{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:22:22Z","timestamp":1784334142022,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Bisacodyl is a widely used laxative that stimulates both motility and secretion. Our aim was to exploit the unique capabilities of MRI to define bisacodyl's mode of action. Two placebo\u2010controlled cross\u2010over trials were performed, one using a single dose of Bisacodyl 5\u2009mg while the second dosed daily for 3 consecutive days. Serial MRI was performed every 75\u2009minutes. Primary endpoint: ascending colon water content as assessed by T1AC AUC<jats:sub>300\u2013450 minutes<\/jats:sub>. Secondary endpoints included: small bowel water content, whole gut transit time (WGTT), colonic volumes, stool frequency, and consistency using Bristol Stool Form Score (BSFS). Exploratory endpoints: changes in the serial segmental volumes were quantified from the number of \u201cmass movements\u201d defined as episodes when segmental volume change from the previous scan was &gt;\u200920% of baseline volume. We also measure the time to defecate after dosing. After 3\u2009days of bisacodyl, ascending colon water content (T1) was 62% greater than after placebo, mean difference T1 AUC<jats:sub>300\u2013450 minutes<\/jats:sub> 50.2 (61.0) sec.min, 95% CI (9.2, 91.2), <jats:italic>P<\/jats:italic>\u2009=\u20090.02, while after a single dose difference was only 11% (<jats:italic>P<\/jats:italic>\u2009=\u20090.58). Both single and repeated doses shortened WGTT (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.049) and time to defecate (<jats:italic>P<\/jats:italic> 0.01). Only repeated doses significantly increased small bowel water content (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.03), the number of \u201cmass movements\u201d (<jats:italic>P<\/jats:italic>\u2009=\u20090.048), bowel frequency (<jats:italic>P<\/jats:italic>\u2009=\u20090.006), and BSFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). Repeated, compared to single dosing of Bisacodyl, additionally increases small bowel and colon water content and increases the number of \u201cmass movements\u201d thereby increasing its laxative effect. MRI is a non\u2010invasive, patient\u2010acceptable technique for evaluating drugs which alter secretion and\/or motility.<\/jats:p>","DOI":"10.1002\/cpt.3532","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T13:19:22Z","timestamp":1734355162000},"page":"1284-1291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Magnetic Resonance Imaging Reveals Novel Insights into the Dual Mode of Action of Bisacodyl: A Randomized, Placebo\u2010controlled Trial in Constipation"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-0917","authenticated-orcid":false,"given":"Abdulsalam","family":"Aliyu","sequence":"first","affiliation":[{"name":"Nottingham NIHR Research Centre University of Nottingham  Nottingham UK"},{"name":"School of Medicine University of Nottingham  Nottingham 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