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Laxative

What are colonoscopy and flexible sigmoidoscopy?

Colonoscopy and flexible sigmoidoscopy are procedures that let your doctor look inside your rectum and colon (large intestine). They use instruments called scopes. Scopes have a light and a tiny camera attached to a long, thin tube. These procedures let your doctor see problems such as inflamed tissue, ulcers, polyps, and cancer.

Colonoscopy checks your entire colon and rectum. Flexible sigmoidoscopy checks the rectum and the lower colon (sigmoid colon) only.

What is a virtual colonoscopy?

A virtual colonoscopy also looks inside your rectum and part of your colon. But it does not use a scope. Instead, it is an x-ray test. Another name for this test is CT colonography.

Who needs a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?

You may need a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy to find the cause of unexplained symptoms such as:

  • Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
  • Changes in your bowel activity, such as diarrhea
  • Pain in your abdomen (belly)
  • Unexplained weight loss

Doctors also use these procedures to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you are at higher risk, you may need to start getting screened for colorectal cancer earlier.

There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.

How do you prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?

To prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy, you will need to:

  • Talk with your doctor about any health problems you have and all of the medicines and supplements that you take. You may need to stop taking some of your medicines and/or supplements before the procedure.
  • Follow the bowel prep instructions from your doctor. The bowel prep clears the stool out of your colon, so your doctor will be able to see the colon during the procedure:
    • You may need to follow a clear liquid diet, usually for about one day before the procedure. Avoid red or purple drinks or gelatin; the dye can look like blood in the colon. You probably need to stop eating and drinking the night before the exam.
    • You will need to take some laxatives. They may be pills, a powder that you dissolve in liquid, an enema, or a combination of these. The laxative will cause diarrhea, so you need to stay close to the bathroom.

For a virtual colonoscopy, you will also need to drink a contrast medium the night before. The contrast medium is a dye or other substance that is visible on x-rays. It can help your doctor tell the difference between stool and polyps.

How are colonoscopy, virtual colonoscopy, and flexible sigmoidoscopy done?

For a colonoscopy:

  • You will have the procedure at a hospital or outpatient center. It usually takes 30 to 60 minutes.
  • You will get IV (intravenous) sedatives or anesthesia, usually along with pain medicine, so you won't be awake or feel pain during the procedure.
  • You'll lie on a table while the doctor inserts a colonoscope through your anus and into your rectum and colon. The scope inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your colon.
  • Once the scope reaches the opening to your small intestine, the doctor will slowly remove the scope. While doing so, your doctor will examine your colon again.
  • If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
  • If you have abnormal tissue, your doctor may do a biopsy.
  • The sedative or anesthesia takes time to wear off completely. You'll stay at the hospital or outpatient center for 1 to 2 hours after the procedure. Then you will need someone to drive you home.

For a virtual colonoscopy:

  • You will have the procedure at a hospital or outpatient center. It usually takes about 10 to 15 minutes.
  • You do not need anesthesia.
  • You'll lie on a table while a specially trained x-ray technician inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view.
  • The table slides into a tunnel-shaped device where the technician takes the x-ray images. You will turn over on your side or stomach to get more images taken.

For a flexible sigmoidoscopy:

  • You will have the procedure at a hospital, medical office, or outpatient center. It usually takes about 20 minutes.
  • You do not need anesthesia.
  • You'll lie on a table while the doctor inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your lower colon.
  • Once the scope has reached the top of the lower colon, the doctor will slowly remove the scope. While doing so, your doctor will examine your lower colon again.
  • If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
  • If you have abnormal tissue, your doctor may do a biopsy.
What should I expect after a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy?

You may feel cramping in your abdomen or bloating during the first hour after the any of these procedures. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.

For a virtual colonoscopy or a flexible sigmoidoscopy, you go back to your regular activities and diet right after the test. For a colonoscopy, you can expect a full recovery and return to your normal diet by the next day.

Your doctor will give you the results of your procedure. If you had a biopsy, it can take a few days to get those results.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Laxative

AGAR
   A dried substance of mucilaginous character abstracted from several species of sea weeds (marine algae) growing along the coast of Asia. Most of... / ...moisture and swelling to a soft mass, and for this purpose is given in constipation as a mechanical laxative; rendering the best service when intestinal secretion is scanty, and in consequence, the fe...1

ALOEALOE
   ...lating purgative, probably affecting only the lower bowel, notably the rectum. In small doses it is laxative. It strongly increases colonic peristalsis, but does not greatly increase the secretions of...... doses for this purpose. Aloes, or its derivative, aloin, is usually an ingredient of many favorite laxative pills, composed of varying amounts of either drug in combination with belladonna, strychnin......t of these cases are profoundly constipated, the explanation of the combination may be found in the laxative action of the aloes. When hemorrhoids are due to feeble venous return, small doses of aloes...1

ARALIA HISPIDA
   The bark of the root of Aralia hispida, LinnĂ© (Nat. Ord. Araliaceae). A perennial undershrub of the eastern section of the United States. Dose, 1 to 30... / ...or renal irritation. Moreover, it often fails. It is, however, useful as a mild renal stimulant and laxative, and occasionally gives a good account of itself in the treatment of gravel. 1

BAPTISIA
   ...—A poisonous alkaloid baptitoxine (baptisine); two glucosides, baptisin, non-poisonous, and baptin, laxative and cathartic; and a yellowish resin. Baptitoxine is identical with cystisine, ulexine, and......ed by a general bodily discomfort or soreness. Profuse viscid ptyalism also occurs. Small doses are laxative; and the drug also appears to stimulate the intestinal glands to secrete more freely and pr...1

CARTHAMUS
   The florets of Carthamus tinctorius, LinnĂ© (Nat. Ord. Compositae). Egypt and the Mediterranean countries, but cultivated in Europe and the United States. Common Names:... / ...t colds; and to determine the eruption in scarlet fever and measles. It is somewhat diaphoretic and laxative, and is little used by physicians.1

CASCARA SAGRADA
   The dried bark of Rhamnus Purshiana, De Candolle (Nat. Ord. Rhamnaceae). A shrub of Northern Idaho and the Pacific coast. Dose, 5 to 30... / ...aromatic fluidextract is a pleasant preparation and has less of a tendency to cause griping. A good laxative is the following: Rx Specific Medicine Cascara (or the Fluidextract of Cascara), 2 fluidoun...1

CONVALLARIACONVA
   The rhizome and rootlets of Convallaria majalis, LinnĂ© (Nat. Ord. Liliaceae.) Common Name: Lily of the Valley. Principal Constituents.—Two... / ...hat drug. Unlike digitalis it is not cumulative, nor is it distinctly poisonous. Moreover, it has a laxative action, and like digitalis, increases diuresis secondarily, by its effects upon blood press... / ...carditis and endocarditis, using it in fractional doses. Convallaria is of less service in stenosis of the aorta than in mitral disorders.1

EUONYMUS
   The bark of the root of Euonymus atropurpureus, Jacquin (Nat. Ord. Celastraceae.). A small shrub or bush of the United States. Dose, 5 to 60... / ...etite, improves digestion, stimulates the hepatic function, and increases nutrition. It has decided laxative properties and is to some extent antiperiodic. Locke declared it one of the few good stomac... / ...value it in so-called chronic ague, and in the constipation and gastric debility associated with or following it. Euonymus is a neglected bitter.1

FARINA TRITICI
   The sifted flour of the grain of Triticum sativum, Lamarck (Nat. Ord. Graminaceae). Common Names: Wheat Flour, Common Flour. Principal Constituents.—Starch,... / ...ing by iodine. Bran, mixed with stewed fruits or baked in a biscuit or cake, is a common mechanical laxative for habitual constipation, often proving more effective than medicines.1

GLYCERINUM
   Glycerin, Glycerol. A liquid composed most largely of a trihydric alcohol (C3H5(OH)3) obtained by the processes of hydrolysis and distillation of... / ...e still in doubt, many contending that it reduces the sugar when in excess in the body. Glycerin is laxative and in very large amounts acts not unlike alcohol, producing a similar intoxication and lik... / ...A 5 per cent solution of phenol in glycerin upon cotton may be used for insertion into the aural canal after rupture of the membrana tympani wh1

GLYCYRRHIZA
   The dried rhizome and roots of Glycyrrhiza glabra typica, Regel et Herder (Spanish Licorice), or of Glycyrrhiza glabra glandulifera, Regel et... / ...and combined with ammonia. Dose, 1 to 8 grains. Action and Therapy.—Glycyrrhiza root is demulcent, laxative, and expectorant. It acts upon mucous surfaces, lessening irritation and relieving coughs, ... / ...and sodium salicylate are more or less masked by the fluidextract. Licorice root is an ingredient of Compound Licorice Powder. (See Senna).1

GUAIACUM
   The resin of the wood of Guaiacum officinale, LinnĂ©, or of Guaiacum sanctum, LinnĂ© (Nat. Ord. Zygophyllaceae). West Indian trees. Dose, 5 to 30... / ...t day. It was also much used in rheumatism, in which it has a better claim to efficiency. Guaiac is laxative, expectorant, and diaphoretic. When it fails to act upon the skin it usually stimulates the... / ...a fourfold dilution of specific medicine, mixed with syrup and water. Stronger preparations than this diluted tincture precipitate heavily.1

HYOSCYAMUS
   ...n griping and tormina. Moreover, it does not restrain secretion and is likely to prove more or less laxative. Great care must be observed, however, in the use of hyoscine and hyoscyamine. The former, ......nausea, and headache induced by it. Hyoscyamus does not, like opium, restrain secretion, and proves laxative rather than constipating. Hyoscyamus is a safer drug for old persons and children than bell...1

JUGLANS CINEREA
   ...ging freely; eczema. Action and Therapy.—In small doses juglans is a mild intestinal stimulant and laxative; in large doses it is emeto-cathartic. It also possesses alterative properties. As a laxati......These conditions are often accompanied by a burning and tenesmic diarrheal or dysenteric discharge. Laxative doses of juglans relieve the latter annoyances. A full laxative dose of extract of butternu......inal secretion. Small doses of the specific medicine (1 to 5 drops) are best for this purpose. As a laxative the extract is preferable, in doses of 1 to 5 grains; sometimes up to 30 grains.1

LEPTANDRA (Veronicastrum virginicum)VEVI4
   ...ortion. Drying, however, deprives the drug of its drastic quality and it becomes a safe cholagogue, laxative, and cathartic. Apparently in ordinary doses it strengthens the functional activity of the ......efore marked involvement of PeyerÂ’s patches had become established. It is questionable whether any laxative should be resorted to in such conditions—an enema is to be preferred. But for pre-typhoid ......ot amounting to enteric fever, its use is justifiable and even beneficial. Leptandra is better as a laxative in malarial fever and prepares the system for the more kindly reception of antiperiodic med...1


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Materia Medica on Laxative

ALOES
   The inspissated juice of leaves of different species of ALOE. Laxa tive or cathartic according to the dose. It acts especially on the lower bowel, and is particularly serviceable in chronic constipation. Dose as a laxative 0.06 to 0.3 Grm. (1 to 5 grs.).2

ALOIN
   The active principle of Aloes, preferable to the crude drug be cause nearly free from odor and much less disagreeable in taste. Dose as a laxative, 0.015 to 0.03 Grm. (% to % .gr.); as a cathartic, 0.06 to 0.13 Grm. (1 to 2 grs.).2

BARBARY BARK
   Bark of stem and root of BERBERIs VULGARIs, Lin. Tonic, stomachic, cholagogue, laxative, antiperiodic. Prescribed in atonic dyspepsia, in torpor of the liver and in enlargement of the spleen.2

BELLADONNAATROP
   The leaves, also the root of ATROPA BELLADONNA, Lin. My driatic, a deliriant narcotic, analgesic, antispasmodic. Suppresses secretion of skin and mucous membranes; antagonistic to Morphine. Externally applied to relieve pain, to restrain secretion of milk and for its effect on the eye. Internally used in night sweats and incon tinence of urine, in febrile conditions, as an adjuvant with laxatives, etc. Dose, 0.03 to 0.13 Grm. (% to 2 grs. )or more. [The derivative alkaloids of Belladonnl-1, Atro2

BITTER-ROOT
   The root of APOCYNUM ANDROsAEMIFOLIUM, Lin. Emetic and cathartic in full doses; in smaller doses, diaphoretic, tonic, laxative and hepatic stimulant. Used especially in dyspepsia with constipa tion and in headache with torpor of the bowels.2

BONESET (Eupatorium)TAMAU2
   The leaves and flowering tops of EUPATORIU M PERFOLIATUM, Lin. Tonic, diaphoretic, febrifuge. in large doses laxative and nauseant or emetic. The remedy deserves more attention than it has received, its range of use being essentially the same as that of Matricaria.2

BROOM (Scoparlus)CYTIS
   The tops of CvTIsUs ScormuUs, (L.) Link. Diuretic, laxative. in large doses emeto-cathartic. A valuable remedy in dropsies of cardiac origin and in palpitation of the heart due to weakness of the muscular structure or to valvular disease. Active constituent Spar teine, q. v.2

BUCKTHORN BARK (Frangula)
   The bark of RHAMNUs FRANGULA, Lin. A mild laxative, es pecially suitable for children and for persons subject to hemorrhoids. Practically superseded by Cascara Sagrada, q. v.2

BUTTERNUT (Juglans)JUCI
   The bark of the root of JUGLANs CINEREA. Lin. Tonic laxative or mild cathartic. Used especially in chronic constipation.2*Slight

BUTTON-BUSH
   The bark of CEPHALANTHUS OCCIDENTALIS, Lin. Bitter tonic. laxative, antiperiodic.2


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Therapeutics Memoranda on Laxative

BRONCHITIS
   In the incipient stage, quinine with a little Dover powder and a laxative may ward off the attack. If inflammatory action is estab lished,... / In the incipient stage, quinine with a little Dover powder and a laxative may ward off the attack. If inflammatory action is estab lished, active diaphoretics (the hot foot bath, hot lemonade witliwa little whiskey,... / ...inhalation is very eflicient. When there is hypersecretion, avoid ammonium chloride and use belladonna, strychnine and counter-irritation.2

CONSTIPATION
   Medicate no more than is necessary. Prescribe regular open... / ...cise, regularity in going to stool; correct the diet; advise a large glass of Apolinaris before breakfast; if necessary prescribe general tonics. The laxatives best suited for habitual use are; 1, glycerin sup positories, when there is simply inertia of the rectum; 2, senna (particularly a cold infu... / ...of sodium phosphate.2

GASTRIC CATARRH
   At first withhold all food, later give milk and lime water. Cleanse stomach of irritating matters by lavage with warm water, washing out finally with... / ... and gastric antiseptics as needed; silver nitrate combined with ext. henbane. Let the diet be simple, and regulate the bowels by use of non-irritant laxatives. Tonics are almost always indicated.2

NEURALGIA
   For immediate relief, prescribe acetanilid, phenacetin or anti pyrin usually conjoined with caffeine and potassium or sodium... / ... strychnine, arsenic and iron are the most generally useful remedies, but attention must always be given to the general condition of the patient, and laxatives, antimalarial remedies or nerve tonics, like phosphorus, prescribed accordingly.2


References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.