Sodium citrate/sodium lauryl sulfoacetate/glycerol

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Sodium citrate/sodium lauryl sulfoacetate/glycerol
Combination of
Sodium citrate Laxative
Sodium lauryl sulfoacetate Laxative
Glycerol Laxative
Clinical data
Trade names Microlax, Micolette Micro enema
AHFS/Drugs.com International Drug Names
ATC code
Identifiers
ChemSpider
  • none

Sodium citrate/sodium lauryl sulfoacetate/glycerol sold under the brandname Microlax and Micolette Micro enema, among others, is a small tube of liquid gel that is used to treat constipation. [1]

Contents

The main active ingredients are sodium lauryl sulfoacetate (0.90% w/v), sodium citrate (9.0% w/v) and glycerol. [2]

Medical uses

The main use is for treatment of constipation. In surgery it is used for pre-operative evacuation of the bowel. [3] In diagnostic testing it is used before x-ray examinations or physical examinations of the colon.

It is safe for use in children. [4] If used in children under 3 years, it is recommended that the nozzle is only inserted half way. [5] It is safe as a laxative during the postnatal period for woman [6] and while breastfeeding. [7]

Contraindications

Microlax (like any other saline laxative) should not be used in cases of intestinal inflammation. [8]

Mechanism of action

Sodium citrate saline is one of the most effective osmotic laxatives (secondary in action only to magnesium citrate). [8] Its laxative action is the result of osmotic imbalance that extracts bound water from stool and pulls it back into the large bowel. The increased water content softens the stool and stimulates the bowel to contract (move its contents to the rectum).

Sodium lauryl sulfoacetate improves the wetting and penetrating abilities of the solution, sorbitol enhances the water-releasing effect of sodium citrate and glycerol helps to lubricate the stool. The combined action helps to soften hard stools and relieve constipation without straining in a very short period of time ~ 15 min. [9]

The ingredients are not absorbed, distributed or metabolised by the human body; all of the composition is excreted in faeces. [9]

History

1960 - Microlax micro-enema was invented in Sweden by Paul Gunnar Embring from Uppsala and Per Ove Mattsson from Stockholm for Pharmacia company. [10] The original purpose of the invention was for clearing the colon and rectum for X-ray investigation "without any risk of the fluid balance of the body being disturbed". [10]

The first use of "Microlax" in commerce was registered on June 16, 1960. [11] In 1962, Microlax registered as the US trademark on February 20, 1962. [11]

In May 1963 first medical article on Microlax published in Danish medical journal Ugeskrift for Læger (Weekly Journal for Physicians). [12]

In 1964, Microenema containing sodium citrate, sodium laurylsulphoacetate and sorbitol was tested in preparation of the bowel for sigmoidoscopy. Results were published in the American Journal of Proctology. [13] In 1965 a comparative study of Microlax and enema published in Ugeskrift for Læger. [14] In 1967 – an article, published in The Medical Journal of Australia proved the results of 1964 US study and confirmed the efficiency of using Microlax as part of preparation for sigmoidoscopy. [15] In 1996 a study in the Journal of the Royal Society of Medicine suggestedmailing "Microlax" micro-enemas to patients who are scheduled for sigmoidoscopy. [16]

Related Research Articles

<span class="mw-page-title-main">Sorbitol</span> Chemical compound

Sorbitol, less commonly known as glucitol, is a sugar alcohol with a sweet taste which the human body metabolizes slowly. It can be obtained by reduction of glucose, which changes the converted aldehyde group (−CHO) to a primary alcohol group (−CH2OH). Most sorbitol is made from potato starch, but it is also found in nature, for example in apples, pears, peaches, and prunes. It is converted to fructose by sorbitol-6-phosphate 2-dehydrogenase. Sorbitol is an isomer of mannitol, another sugar alcohol; the two differ only in the orientation of the hydroxyl group on carbon 2. While similar, the two sugar alcohols have very different sources in nature, melting points, and uses.

<span class="mw-page-title-main">Enema</span> Injection of fluid into rectum, typically en route to the colon

An enema, also known as a clyster, is an injection of fluid into the lower bowel by way of the rectum. The word enema can also refer to the liquid injected, as well as to a device for administering such an injection.

<span class="mw-page-title-main">Constipation</span> Infrequent or difficult bowel movements

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

<span class="mw-page-title-main">Laxative</span> Agents that relax and loosen the bowels and stools

Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.

<span class="mw-page-title-main">Colonoscopy</span> Examination of the bowel

Colonoscopy or coloscopy is a medical procedure involving the endoscopic examination of the large bowel (colon) and the distal portion of the small bowel. This examination is performed using either a CCD camera or a fiber optic camera, which is mounted on a flexible tube and passed through the anus.

Encopresis is voluntary or involuntary passage of feces outside of toilet-trained contexts in children who are four years or older and after an organic cause has been excluded. Children with encopresis often leak stool into their undergarments.

ATC code A06Drugs for constipation is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products. Subgroup A06 is part of the anatomical group A Alimentary tract and metabolism.

Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three bowel movements per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during feces, without organic abnormalities. Many illnesses, including endocrine, metabolic, neurological, mental, and gastrointestinal obstructions, can cause constipation as a secondary symptom. When there is no such cause, functional constipation is diagnosed.

<span class="mw-page-title-main">Colorectal surgery</span> Field in medicine for disabilities in the rectum

Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular. The word proctology is derived from the Greek words πρωκτός proktos, meaning "anus" or "hindparts", and -λογία -logia, meaning "science" or "study".

<span class="mw-page-title-main">Fecal impaction</span> Solid buildup of feces in the rectum due to chronic constipation

A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation. Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives, enemas, and pulsed irrigation evacuation (PIE) as well as digital removal. It is not a condition that resolves without direct treatment.

Proctitis or anusitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum.

<span class="mw-page-title-main">Bisacodyl</span> Laxative

Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a colonoscopy.

<span class="mw-page-title-main">Sodium picosulfate</span> Chemical compound

Sodium picosulfate is a contact stimulant laxative used as a treatment for constipation or to prepare the large bowel before colonoscopy or surgery.

<span class="mw-page-title-main">Macrogol</span> Medication for constipation, classified as an osmotic laxative

Macrogol, also called polyethylene glycol (PEG), is used as a laxative to treat constipation in children and adults. It is taken by mouth. Benefits usually occur within three days. Generally it is only recommended for up to two weeks. It is also used as an excipient. It is also used to clear the bowels before a colonoscopy, when the onset of the laxative effect is more rapid, typically within an hour.

Bowel management is the process which a person with a bowel disability uses to manage fecal incontinence or constipation. People who have a medical condition which impairs control of their defecation use bowel management techniques to choose a predictable time and place to evacuate. A simple bowel management technique might include diet control and establishing a toilet routine. As a more involved practice a person might use an enema to relieve themselves. Without bowel management, the person might either suffer from the feeling of not getting relief, or they might soil themselves.

<span class="mw-page-title-main">Docusate</span> Laxatives/stool softeners

Docusate is the common chemical and pharmaceutical name of the anion bis(2-ethylhexyl) sulfosuccinate, also commonly called dioctyl sulfosuccinate (DOSS).

<span class="mw-page-title-main">Rectum</span> Final portion of the large intestine

The rectum is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. The adult human rectum is about 12 centimetres (4.7 in) long, and begins at the rectosigmoid junction at the level of the third sacral vertebra or the sacral promontory depending upon what definition is used. Its diameter is similar to that of the sigmoid colon at its commencement, but it is dilated near its termination, forming the rectal ampulla. It terminates at the level of the anorectal ring or the dentate line, again depending upon which definition is used. In humans, the rectum is followed by the anal canal, which is about 4 centimetres (1.6 in) long, before the gastrointestinal tract terminates at the anal verge. The word rectum comes from the Latin rēctumintestīnum, meaning straight intestine.

Transanal irrigation is medical procedure in which water is used to evacuate feces from the rectum and descending colon via the anus.

Sodium lauryl sulfoacetate (SLSA) or lathanol is an organic compound used in many cleaning and hygiene products as an anionic surfactant. Also it is used as in sodium citrate/sodium lauryl sulfoacetate/glycerol laxative products.

Constipation in children refers to the medical condition of constipation in children. It is a functional gastrointestinal disorder.

References

  1. ↑ Burke A (July 1994). "The management of constipation in end-stage disease". Australian Family Physician. 23 (7). Royal Australian College of General Practitioners: 1248–1253. PMID   8060271.
  2. ↑ "Summary of Product Characteristics PL 36301/0019: Micralax Micro-enema" (PDF). Medicines and Healthcare products Regulatory Agency. 2010-05-25. Archived from the original (PDF) on 2014-10-26. Retrieved 2014-10-26.
  3. ↑ Mann CV, Berthoud MC (2002). "Day Case Haemorrhoidectomy". In Mann CV (ed.). Surgical Treatment of Haemorrhoids. Springer Science & Business Media. p. 167. ISBN   1852334967 . Retrieved 2014-10-26. (Accessed at Google Books)
  4. ↑ Thomson K, Tey D, Marks M (2011). Paediatric Handbook (8th ed.). John Wiley & Sons. ISBN   978-1444359152 . Retrieved 2014-10-26. (Accessed at Google Books)
  5. ↑ Rutter P, Newby D (2011). "Osmotic laxatives". Community Pharmacy: Symptoms, Diagnosis and Treatment. Elsevier Health Sciences. p. 280. ISBN   978-0729580793 . Retrieved 2014-10-27. (Accessed at Google Books)
  6. ↑ "Women and Newborn Health Service Clinical Guidelines" (PDF). King Edward Memorial Hospital for Women. September 2014. Archived (PDF) from the original on 2014-11-29. Retrieved 2014-10-26.
  7. ↑ Jones W (2013). "The safety of drugs in breastmilk". Breastfeeding and Medication. Routledge. p. 128. ISBN   978-1136178153 . Retrieved 2014-10-26. (Accessed at Google Books)
  8. 1 2 Capasso FC, Gaginella TS (1997). "Natural Laxatives of Mineral Origin". Laxatives. Springer Science & Business Media. p. 59. ISBN   8847022274 . Retrieved 2014-10-27. (Accessed at Google Books)
  9. 1 2 "Microlax Rectal Solution: Summary of Product Characteristics, CRN 2100068" (PDF). Health Products Regulatory Authority (HPRA), Ireland. 2011-05-30. Archived (PDF) from the original on 2014-11-29. Retrieved 2014-11-08.
  10. 1 2 "US patent: 3211614 (A) ― 1965-10-12". Espacenet. Archived from the original on 2022-06-19. Retrieved 2014-10-26.
  11. 1 2 "Word mark: Microlax". United States Patent and Trademark Office. Archived from the original on 2014-10-26. Retrieved 2014-10-26.
  12. ↑ Ingomar CJ (May 1963). "[Microlax, a new drug for evacuation of the rectum]". Ugeskrift for Laeger. 125: 736–738. PMID   13956524. Archived from the original on 2014-12-18. Retrieved 2014-10-26.
  13. ↑ Lieberman W (April 1964). "Rapid patient preparation for sigmoidoscopy by microenema". American Journal of Proctology. 15: 138–141. PMID   14139893.
  14. ↑ Reimers J, Knoth M (September 1965). "[Preparation for recto-sigmoidoscopy. A comparative study of Microlax and enemata]". Ugeskrift for Laeger. 127 (35): 1082–1084. PMID   5829676.
  15. ↑ Hughes LE (July 1967). "The use of a micro-enema as preparation for sigmoidoscopy". The Medical Journal of Australia. 2 (5): 215–217. doi:10.5694/j.1326-5377.1967.tb97721.x. PMID   6057897. S2CID   29922247.
  16. ↑ Marsh SK, Huddy SP (November 1996). "Self-administered disposable micro-enemas before outpatient sigmoidoscopy". Journal of the Royal Society of Medicine. 89 (11): 616–617. doi:10.1177/014107689608901106. PMC   1295996 . PMID   9135589.
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