Nutrition Interventions for Children with Special Health Care Needs

Table 6-1: Laxatives
Instructions on packages should be followed. Contact physician if age-appropriate instructions are not available. Encourage families to report additions or changes in routines
and medications so this information may be considered in prescribing medications and monitoring progress.
Brand/Common
Name
Action Comments
Site of
Action
Onset of
Action (hours)
Laxative Type
small
0.5-3
• May alter fluid and electrolyte
and Attracts/retains water in
balance
Epsom salts
large intestinal lumen, increasing
• Sulfate salts are considered the Milk of magnesia
intestine intraluminal pressure;
most potent
• May decrease tetracycline
cholecystokinin release
0.03-0.25 colon absorption
Fleets enema ®
Saline
Magnesium Sulfate
Magnesium Hydroxide
Magnesium Citrate
Sodium Phosphate
Sodium Phosphate/
Biphosphate enema
Section 2 - Problem-Based Nutrition Interventions
Cascara
Senokot ®
Ex-Lax ®
Dulcolax ®
Fletcher’s Castoria ®
• Cascara and senna may cause
yellow-brown urine; alkaline urine
may turn pink-red or red-violet
• Bile must be present for
phenolphthalein to have effect
• Do not give Biscodyl tablets within
1 hour of antacids or milk products
• May prefer castor oil when complete
evacuation is required
6-10
Direct action on intestinal
mucosa; stimulates
myenteric plexus; alters
water and electrolyte
colon
Irritant/Stimulant
Cascara
Danthron
Senna
Phenolphthalein
Casanthranol
Nutrition Interventions for Children With Special Health Care Needs 75
Bisacodyl Tablets 0.25-1
2-6
Bisacodyl Suppository
Castor Oil
Safest and most physiological
Citrucel®
Hydrocil®
Metamucil®
Chronulac®
Malt supex®
Do not give with salicylates, digitalis,
or cardiac glycosides
Holds water in stool;
mechanical distention;
malt soup extract reduces
fecal pH.
small
and
large
intestine
12-24 (up to 72
hr)
Bulk-Producing
Methylcellulose
Psyllium
Polycarbophil
May cause obstruction if passage is
stopped
Not for infants less than 1 year of age
or children with history of aspiration.
Mineral oil
Lubricates intestine;
retards colonic absorption
of fecal water; softens
stool
6-8 colon
Administer on empty stomach
Lubricant
Mineral oil (1-2 tsp/
day)
Oil enema (1-4 oz)
Colace®
Doss®
Beneficial when feces are hard or
dry, or in anorectal conditions where
passage of a firm stool is painful
Detergent activity;
facilitates admixture of fat
and water to soften stool.
small
and
large
intestine
24-72
Surfactants
Docusate sodium (do
not use if mineral oil
given)