Safety and Efficacy of a Bulk Laxative Containing Senna versus Lactulose in the Treatment of Chronic Constipation in Geriatric Patients

Kinnunen, O; Winblad, Ilkka; Koistinen, P.; Salokannel, Juhani

doi:10.1159/000139866

Cited by 61 publications

(44 citation statements)

References 5 publications

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“…Two trials showed bulk in combination with senna was superior to lactulose. 55,56 Other direct comparisons between different laxatives or laxatives and fiber were inconclusive because of the limited number of studies, small sample sizes, or methodologic flaws. There were no definitive data that suggested fiber increased frequency more than laxatives or vice versa.…”

Section: Discussionmentioning

confidence: 99%

The Treatment of Chronic Constipation in Adults A Systematic Review

et al. 1997

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OBJECTIVE:To evaluate whether laxatives and fiber therapies improve symptoms and bowel movement frequency in adults with chronic constipation. CONCLUSIONS: Both fiber and laxatives modestly improved bowel movement frequency in adults with chronic constipation. There was inadequate evidence to establish whether fiber was superior to laxatives or one laxative class was superior to another. DATA SOURCES:

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Section: Discussionmentioning

confidence: 99%

The Treatment of Chronic Constipation in Adults A Systematic Review

et al. 1997

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“…132,138,139 A senna-fiber combination was more effective than lactulose in treating constipation in geriatric long-stay patients. 116,140 A meta-analysis found that stimulant laxatives provided superior efficacy for chronic idiopathic constipation (relative risk, 0.54; 95% confidence interval [CI], 0.42-0.69). The number needed to treat with stimulant laxatives was 3 (95% CI, 2.0-3.5).…”

mentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

Shin

Jung

Lee

et al. 2016

J Neurogastroenterol Motil

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The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This article includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation (AGREE) II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods.

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“…In the present study, improvement in the frequency of bowel movements and stool form was better than that observed in previous studies done on Isabgol , lactulose, Senna, and combination of “ Isabgol and senna.”[142022–25] This superiority in the outcomes of the present study over previous clinical studies done on Senna alone or in combination with Isabgol husk can be due the addition of Triphala to the combination of “ Isabgol and senna.” Triphala is prepared by mixing equal parts of Emblica officinalis ( Amalaki ), Terminalia belerica ( Bibhitak ), and Terminalia chebula ( Haritaki ). It is taken in powder form in dosages of 3 to 6 g daily for the treatment of flatulence and constipation.…”

Section: Discussionmentioning

confidence: 64%

An open-label, prospective clinical study to evaluate the efficacy and safety of TLPL/AY/01/2008 in the management of functional constipation

Munshi¹,

Bhalerao²,

Rathi³

et al. 2011

J Ayurveda Integr Med

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Functional constipation is one of the most common gastrointestinal symptoms across the globe. Its high prevalence rate, economic burden, and adverse implications on the quality of life make constipation a major public health issue. Though various treatment options are available for the management of constipation, evidence for their efficacy and safety are limited. An open-label, prospective, interventional, and exploratory clinical trial was carried out to evaluate the efficacy and safety of “TLPL/AY/01/2008” in 34 patients suffering from functional constipation. “TLPL/AY/01/2008” is an Ayurvedic proprietary polyherbal formulation in powder form, containing Isabgol husk, Senna extract, and Triphala extract. Administration of “TLPL/AY/01/2008” for 14 days showed a significant increase in mean weekly bowel movements from 10.19 ± 05.64 to 18.29 ± 05.72 (P<0.05). The mean average time spent on toilet for bowel evacuation reduced significantly from 11.02 ± 05.43 minutes (baseline value) to 08.70 ± 04.72 minutes on day 14 (P<0.05). Mean stool form score assessed on Bristol stool form scale was improved from 02.97 ± 00.48 (baseline value) to 04.61 ± 00.84 (P<0.05) on day 14. A significant improvement (P<0.05) was also noted in straining during defecation, sensation of incomplete evacuation, sensation of anorectal blockage, and other associated symptoms of functional constipation. The significant improvement in most of the above symptoms was endured for a post-treatment observatory period of one week. All the study patients showed an excellent tolerability to the study drug. These findings suggest that “TLPL/AY/01/2008” is an effective, safe, and non-habit-forming herbal laxative formulation for the management of constipation. Comparative clinical studies with larger sample size would be able to confirm the above findings.

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Safety and Efficacy of a Bulk Laxative Containing Senna versus Lactulose in the Treatment of Chronic Constipation in Geriatric Patients

Cited by 61 publications

References 5 publications

The Treatment of Chronic Constipation in Adults A Systematic Review

The Treatment of Chronic Constipation in Adults A Systematic Review

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

An open-label, prospective clinical study to evaluate the efficacy and safety of TLPL/AY/01/2008 in the management of functional constipation

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