REVIEW Bisacodyl is a diphenylmethane stimulant laxative drug that works directly on the colon to produce a bowel movement. It is typically prescribed for relief of constipation and for the management of neurogenic bowel dysfunction as well as part of bowel preparation before medical examinations, such as for a colonoscopy. Bisacodyl is a modified triphenylmethane derivative and was first used as a laxative in 1953 due to its similarity to phenolphthalein. Mechanistically, Bisacodyl influence intestinal fluid transport not by stimulation of mucosal adenylate cyclase More recent studies suggest that bisacodyl may decrease the expression of AQP3 (aquaporin3) in the colon, which inhibits water transfer from the luminal to the vascular side and leads to a laxative effect. This study also showed that direct activation of colon macrophages by bisacodyl increases the secretion of PGE(2), which acts as a paracrine factor and decreases AQP3 expression in colon mucosal epithelial cells.
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Mereyala, Hari Babu; Sambaru, Kalyani; Synthesis of triphenylmethane derivative. Bisacodyl Indian Journal of Chemistry, Section B: Organic Chemistry Including Medicinal Chemistry (2005), 44B(3), 615-617.
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Wexner SD, Beck DE, Baron TH, Fanelli RD, Hyman N, Shen B, Wasco KE; American Society of Colon and Rectal Surgeons; American Society for Gastrointestinal Endoscopy; Society of American Gastrointestinal and Endoscopic Surgeons. A consensus document on bowel preparation before colonoscopy: prepared by a task force from the American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Gastrointest Endosc. 2006 Jun;63(7):894-909.
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