Chronic constipation: diagnosis and current treatment options

Blaker, Paul; Wilkinson, Mark D.

doi:10.1002/psb.626

Cited by 5 publications

(8 citation statements)

References 29 publications

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“…Laxatives such as crownvetch should be used with caution in late pregnancy due to their secretion from breast milk. Therefore, constipation cannot be completely treated until the end of pregnancy ( 3 , 9 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial

Mirghafourvand

Rad

Mohammad‐Alizadeh‐Charandabi

et al. 2016

Iran Red Crescent Med J

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BackgroundProbiotics can alter the colonic microbiota and might improve bowel function.ObjectivesThe aim of this study was to evaluate the effect of the consumption of yogurt, enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 (CFU) on the symptoms of constipated pregnant women.Materials and MethodsThis triple-blind randomized controlled trial was conducted on 60 constipated pregnant women who were diagnosed by the ROME III criteria in Tabriz, Iran from December 2014 to July 2015. Participants were randomly put into two groups including the treatment and the control group through block randomization. The treatment group received 300 g of yogurt enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 colony forming units (CFU) (n = 30) while the control group received conventional yogurt (n = 30) for 4 weeks. The defecation frequency, stool consistency, straining during defecation, sensation of anorectal obstruction, sensation of incomplete evacuation and manual manoeuvres to facilitate defecation were primary outcomes while the amount of defecation, stool colure, and quality of life were secondary outcomes.ResultsThe frequency of defecation was increased from 2.1 (0.8) at baseline to 8.3 (4.4) in the probiotic yogurt group vs. 2.3 (0.7) at baseline to 8.1 (4.3) in the conventional yogurt group at the end of 4th week. These results were based on the repeated measure ANOVA test and there was no statistically significant difference between the two groups (mean difference: 0.1; Confidence Interval 95%: -1.4 to 1.7; P = 0.872). Constipation symptoms including straining, anorectal obstruction, manipulation to facilitate defecation, consistency of stool and color of stool were improved significantly (P < 0.05) in both groups. In addition, the amount of defecation was significantly increased in both groups (P < 0.05), while incomplete evacuation was significantly reduced in the treatment group (P = 0.01). There was no statistically significant difference between the groups in the mean scores of physical (P = 0.726) and mental (P = 0.678) aspects of quality of life after the intervention with the adjusting of baseline scores.ConclusionsConsumption of 300 g/day probiotic and conventional yogurt can play a role in improving the symptoms of constipation during pregnancy.

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Section: Introductionmentioning

confidence: 99%

The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial

Mirghafourvand

Rad

Mohammad‐Alizadeh‐Charandabi

et al. 2016

Iran Red Crescent Med J

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“…Constipation is a common digestive complaint and a collective term used by the patient to imply that stools are too hard, too infrequent, or too difficult to pass. Constipation can be a debilitating medical problem and a symptom of many diseases 1,2 . The prevalence of chronic constipation (CC) is probably underestimated as many patients may not seek medical advice for the condition, but its impact on quality of life and economic burden has been demonstrated 3–5 .…”

Section: Introductionmentioning

confidence: 99%

“…Constipation can be a debilitating medical problem and a symptom of many diseases. 1,2 The prevalence of chronic constipation (CC) is probably underestimated as many patients may not seek medical advice for the condition, but its impact on quality of life and economic burden has been demonstrated. [3][4][5] Constipation is more common in women and elderly.…”

Section: Introductionmentioning

confidence: 99%

Prucalopride in the treatment of chronic constipation in patients from the Asia‐Pacific region: a randomized, double‐blind, placebo‐controlled study

Zou

Yuan

et al. 2012

Neurogastroenterology Motil

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BackgroundThe study evaluated efficacy and safety of the 2 mg dose of prucalopride compared to placebo in patients with chronic constipation (CC) from the Asia-Pacific region.MethodsRandomized, placebo-controlled, parallel-group, phase III study with 2-week run-in, 12-week treatment phase, and 1-week follow-up. Adult patients with CC (≤2 spontaneous bowel movements per week) received 2 mg prucalopride or placebo, once-daily, for 12 weeks. Primary efficacy measure was percentage of patients with average of ≥3 spontaneous complete bowel movements (SCBMs) per week (Responders) during the 12-week treatment. A key secondary endpoint was Responders during first 4 weeks of treatment. Other efficacy assessments were based on patient diaries, their assessments of symptoms and quality of life, and investigator’s assessment on efficacy of treatment. Safety assessments included adverse events, laboratory values, and cardiovascular events.Key ResultsEfficacy and safety were evaluated for 501 patients who received study drug. On the primary endpoint, prucalopride was significantly more effective than placebo with 83 (33.3%) vs 26 (10.3%) patients having a weekly average of ≥3 SCBMs during the 12-week treatment (P < 0.001). Respective percentages were 34.5%vs 11.1% over first 4 weeks (P < 0.001). On other secondary endpoints, clinical improvement was generally larger and statistically superior (P < 0.001) in the prucalopride group. Most frequently reported adverse events were diarrhea, nausea, abdominal pain, and headache.Conclusion & InferencesPrucalopride 2 mg given once-daily significantly improved bowel function, associated symptoms, and satisfaction in CC over a 12-week treatment period, and was safe and well tolerated by patients in the Asia-Pacific region.

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“…Thus, the studies included emphasized changes to diets with foods rich or enriched in fiber and fiber supplements in dietary plans. The majority of clinical guidelines recommend fiber‐rich diets, such as vegetables, fruits, and whole foods, which are a primary treatment for constipation (Blaker & Wilkinson, 2010; Costilla & Foxx‐Orenstein, 2014; Emmanuel et al, 2017; Liu, 2011). Planning adequate water intake as well as the ingestion of probiotics is still highly recommended.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of therapeutic responses to circumstantial factors or reasons pertaining to constipation are linked to the administration of laxative drugs. Nevertheless, several studies have described ways to treat or reduce chronic constipation through nonpharmacological interventions and their importance to control symptoms (Blaker & Wilkinson, 2010; Emmanuel et al, 2017; Lamas, Lindholm, Stenlund, Engstrom, & Jacobsson, 2009; Liu, 2011; Spinzi et al, 2009). Other studies refer to nurses’ important role in helping patients manage constipation (Lamas et al, 2009).…”

mentioning

confidence: 99%

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review

Pinto

Oliveira

Fernandes

et al. 2020

J of Nursing Scholarship

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Constipation is a health condition that presents a significant problem to the people suffering from it, generally defined as fewer than three bowel movements per week, and with great prevalence and impact on quality of life in adults and elderly people (Bub, Brinckmann, Cicconetti, & Valentine, 2006;Rao et al., 2015). It affects the overall well-being of individuals, has a multifactorial character, and can be influenced by physical, psychological, physiological, emotional, and environmental factors. Studies have reported an incidence of constipation among ambulatory adult patients over 65 old of 26% in men and 34% in women. Incidence is considerably higher in people living in nursing homes and hospitals than in those people living in the community (Lim & Childs, 2013). Dementia and acute stroke and palliative cancer patients are particular clinical conditions cited by researchers for constipation (Bub et al.Abstract Purpose: To identify nonpharmacological clinically effective interventions for constipation in adults. Methods: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. Results: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. Conclusions: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families.Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. Clinical Relevance: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

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Chronic constipation: diagnosis and current treatment options

Abstract: Constipation is a common and often chronic condition of multifarious aetiology. Our Drug review considers the evaluation and management of patients with primary chronic constipation, followed by sources of further information.www.prescriber.co.uk Prescriber

Cited by 5 publications

References 29 publications

The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial

The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial

Prucalopride in the treatment of chronic constipation in patients from the Asia‐Pacific region: a randomized, double‐blind, placebo‐controlled study

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review

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