What to do before visiting a proctologist and what to expect from a doctor

Pharmacology

The drug is a laxative. Intended for rectal use. The composition contains several active components that enhance each other’s effect on the human body, helping to soften stool and facilitate the process of defecation.

Sorbitol helps increase the amount of fluid entering the intestinal lumen, which increases the volume of stool and softens it. As a result, the process of defecation is greatly facilitated.

Sodium citrate helps displace fluid from stool.

As a result, water is displaced from the stool and the amount of fluid entering the intestines increases, which significantly facilitates the process of defecation in people who suffer from hemorrhoids and constipation.

The effect of the drug is observed within 5-10 minutes from the moment of using the microenema. But the effect of the drug may depend on the patient’s personal characteristics.

Information on pharmacodynamics is not available.

Microlax

Microlax ®

(English Microlax ®) - a laxative, a one-time enema. It is used for constipation, and in preparing the intestines for instrumental studies, such as colonoscopy, anorectal and colonic manometry, X-ray or ultrasound examination of the abdominal cavity and others.

Dosage form and composition of Microlax

Dosage form and composition of Microlax is a solution for rectal administration, sold in pharmacies in the form of tubes, which are microenemas containing 5 ml of the drug solution. Active ingredients of Microlax:

• sodium citrate (90 mg in 1 ml solution)
• sodium lauryl sulfoacetate 70% – 12.9 mg (corresponds to 9 mg sodium lauryl sulfoacetate)
• sorbitol solution 70% – 893 mg (corresponds to 625 mg of sorbitol).

Excipients: glycerol, sorbic acid, aq.

How to use Microlax

Having broken off the seal on the tip, you need to lightly squeeze out a little Microlax solution in order to lubricate the inserted end of the tube. After this, the tip of the Microlax tube is inserted into the patient's anus. For children under three years of age, half the length of the tip is inserted; for all others, the entire length is inserted. After which, by pressing the tube, its contents are injected into the rectum. The pressure on the tube stops only after removing its tip from the patient's anus.

Microlax in pediatrics

The components that make up the drug Microlax have the following effect (Gorelov A.V., Shevtsova G.V.):

• sodium citrate is a peptizing agent that displaces bound water contained in feces
• sodium lauryl sulfoacetate dilutes the intestinal contents.
• sorbitol solution enhances the laxative effect by stimulating the flow of water into the intestinal lumen
• sorbic acid is a preservative
• glycerol - thickener

Thus, an increase in the amount of water due to peptization and liquefaction helps soften the stool and facilitate bowel movements.
Microlax can be used in patients with chronic constipation, including those complicated by encopresis, in preparation for endoscopic (rectoscopy) and x-ray examination of the gastrointestinal tract. Microlax is approved for use in children, starting from the first days of life, as well as in pregnant and nursing mothers. The laxative effect usually occurs within 5-15 minutes. Long-term use of the drug is possible. Microlax is available in a micro-enema (a polyethylene tube with a tip and a break-off seal) for single use. For children over 3 years old, the tip is inserted into the rectum along its entire length and the contents of one microenema are squeezed out completely (5 ml). For newborns and children under 3 years of age, the tip is inserted halfway. The duration of use of Microlax and the treatment regimen are determined by the doctor.

By causing softening of stool and making defecation easier, Microlax makes it less painful, which is especially important for children. The child should get used to regular bowel movements and not avoid bowel movements due to unpleasant sensations that force him to hold stool. The absence of fear of using the potty allows for faster development of the reflex to defecation and social adaptation of the child.

The following qualities of Microlax allow it to be used in pediatric practice (Gorelov A.V., Shevtsova G.V.):

• Possibility of use even in newborns
• individual, disposable microenema
• ease and hygiene of drug administration
• a small volume of solution injected into the rectum, which allows you to hold it freely
• rapid onset of effect
• almost complete absence of contraindications (except for individual sensitivity to the components of the drug)

general information

Defecation occurs 5–15 minutes after administration of the drug.
There are no restrictions on the use of Microlax by pregnant and nursing mothers. According to the pharmacological index, Microlax belongs to the group “Laxatives in combinations”. According to ATC, Microlax belonged to the section “A06 Laxatives” and has the code “A06AG11 Lauryl sulfate, including in combination with other drugs.”

Firms -, Sweden, McNeil AB, Sweden, Famar Orleans, France (Johnson & Johnson).

Professional medical publications addressing the use of Microlax

• Gorelov A.V., Shevtsova G.V. Chronic constipation in children // Issues of practical medicine. – 2014. – T. 9. – No. 6. – P. 46-53.

On the website gastroscan.ru in the literature catalog there are sections “Laxatives” and “Constipation and Diarrhea”, containing professional medical articles relating to laxatives and their use for constipation.
Microlax has contraindications, side effects and application features; consultation with a specialist is necessary.

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How to use Microlax

The medicine is used rectally. Before giving an enema, you need to wash your hands well and thoroughly clean the area around the anus. The seal must be broken off immediately before insertion. After removing the seal, you need to press on the tube so that the solution comes out. After this, the tip is inserted into the anus and the entire contents of the tube are squeezed out. You need to take out the enema with the walls of the tube compressed.

From the age of 3, the tip must be inserted completely. For younger children, half will be enough. One enema will be enough for a one-time dose.

The frequency of use and dosage can only be determined by a specialist, taking into account the individual characteristics of the patient.

Many people wonder about the emergence of addiction. Doctors say that you should not take the medicine for a long time. If a person has chronic constipation, then it is worth making an appointment with a doctor to undergo an examination and prescribe further treatment.

It is not recommended to take the medicine in parallel with alcoholic beverages.

Reviews about the drug are in most cases positive. In 95% of cases, the treatment takes place without any adverse reactions or discomfort. Parents note that Microlax has a much better and more effective effect on young children than other medications.

Benefits of an enema

Laxatives intended for oral use begin to act after at least 4-5 hours. In contrast, rectal placement of Microlax leads to defecation almost immediately, which accordingly quickly improves well-being and allows you to eliminate discomfort in the shortest possible time. But this is not the only advantage of Microlax. Other advantages of the drug include:

• no toxic effects on internal organs;
• the possibility of using microenemas in any trimester of pregnancy;
• no age restrictions - the drug is suitable for eliminating constipation in infants and young children;
• a small number of contraindications;
• Convenience of administering an enema - a thin and semi-rigid applicator allows you to insert it into the anus correctly and quickly

Microlax is not addictive and can be used periodically for occasional constipation. Short courses of daily use of the drug are also permitted, but it must be borne in mind that in order to fully restore intestinal function, it may be necessary to take other medications.

Microlax is also convenient because each container contains a single dose, so there is no need to determine the amount of the drug.

Microlax does not interact with systemic medications. This is due to the fact that the components of the drug act only at the intestinal level and do not enter the blood. When using other drugs intended for rectal administration at the same time, you must wait until you have emptied before administering them. All components of Microlax are excreted along with the feces. After which you can safely insert suppositories with anti-inflammatory, regenerating or analgesic properties.

Analogs

To date, no drugs have been developed that could be classified as analogues of the active component. But there are analogues that are similar in the principle of influence and the list of indications for use. These products include glycerin suppositories, which can be given to adults and children from infancy. The cost of many analogues is lower.

Analogs based on the principle of action also include Glycerin and Norgalax. These drugs also have a laxative effect and are used rectally. Glycerin is also available in solution form for topical and external use.

Contraindications and adverse reactions

An absolute contraindication to administering Microlax microenemas is hypersensitivity to one or more components of the drug. Proctologists do not recommend using any laxatives for:

• intestinal obstruction;
• rectal bleeding;
• dehydration.

Caution when using the drug should be exercised by persons on a sodium-restricted diet and with severe kidney and heart disease. Intestinal obstruction is indicated by the absence of stool and gas for several days, severe cramping pain in the lower abdomen, weakness, sweating, drop in blood pressure, and vomiting.

Adverse reactions during an enema rarely develop. Most often, patients note a burning sensation in the rectal area. In rare cases, rashes appear on the skin around the anus and irritation occurs.

The burning sensation does not require discontinuation of the drug; it completely disappears after the intestinal contents are released. If other adverse reactions are noted, you should stop using Microlax further. To reduce the intensity of symptoms, you need to rinse the anus with warm water, dry it and lubricate it with an ointment with regenerating or antihistamine properties.

Analogues and substitutes

There are no analogues of Microlax that are completely identical in composition. When choosing substitutes, preference is given to those products that help quickly solve the problem, this mainly applies to rectal suppositories. Instead of Microlax, you can use suppositories:

• Glycerin;
• Glycelax;
• Bisacodyl;
• Sea buckthorn.

Glycelax and glycerin suppositories are suitable for relieving constipation in infants. Starting from three months.

Microclysters-substitutes for Microlax

Not all of the microclyster analogues listed above can be used to relieve constipation in children. Therefore, before purchasing them, you need to carefully study the indications and contraindications for the chosen product.

How to properly administer microenemas to adults and children?

The drug Microlax® is used rectally (inside the rectum), in the form of microenemas. It is available in convenient tubes - each containing 5 ml of solution - the optimal dose to cope with constipation.

The tip of the tube is also very convenient. It is of such a length that it can be completely inserted into the rectum of an adult or a child over 3 years old, as a result, the medicine will get to the right place and immediately begin to act.

For children under 3 years of age, the tip is inserted halfway. For convenience, there is a special mark on it.

What to expect from your first consultation with a proctologist

The first appointment is a consultation and visual examination. The doctor collects anamnesis and reads the medical documentation. The examination can be carried out on a couch or in a special chair. The doctor may perform a digital examination of the rectum. It can be performed after anesthesia with ointment or gel, but this is only required in 5% of cases, because all manipulations are absolutely painless. During a digital examination, the condition of the skin in the anal area, mucous membrane, sphincter contractility, and whether there are hemorrhoids or other neoplasms are assessed.

The specialist begins the appointment with a conversation, studying the medical history and tests (if available). But the matter is not limited to conversations alone - the doctor conducts a visual examination of the perineum and anus, as well as a digital examination. If necessary, anoscopy and sigmoidoscopy are performed, for which special devices are used.

In order for the doctor to get a true picture of what is happening to the body, the patient needs to prepare in advance.

Kolosovsky Yaroslav Viktorovich

surgeon, mammologist, oncologist, phlebologist

A timely visit to a proctologist is incredibly important for the patient, since in many cases contacting a doctor immediately after the onset of symptoms allows you to save life and health. Many diseases of the rectum are very dangerous. About 33% of all outpatients are treated for hemorrhoids, which are often complicated by bleeding. 5% of patients are diagnosed with colorectal cancer during an appointment with a proctologist, and the earlier it is detected, the greater the chance of successfully curing the pathology.

Proctological diseases are becoming more common today due to physical inactivity, a sedentary lifestyle and poor nutrition. Impaired defecation, pain in the projection of the rectum, discharge from the anus - all these symptoms are reasons to consult a doctor as soon as possible, because any disease is easier to treat at an early stage, and the prognosis for it becomes much better.

Recommended diet before visiting a proctologist

The day before a visit to the doctor, exclude fatty, fried, heavy fish and meat dishes, and mushrooms from the diet. It is advisable to eat vegetable soups, cereals, white meat chicken or turkey, a lot of vegetables and fruits, which stimulate peristalsis as they contain a lot of fiber.

You should not eat foods that cause gas formation in the intestines and flatulence: legumes, potatoes, cabbage, carbonated drinks, black and whole grain bread. It is necessary to completely eliminate alcohol, because it has a bad effect on the condition of the gastrointestinal tract.

On the day of your appointment, you should not eat for several hours before the proctological examination. If you go to the doctor in the first half of the day, it is better not to eat in the evening. If the reception is late in the evening, a light breakfast is allowed. You can drink water, fruit juices without sugar and pulp until your appointment.

If the reception takes place in the first half of the day, then there is no need to have breakfast. If in the second case and the patient cannot remain without food for a long time, then you can allow yourself a light breakfast of foods that do not cause gas formation.

It is recommended to take slippers, a diaper and toilet paper with you.

Reviews from doctors about the procedure

Performing a cleansing enema is what doctors advise for long-term constipation. Of course, you will have to spend a little time figuring out how to give an enema yourself, but the result will be worth it.

Vladimir Pavlovich Kiriyenko, proctologist: “Timely lavage of the intestines quickly improves the condition of patients - there is no point in dragging on to the point of fainting. In addition, when performing manipulations at home, either independently or with the help of calling a doctor, patients do not experience such embarrassment as in the hospital.”

Doctors remind us of the importance of consulting with a professional: the patient does not always know that he has contraindications to the procedure.

According to surgeon A. Markovskaya: “The main obstacle to independent intestinal lavage is ignorance of the optimal volume and temperature of the administered fluid. It is very easy to harm yourself, so avoid self-medication as much as possible. Moreover, nowadays it is very easy to call a specialist to your home.”