How does colace work in the body

The study found no difference in stool frequency, volume, or consistency between docusate and placebo. A number of systematic reviews have studied the literature on bowel regimens and have noted the paucity of high-quality data supporting the efficacy of docusate, despite its widespread use. Although docusate is considered a benign therapy, there is certainly potential for harm to the patient and detrimental effects on the healthcare system.

Patients commonly complain about the unpleasant taste and lingering aftertaste, which may lead to decreased oral intake and worsening nutritional status.

This process negatively impacts patient satisfaction and potentially increases healthcare costs if hospital length of stay is increased. Another important consideration is that patients may refuse truly necessary medications due to the excessive pill burden. Costs to the healthcare system are increased needlessly when medications that do not improve outcomes are prescribed. Additionally, every medication order creates an opportunity for medical error.

Lastly, bacteria were recently found contaminating the liquid formulation, which carries its own obvious implications if patients develop iatrogenic infections. Instead of using docusate, prescribe agents with established efficacy. In , a systematic review published in the American Journal of Gastroenterology graded the evidence behind different therapies for chronic constipation.

All other currently available agents that were reviewed had poor evidence to support their use. A more recent study in people prescribed opioids similarly found evidence to support the use of polyethylene glycol, lactulose, and sennosides. Their recommendations for laxative therapy are similar to those of the previously discussed reviews. Nonpharmacologic treatments include dietary modification, mobilization, chewing gum, and biofeedback.

If pharmacotherapy is required, use laxatives with the strongest evidence. Docusate is commonly used for the treatment and prevention of constipation in hospitalized patients, with significant associated costs. This common practice continues despite little evidence supporting its efficacy and many trials failing to show benefits over placebo. Decreased utilization of ineffective therapies such as docusate is recommended. Returning to the case presentation, the hospitalist should start the patient on alternative therapies, instead of docusate, such as polyethylene glycol, lactulose, psyllium, or sennosides, which have better evidence supporting their use.

Do you think this is a low-value practice? Ask a doctor or pharmacist if this medicine is safe to use if you have: stomach pain; nausea; vomiting; or a sudden change in bowel habits that lasts over 2 weeks. Do not give this medicine to a child without medical advice.

Side Effects. Stop using docusate and call your doctor at once if you have: rectal bleeding or irritation; or no bowel movement after 72 hours. Less serious side effects may be more likely, and you may have none at all. Avoid using mineral oil, unless told to do so by a doctor. Use exactly as directed on the label, or as prescribed by your doctor.

Drink plenty of liquids while you are using docusate. Do not take the rectal enema by mouth. Rectal medicine is for use only in the rectum. Wash your hands before and after using the enema. You should not use docusate for longer than 1 week, unless your doctor tells you to. Store at room temperature away from moisture and heat. Do not freeze liquid medicine.

What to Expect The liquid and capsule forms of docusate typically take about one to two days to work. Additional Dosage Information Your dosage will depend on the formulation of docusate you use and other factors. Follow the instructions on the label carefully. Psyllium was superior in its effect on stool frequency, stool water content, total stool output, and the combination of several objective measures of constipation.

Compared with baseline, psyllium increased stool water content by 2. Docusate does not appear to have any effect on stool water content or amount of stool. In a study of constipation treatment in patients receiving opioids, Dr. A total of 74 patients were randomized to receive docusate mg twice a day plus senna, or placebo plus senna. Once the study was started, inclusion criteria were broadened to include hospice patients with nonmalignant disease and patients who were not on opioids.

There were no significant between the groups in stool volume, frequency, consistency, or in perceived completeness of evacuation. In a randomized, controlled study of elderly patients on a medicine ward, 34 patients were randomized to docusate or control no laxatives J Chronic Dis.

There was no difference in frequency or quality of stools between groups. A systematic review of the usefulness of docusate in chronically ill patients concluded that the widespread use of docusate for the treatment of constipation in palliative-care patients is based on inadequate experimental evidence J Pain Symptom Manage.

Davendra Ramkumar and his colleagues published a systematic review of drug trials for the treatment of constipation in Am J Gastroenterol. Only polyethylene glycol and tegaserod received grade A evidence for published trials. Psyllium and lactulose received grade B evidence.