Modes of action

• Laxatives include i. antispasmodic agents such as anticholinergics (e.g. propantheline) and mebeverine (a phenylethylamine derivative of reserpine)

ii. non-absorbable disaccharides (e.g. lactulose) which soften the stool by an osmotic effect and by lactic acid production from a bacterial fermenting effect iii. irritants, such as castor oil, which is hydrolysed in the small intestine releasing ricinoleic acid

• Bulking agents are hydrophilic and thus increase the water content of the stool.

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