Chronic Constipation: An Evidence-Based Review

Leung, Lawrence C.; Riutta, Taylor; Kotecha, Jyoti; Rosser, Walter

doi:10.3122/jabfm.2011.04.100272

Cited by 273 publications

(199 citation statements)

References 168 publications

(155 reference statements)

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“…Effectiveness of therapy for CC should emphasize, in addition to the proportionate improvement of bowel frequency, on predominant symptoms and psychosocial distress. 10,24,25 This post hoc analysis demonstrated positive associations between improvement in symptoms (improvement of ≥ 1 point) and efficacy response (average increase of ≥ 1 SCBMs/week and average increase of ≥ 1 SBMs/week) with prucalopride treatment. Significant associations were established between improvements in bloating, hard stools and straining and responses in efficacy variables in Asian and non-Asian patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Prucalopride in the Treatment of Chronic Constipation in Asian and Non-Asian Women: A Pooled Analysis of 4 Randomized, Placebo-controlled Studies

Tack

Quigley

Zou

et al. 2014

J Neurogastroenterol Motil

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Background/Aims To compare the efficacy and safety of prucalopride, a novel selective high-affinity 5-hydroxytryptamine type 4 receptor agonist, versus placebo, in Asian and non-Asian women with chronic constipation (CC). Methods Data of patients with CC, receiving once-daily prucalopride 2-mg or placebo for 12-weeks, were pooled from 4 double-blind, randomized, phase-III trials (NCT00488137, NCT00483886, NCT00485940 and NCT01116206). The efficacy endpoints were: average of ≥ 3 spontaneous complete bowel movements (SCBMs)/week; average increases of ≥ 1 SCBMs/week; and change from baseline in each CC-associated symptom scores (bloating, abdominal pain, hard stool and straining). Results Overall, 1,596 women (Asian [26.6%], non-Asian [73.4%]) were included in this analysis. Significantly more patients in the prucalopride group versus placebo experienced an average of ≥ 3 SCBMs/week in Asian (34% vs. 11%, P < 0.001) and non-Asian (24.6% vs. 10.6%, P < 0.001) subgroups. The number of patients reporting an increase of ≥ 1 SCBMs/week from baseline was significantly higher in the prucalopride group versus placebo among both Asian (57.4% vs. 28.3%, P < 0.001) and non-Asian (45.3% vs. 24.0%, P < 0.001) subgroups. The difference between the subgroups was not statistically significant. Prucalopride significantly reduced the symptom scores for bloating, hard stool, and straining in both subgroups. Conclusions Prucalopride 2-mg once-daily treatment over 12-weeks was more efficacious than placebo in promoting SCBMs and improvement of CC-associated symptoms in Asian and non-Asian women, and was found to be safe and well-tolerated. There were numeric differences between Asian and non-Asian patients on efficacy and treatment emergent adverse events, which may be partially due to the overlap with functional gastrointestinal disorders in non-Asian patients.

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Section: Discussionmentioning

confidence: 99%

Effect of Prucalopride in the Treatment of Chronic Constipation in Asian and Non-Asian Women: A Pooled Analysis of 4 Randomized, Placebo-controlled Studies

Tack

Quigley

Zou

et al. 2014

J Neurogastroenterol Motil

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“…Promotility agents are advised as are good diet, stool softeners, and hydration (Bellini et al 2006, Wagner et al 2007. There is little evidence on the benefits of exercise and chronic constipation (Leung et al 2011), but practical experience often reported is that doing exercise or standing in a standing table or frame does seem to help. This would be in line with the former recommendations for exercise.…”

Section: Gastrointestinal Problemsmentioning

confidence: 99%

Rehabilitation in Muscular Dystrophies: Changing Approach

Groot¹,

Voet²,

Jansen³

et al. 2012

Muscular Dystrophy

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“…An evidence-based review for diagnosis and treatment of constipation provides good information. 18 Simultaneously, however, it seems that much is not yet recognized or maybe not just studied. Following all the typical "tricks of the trade" does not necessarily lead to success.…”

Section: Practical Information For Common Problemsmentioning

confidence: 99%

In this Issue: Testing Characteristics of Patient-Centered Medical Homes, Patient Self-Care, Predicting Outcomes, and Practical Clinical Information

Bowman¹,

Neale²

2011

The Journal of the American Board of Family Medicine

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Use of electronic health records (EHRs) is taking off. They are intuitively appealing, but they are not always better than the paper version. One aspect that electronic records should help with is the availability of test results; another possibility is more appropriate and timely orders with the use of prompting. After implementing an EHR, Metz et al 1 identified improvements in both of these areas for routine prenatal studies in a family medicine residency, and very good rates for both ordering and charting were improved to near perfect.Pandhi et al 2 try to tease out whether the accessibility aspect of medical homes increases preventive services beyond what occurs when there is continuity between a physician and an insured patient. The answer is yes. Even for the patients with continuity, those who rated accessibility of their continuity of care office as very good or excellent on all 8 evaluative questions received more preventive services.Getting it all done is not easy. Sloane et al 3 present their findings on primary care practices that took on quality in a big way, leading to sustainability of data measurement and changed processes. They provide helpful information about just how hard it can be to make needed quality changes, as well as helpful insights for others trying to leap the quality chasm.

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Chronic Constipation: An Evidence-Based Review

Cited by 273 publications

References 168 publications

Effect of Prucalopride in the Treatment of Chronic Constipation in Asian and Non-Asian Women: A Pooled Analysis of 4 Randomized, Placebo-controlled Studies

Effect of Prucalopride in the Treatment of Chronic Constipation in Asian and Non-Asian Women: A Pooled Analysis of 4 Randomized, Placebo-controlled Studies

Rehabilitation in Muscular Dystrophies: Changing Approach

In this Issue: Testing Characteristics of Patient-Centered Medical Homes, Patient Self-Care, Predicting Outcomes, and Practical Clinical Information

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