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Lassativi: nessuna controindicazione per i farmaci a base di frutto-oligosaccaridi, galattani, fibra di bamboo. Controindicati: olio di ricino, olio di semi di lino, i bicarbonati, senna, macrogol e hispagula (33).
Lattulosio: Il lattulosio è un disaccaride sintetico scarsamente assorbibile perché non esiste nell’intestino tenue un enzima capace di idrolizzarlo e quindi raggiunge immodificato il colon dove viene scisso in acido lattico ad opera della flora intestinale saccarolitica. L’acido lattico favorisce la peristalsi intestinale, l’assorbimento intestinale dell’ammoniaca (NH3) che viene trasformata in (NH4+) ione ammonio non assorbibile e inoltre l’ac.lattico favorisce la crescita dei Lactobacilli e dei Bifidobatteri a scapito dei batteri “coliformi” putrefattivi quali il clostridium e l’Escherichi Coli. Gli effetti biochimici esplicati dal lattulosio concorrono a favorire l’aumento della motilità intestinale e la conseguente formazione di feci soffici e voluminose con tendenza alla normalizzazione delle funzioni escretorie. In gravidanza e allattamento si può assumere alle dosi indicate e solo in caso di necessità non essendoci studi di certezza sulla sua assoluta innocuità.
Olio di ricino: assolutamente controindicato in gravidanza perché può indurre l’insorgenza di contrazioni uterine, parto prematuro, aborto, morte fetale intrauterina. Altrettanto controindicati la senna, e l’olio di semi di lino perché agiscono prevalentemente stimolando i plessi mioenterici e con lo stesso meccanismo possono stimolare i centri delle contrazioni miometriali.
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