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Medicine (MD/DO)
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USMLE Step 1
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Gastroenterology
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Laxatives
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Stimulant Laxatives

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Stimulant Laxatives

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Stimulant Laxatives

Stim-mule Pooping-pill
DikeHAfifi
8 KEY FACTS
MECHANISM OF ACTION
Enteric Nerve Stimulation
Intestine Nerve Stim-mule

Stimulant laxatives work by triggering enteric nerve stimulation and causing colonic contraction. It takes around 6-12 hours to work.

Colonic Contraction
Colon Flexing

Stimulant laxatives will stimulate the myenteric plexus and Auerbach plexus. This stimulation will cause an increase in intestinal motility and secretions.

INDICATION
Constipation
Corked Con-toilet

Healthcare providers should consider pharmacological options to treat constipation after initial interventions for lifestyle and increased fiber and fluid consumption fail to relieve symptoms. The first pharmacological recommendation is bulk-forming laxatives, while osmotic laxatives and stimulant laxatives are the second lines in this regard.

DRUGS
Senna
Senna

Senna is used as a short-term basis for treating constipation and can be used to empty the bowels before medical procedures, such as surgery and colonoscopy. Some brands of Senna are Senokot, Senexon, SennaGen, and Little Tummy's Stimulant Laxative Drops.

Sodium Picosulfate
Salt-shaker Pickle-sulfur-match

Patients taking sodium picosulfate are instructed to drink large amounts of water to compensate for dehydration and electrolyte imbalance that can appear. Its combination with magnesium citrate is often used to empty a patient's bowel before a colonoscopy. Some of the brand names are Laxoberon, Picolax, and Guttalax.

Bisacodyl
Bicycle-cod

Bisacodyl is also used to empty the bowels of patients before surgery due to its short-term basis. Some brands of bisacodyl are Correctol, Bisacolax, Codulax, and Dulcolax. The patient is instructed not to drink with milk and suggested to take it at bedtime.

Cascara
Cash-mascara

Cascara is one of the OTC laxatives that is now used in supplements. It can cause liver injury if used in high doses for a long period of time.

SIDE EFFECTS
Diarrhea
Toilet

The most common side effect of stimulant laxatives is diarrhea. Unless indicated, it's suggested not to consume a stimulant laxative for more than a week. Other side effects may include abdominal cramps, burping, and nausea.

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