in oxygenated Ringer's solution in vitro. Intestinal barrier function was assessed by measuring transepithelial electrical resistance (TER) and mucosal-to-serosal fluxes of (3)H-mannitol and (14)C-inulin. Statistical analyses of data collected over a 120-min time course included 2-way ANOVA for the effects of time and treatment on indices of barrier function., Results: Application of 1 micromol/L lubiprostone to the mucosal surface of ischemic-injured ileum in vitro induced significant elevations in TER compared to non-treated tissue. Lubiprostone also reduced mucosal-to-serosal fluxes of (3)H-mannitol and (14)C-inulin. Alternatively, application of a polyethylene laxative (PEG, 20 mmol/L) to the mucosal surface of ischemic tissues significantly increased flux of (3)H-mannitol and (14)C-inulin., Conclusion: This experiment demonstrates that lubiprostone stimulates recovery of barrier function in ischemic intestinal tissues whereas the PEG laxative had deleterious effects on mucosal repair. These results suggest that, unlike osmotic laxatives, lubiprostone stimulates repair of the injured intestinal barrier.

Background & Aims: Symptoms of constipation are extremely common, especially in the elderly. The present study aim to identify an efficacious treatment strategy for constipation by evaluating the secretion-promoting and laxative effect of a herbal compound, naringenin, on intestinal epithelial anion secretion and a rat constipation model, respectively., Methods/principal Findings: In isolated rat colonic crypts, mucosal addition of naringenin (100 microM) elicited a concentration-dependent and sustained increase in the short-circuit current (I(SC)), which could be inhibited in Cl- free solution or by bumetanide and DPC (diphenylamine-2-carboxylic acid), but not by DIDS (4, 4'- diisothiocyanatostilbene-2, 2'-disulfonic acid). Naringenin could increase intracellular cAMP content and PKA activity, consisted with that MDL-12330A (N-(Cis-2-phenyl-cyclopentyl) azacyclotridecan-2-imine-hydrochloride) pretreatment reduced the naringenin-induced I(SC). In addition, significant inhibition of the naringenin-induced I(SC) by quinidine indicated that basolateral K+ channels were involved in maintaining this cAMP-dependent Cl- secretion. Naringenin-evoked whole cell current which exhibited a linear I-V relationship and time-and voltage- independent characteristics was inhibited by DPC, indicating that the cAMP activated Cl- conductance most likely CFTR (cystic fibrosis transmembrane conductance regulator) was involved. In rat constipation model, administration of naringenin restored the level of fecal output, water content and mucus secretion compared to loperamide-administrated group., Conclusions: Taken together, our data suggest that naringenin could stimulate Cl- secretion in colonic epithelium via a signaling pathway involving cAMP and PKA, hence provide an osmotic force for subsequent colonic fluid secretion by which the laxative effect observed in the rat constipation model. Naringenin appears to be a novel alternative treatment strategy for constipation.

Objective: To investigate the relationship between the laxative potency and anthraquinones content of six kinds of traditional Chinese drugs (TCDs) like Rheum tanguticum, Polygonum cuspidatum, R. palmatum, R. officeinale, Semen Cassiae and Radix Polygoni Multiflori., Method: The half effective dose (ED50) was applied to determine the laxative potency and the content of anthraquinones was evaluated by RP-HPLC., Result: The ED50 for the six kinds of TCD was 0.458, 0.686, 0.925, 1.004, 1.047, 1.986 g x kg(-1), respectively, and the sequence of laxative potency was R. tanguticum > P. cuspidatum > R. palmatum > R. officeinale > Semen Cassiae > Radix Polygoni Multiflori. In terms of the HPLC quantitative determination, the content of combined anthraquinones was 2.82% ,1.64%, 1.44%, 0.82%, 0.15%, 0.019%, respectively,and the sequence was R. tanguticum > Polygoni cuspidatum > R. palmatum > P. cuspidatum > Semen Cassiae > Radix Polygoni Multiflori., Conclusion: There is a great difference in laxative potency between TCDs, and the relationship between laxative potency and the content of combined anthraquinones was found. The bioassay may be utilized to evaluate and control the quality of TCD with the chemical methods.

Constipation is a major source of distress for patients with cancer, significantly affecting quality of life. It can be secondary to disease sequelae, side effects of treatment, or preexisting conditions. It often is unrecognized, underassessed, and ineffectively managed. Nurses play a key role in the prevention and management of constipation and need evidence-based interventions. This article summarizes the existing research evidence for constipation interventions and identifies gaps. Many of the strategies have been evaluated in nononcology populations; researchers should evaluate their effectiveness in oncology populations.

Identification and taxonomy analysis conducted at Herbarium Bogoriense at Research Centre for Biology, Indonesian Institute of Sciences Bogor. The name of the plant was C. tiglium L. The result of analysis on C. tiglium, ethanol extract as laxative material using the intestinal transit method showed treatment group that received dosage 0.06 mL/30 g b.wt. (72.5%) was significantly different compared to negative control (48.4%) or positive control (50.6%) which showed the weak effect as laxative at the dosage of 0.75 mL/30 g b.wt. It showed that ethanol extract of C. tiglium seed at dosage 0.06 mL/30 g is effective as laxative. The test result of the treatment using dosage 0.06, 0.04, 0.026 and 0.07 mL/28 g of body weight showed the mice population response 100, 60, 40 and 40% consecutively. The Thompson and Weil analysis result showed the ED50 was at 0.027 mL or equal to 639,5 g kg(-1) b.wt. The LD50 was at 0.0707 equals with 1674,5 mg kg(-1) b.wt. Safety limit is the range of dosage that cause the lethal effect and the dosage that gives the intended effect. The safety limit is represented by the comparison of LD50/ED50. Calculation result that the extract safety limit was LD50/ED50 = 0.0707/0.027 = 2.7.

Objectives: Constipation is one of the most frequent gastrointestinal symptoms. Traditionally, drug therapy for constipation is not prescribed and controlled by physicians. Instead, laxatives are sold by pharmacists as over-the-counter (OTC) medication. The aim of this study was to explore the safety and usage pattern of the OTC laxative sodium picosulfate use by collecting data from patients at their pharmacies. The study describes how self-treatment of constipation is practiced. In addition, the characteristics of patients buying the contact laxative, sodium picosulfate, for self-treatment of constipation were analyzed., Methods: The survey was a pharmacy-based observational study (PHOBS) in community pharmacies in Germany. Participating pharmacists asked customers requesting a specific contact laxative to participate in the study. Customers gave verbal informed consent to study participation before receiving a structured questionnaire to be completed at home and then returned to the pharmacy., Results: Data from 1,845 patients recruited by 243 pharmacies were collected. Compliance with the recommended dosage of 5 â 10 mg/day was 96%, compliance with the indication of constipation was 99%. More than 90% rated the efficacy as "very good" to "good". There was no weakening of the efficacy rating with increasing duration of use. 8% of patients reported mild-to-moderate adverse events. Nearly 60% of respondents reported to be satisfied with less than 1 bowel movement per day. Therefore, users appear to have a rational way of using OTC laxatives., Conclusions: Self-medication of constipation with sodium picosulfate is efficacious and considered to be safe.

We investigated the laxative activity of an extract of agarwood leaves from Aquilaria sinensis. The laxative activity was measured in mice by counting the stool frequency and stool weight, and the drugs were orally administered. An acetone extract of agarwood leaves and senna (a representative laxative drug) both increased the stool frequency and weight, but a methanol extract did not. The laxative effect of the acetone extract was milder than that of the anthraquinoid laxative, senna, and the former did not induce diarrhea as a severe side effect. We identified the main constituent contributing to the laxative effect of the acetone extract as genkwanin 5-O-beta-primeveroside (compound 4). Compound 4 strengthened the spontaneous motility and induced contraction in the ileum. This ileal contraction induced by compound 4 was inhibited by atropine, but not by azasetron, suggesting that the effect of compound 4 was mediated by acetylcholine receptors, and not by serotonin. The laxative mechanism for compound 4 may in part involve stimulation of intestinal motility via acetylcholine receptors.

Chronic constipation is a frequent complaint in clinical practice. It is usually amenable to laxatives, which are available with and without prescription. An overemphasis on evidence-based analysis and aggressive marketing of newly developed laxative agents has tilted the recommendations toward more expensive, but not necessarily more effective, agents. This review addresses each of the four classes of laxatives and provides suggestions about their appropriate use in clinical practice.

The aims of this study were to determine the effects of konjac glucomannan (KGM), a water-soluble dietary fiber from Amorphophallu konjac C. Koch, on the cytotoxicity and DNA damage of fecal water-treated Caco-2 cells, a human colon adenocarcinoma cell line, and to compare these effects with those of inulin, oligofructose (FO), cellulose and no fiber diet. In addition, the possible mechanisms by which dietary fibers modulated the toxicity of feces were investigated. Seven-week-old BALB/c mice were randomly allocated to consume an AIN-93 diet that contained no dietary fiber (FF) or 5 % (w/w) KGM, inulin, FO, or cellulose for 3 weeks. Fresh feces were collected during days 18 - 21. Our results indicated that the survival rate (%) of fecal water-treated Caco-2 cells was similarly enhanced by each dietary fiber as compared with that of FF group, respectively. The inhibition of fecal water-induced DNA damage of Caco-2 cells was in the descending order of inulin> FO> cellulose, KGM group. Cellulose significantly exerted a bulk effect, while KGM, inulin and FO significantly increased the ratio of lactobacilli and bifidobacteria in feces, respectively, as well as the ferrous ion-chelating ability of fecal water, respectively. Therefore, this study suggests that KGM, inulin and FO may reduce the toxicity of fecal water mainly by increasing the fecal probiotics and ferrous ion-chelating activities while cellulose may act mainly by increasing the fecal bulk. FF: fiber free FO: oligofructose KGM: konjac glucomannan.