Nitric oxide as a mediator of bisacodyl and phenolphthalein laxative action: induction of nitric oxide synthase.

Bisacodyl and phenolphthalein are diphenylmethane laxatives that have effects on intestinal water and electrolyte transport and smooth muscle contractility. Nitric oxide (NO) is produced in the intestine, where it stimulates electrolyte secretion and relaxes smooth muscle. Therefore, we studied in rats the effect of these laxatives on diarrhea, fluid transport in vivo, gastrointestinal transit and NO synthase activity in the absence and presence of inhibitors of NO synthesis. Both laxatives (50 mg/kg p.o.) produced diarrhea, which was delayed in onset by 25 mg/kg (i.p.) of the NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME). The L-NAME effect was reversed by the NO donor isosorbide-5-mononitrate (30-120 mg/kg i.p.). L-Arginine (600 and 1500 mg/kg i.p.) prevented the inhibitory effect of L-NAME on diarrhea. The laxatives evoked water and electrolyte secretion and enhanced the transit of a suspension of charcoal through the gastrointestinal tract. This was inhibited by L-NAME but not D-NAME. The inhibitor of inducible NO synthase, dexamethasone (0.03-0.3 mg/kg i.p.), prevented the effects of both laxatives on electrolyte and water transport. Stimulation by these drugs of NO synthase was also inhibited by dexamethasone. The results demonstrate that bisacodyl and phenolphthalein stimulate water and electrolyte secretion, promote transit of intraluminal contents and produce diarrhea in association with enhanced production of NO. Furthermore, it appears that the NO is derived principally from activation of an inducible form of NO synthase.