Word to the pharmacist
Constipation... How much is in this word... We will not specify WHAT exactly there is a lot in the body with this problem, but rather discuss a situation when you need not just to get rid of ballast, but to bring your own intestines to the most sterile state for carrying out proctological examinations, intestinal x-rays or before surgery.
Two products are suitable for this purpose: Lavacol and Fortrans. This is the same case when the drugs seem to be the same, but at the same time slightly different. The principle of their operation is reminiscent of a well-known advertisement in which a housewife is trying to get rid of a blockage in a sewer pipe. A little magic remedy and voila! The garbage is gone! It’s about the same with cleansing the intestines: a little effort and possible embarrassment are not scary for you.
Reviews from doctors
For the drug Fortrans, reviews from doctors recognize only its function as cleansing the intestines. Doctors evaluate the drug using different criteria than the people taking it. So patients’ impressions of Fortrans are their very subjective opinions.
The effectiveness of Fortrans from the point of view of medical specialists lies in its ability to cleanse the intestines, so that nothing interferes with various manipulations (therapeutic or diagnostic) and only one intestine remains, like a hollow tube. Based on these parameters, Fortrans has excellent efficiency and cleanses the intestines almost perfectly. As a result, the best conditions are created for medical procedures. Therefore, doctors speak positively about the drug.
Fortrans: how does it work?
The drug belongs to the group of osmotic laxatives that can effectively retain fluid in the intestines. In this case, there is a significant increase in the volume of feces and their rapid removal to the outside. The active component is macrogol 4000. The composition also includes a variety of auxiliary elements.
Fortrans can only be used by adults. The powder in the bag should be dissolved in 1 liter of water. For every 15 - 20 kilograms of weight you need to drink 1 liter of the resulting solution. Thus, the average person weighing about 60 kilograms should drink approximately 3 liters of fluid. The first glass is drunk within 10 minutes, the remaining solution - within the first hour. The entire dosage can be divided into two doses, but the last portion is taken 4 hours before the scheduled procedure.
Probably the main difficulty lies in the amount of liquid that needs to be drunk, because it is not so easy to forcefully enjoy 3–4 liters of a solution that has a specific taste. In addition, taking it may be accompanied by side symptoms, usually in the form of allergic reactions, swelling, the appearance of rashes on the skin, abdominal pain, and vomiting.
There is also a list of contraindications that it is better to know about in advance. This is the presence of intestinal obstruction, intestinal tumors, damage to the mucous membrane (for example, with ulcerative lesions), an allergy to polyethylene glycol, children under 15 years of age and the general serious condition of the patient. For these conditions, Fortrans is contraindicated! During the lactation period and during pregnancy, the benefit-risk ratio is carefully assessed.
Price and analogues of fortrans
The cost of the drug is about 600 rubles per package with 4 packets. But there are cheaper alternatives. Synonyms for Fortrans are other medications with macrogol as the main active ingredient. These are Lavacol and Forlax. All are sold as water-soluble powders for oral administration.
Analogues are medications that are similar in principle of operation, but contain a different active substance. In the form of syrup you can buy Lactulose, Normaze, Protalc, Goodluck. Lactulose promotes the proliferation of bacteria that normalize the activity of the large and small intestines, as well as other organs involved in digestion. Due to its mild effect it is suitable for long-term and regular use.
Lavacol is a Russian analogue of Fortrans. Its advantage is the price of about 200 rubles, as well as a less unpleasant taste. You can also highlight Forlax as a medicine that is well suited for children.
Lavacol: cheap and cheerful?
It makes no sense to explain the principle of action and side symptoms: everything is the same as in Fortrans. And the active component is also macrogol. However, the method of application is different. Lavacol is released in powder form, which should be dissolved in 200 ml of pre-boiled and cooled water, 15 powders in total. The solution is drunk on an empty stomach, 1 glass every 20 minutes, reaching a total volume of 3 liters so that the first dose is taken 18-20 hours before the upcoming procedure. After consuming Lavacol, according to the instructions, it is possible to “take only liquid food.”
Contraindications for Lavacol are somewhat broader than for Fortrans. To the above conditions one must add severe dehydration, toxic dilatation of the intestine, renal dysfunction, and acute abdominal pain.
Incredible but true: both drugs can cause diarrhea in overdose. For me personally, this fact has always been surprising. Agree, it’s strange: a laxative causes diarrhea. It's like the warning on a bag of peanuts: be careful, there are nuts inside! Well, who would have thought?
Description of the drug
The main substance of the drug Fortrans is macrogol 4000. It is this that provides the laxative effect.
The powder contains:
- Sodium chloride.
- Sodium saccharinate.
- Sodium bicarbonate.
- Potassium chloride.
- Sodium sulfate anhydrous.
The auxiliary components included in the laxative are necessary to maintain normal salt and alkaline balance in the body, and are also responsible for the sweetish taste of the drug. If you take a product called Macrogol 4000 separately, this can lead to dehydration. However, the use of Fortrans is also possible only with the permission of a doctor.
The drug is produced in powder form. It is necessary to prepare a solution from it, which is taken orally. The powder is white in color and easily dissolves in water. It is packaged in paper bags. There are 4 of them in each package.
Recommendation:
“Fortrans has a specific taste that many people find unpleasant. Even passionflower extract, which is part of the powder, is not able to radically change it. In order not to provoke vomiting, you need to take the medicine with juice squeezed from citrus fruits (orange, grapefruit or lemon).”
What's the difference?
- Price. A package of Fortrans can be purchased at pharmacies for about 580 rubles ($7). A similar package of Lavacol costs 180 rubles ($2.5);
- Taste. Fortrans has a somewhat oily, sugary taste. Some patients vomit after consuming it. There are recommendations to add a little lemon juice to the solution, but there is no information about this in the instructions. Lavacol has a salty taste, similar to a weak solution of salt with a little sugar. Some people compare it to ordinary mineral water. What is best is up to the patient to decide. Everyone's taste preferences are different;
- Manufacturer. Fortrans is an imported drug. It is produced in France. Lavacol is manufactured in Moscow;
- Application. The volume drunk is almost the same. With strong thirst, 3 liters can go unnoticed, but in the absence of it you will have to try;
- Result. In fact, the result is the same: a calm patient, confident in his own cleanliness and a satisfied doctor, calmly examining the intestines, and not... however, it doesn’t matter. It is impossible to surprise a proctologist with anything, and concern for health should come first, and not high morality that is completely inappropriate in this case.
Reviews from patients are extremely contradictory. Some people are absolutely and completely satisfied with Fortrans, while others prefer Lavacol, which is similar to it. This can only be explained by different criteria for selecting the drug and individual characteristics, as well as personal experience, because quite often proctological examinations, for example, X-rays of the intestines or colonoscopy, have to be repeated periodically. Therefore, when purchasing Lavacol or Fortrans, answer the question “Which is better?” is possible only by studying them, so to speak, “in your own intestines.”
Mechanism of action of fortrans
The powder dissolves quickly in water and does not cause electrolyte imbalance, so taking it does not lead to dehydration of the body. The drug acts in the small and large intestines and does not have a toxic effect on the body.
Fortrans has a laxative effect, increasing osmotic pressure in the intestines and retaining water in it. This promotes the dissolution of food masses, swelling of the intestinal contents and increased peristalsis. As a result, emptying occurs.
A distinctive feature of the drug is that it cleanses not only the large but also the small intestine of a person. In this case, excess fluid is not removed from the body and dehydration does not develop. Fortrans does not penetrate the systemic bloodstream, is not absorbed in the intestines, and is excreted unchanged from the body.
The effect occurs 1-1.5 hours after administration. It lasts for 2-5 hours.
If after 3 hours there is no bowel movement, then you need to massage your stomach or increase physical activity.
Fortrans should not be taken frequently; it is used for one-time bowel cleansing and is not prescribed for the treatment of constipation.
Acts of defecation occur several times, which can be achieved by taking the drug in portions. Cleaning is gentle and safe for the body. As a rule, the restoration of normal bowel movements, after stopping the use of Fortrans, occurs in the patient quite quickly.
Doctor's opinion: which is better, Fortrans or Lavacol?
Very often, patients ask to replace expensive Fortrans with cheap Lavacol. From the point of view of the mechanism of action and composition of both drugs, there is no difference between them. As they say: “Their main difference is that they are no different!” But my colleagues, endoscopists, doctors who directly examine the intestines, still prefer Fortrans. Maybe because they are used to working with it, but many doctors have never heard of Lavacol. The accuracy of the diagnosis depends on the quality of preparation; fecal remains on the intestinal walls cover small tumors and polyps, and the more of these feces remain, the lower the quality of the study. The doctor will most likely see rectal polyps, but intestinal polyps in the area of the bends may be missed. Ultimately, the doctor may say that the study is incomplete and needs to be repeated. I don’t recommend saving on your own health. Although, I think, the general doctor will not refuse to prescribe a cheaper drug.
There is a Boston Colonoscopy Bowel Preparation Score. It consists of an assessment of three sections of the colon - the left segment, the transverse colon and angles, and the right segment. Cleaning in each department can be 1 point, 2 and 3. Maximum 9 points. So, bowel cleansing above 6 points is considered good. With this cleansing, the colonoscopy will go flawlessly.
To cleanse the intestines in this way, you need to use double cleansing, namely, 2 liters of solution the day before and 2 liters on the day of the examination, the last portion of the medicine should be drunk 4 hours before the procedure. The procedure is ideally scheduled no earlier than 12 noon. If you drink Fortrans or Lavacol according to this scheme, and before that stick to a 3-day diet, you can achieve good bowel cleansing; for diagnosing flat forms of cancer, this is very important - good preparation for 6-7 points.
There are other drugs that are used to cleanse the intestines, including castor oil, Duphalac, and fleet soda. In my opinion, Flit is the best. He is beyond competition. Fortrans is slightly inferior to it. And other means can be used only as a last resort, when there is no better option.
Read about intestinal examination without colonoscopy.
Use of Fortrans - indications
Some medical procedures require preliminary complete cleansing of the intestines. This is the main indication for the use of Fortrans. Complete bowel cleansing (or lavage) is a necessary condition for the following manipulations:
- Surgical operations on the intestines or adjacent organs.
- Endoscopic examination of the intestines (irrigoscopy, colonoscopy).
- X-ray examination of the intestine (irrigography).
Fortrans can also be used as one of the stages in the treatment of constipation, to relieve symptoms.
Advantages and disadvantages
Advantages of using the drug Fortrans:
- With its help, it is possible to cleanse not only the large intestine, but also the small intestine.
- The drug can be used at home.
- The dose is easy to calculate, just know your body weight. For every 20 kg of weight you need to drink a liter of solution. To prepare this volume you need 1 sachet of medicine.
- The drug is easy to take. It is drunk in the evening for 4-5 hours.
- Four sachets are enough to perform a complete cleaning.
As for the disadvantages of the drug, these include the unpleasant taste of the finished solution and the need to take large volumes of liquid.
Side effects that may develop after taking Fortrans:
- Nausea and vomiting. After completing the course, these phenomena go away on their own.
- Bloating.
- Allergic reactions: skin rash, swelling. Isolated cases of anaphylactic shock have also been reported.
