The Laxative Effects of Lactulose in Normal and Constipated Subjects

Bass, Paul; Dennis, Susana

doi:10.1097/00004836-198100031-00005

Cited by 84 publications

(31 citation statements)

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“…Lactulose was superior to placebo in terms of mean bowel movement frequency per week in the 3 trials 53-55. Lactulose was also superior to ispaghula in terms of mean bowel movement frequency per week and a trend of causing less abdominal pain was observed 56.…”

Section: Pharmacological Treatmentsmentioning

confidence: 88%

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool

Gwee¹,

Ghoshal²,

Gonlachanvit³

et al. 2013

J Neurogastroenterol Motil

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Chronic constipation (CC) may impact on quality of life. There is substantial patient dissatisfaction; possible reasons are failure to recognize underlying constipation, inappropriate dietary advice and inadequate treatment. The aim of these practical guidelines intended for primary care physicians, and which are based on Asian perspectives, is to provide an approach to CC that is relevant to the existing health-care infrastructure. Physicians should not rely on infrequent bowel movements to diagnose CC as many patients have one or more bowel movement a day. More commonly, patients present with hard stool, straining, incomplete feeling, bloating and other dyspeptic symptoms. Physicians should consider CC in these situations and when patients are found to use laxative containing supplements. In the absence of alarm features physicians may start with a 2-4 week therapeutic trial of available pharmacological agents including osmotic, stimulant and enterokinetic agents. Where safe to do so, physicians should consider regular (as opposed to on demand dosing), combination treatment and continuous treatment for at least 4 weeks. If patients do not achieve satisfactory response, they should be referred to tertiary centers for physiological evaluation of colonic transit and pelvic floor function. Surgical referral is a last resort, which should be considered only after a thorough physiological and psychological evaluation.

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Section: Pharmacological Treatmentsmentioning

confidence: 88%

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool

Gwee¹,

Ghoshal²,

Gonlachanvit³

et al. 2013

J Neurogastroenterol Motil

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“…Reducing agents such as ascorbic acid prevents the formation of nitrosated and nitrated compounds [23]. Intramucosal production of carcinogenic nitrosamines has also been suggested [24]. There have been concerns that widespread treatment with proton pump inhibitors could lead to an increase in gastric cancer [25, 26], since such therapy causes corpus-dominant gastritis in patients with H. pylori infection which is associated with hyposecretion [27].…”

Section: Histology Of Gastric Cancermentioning

confidence: 99%

Epidemiological aspects of gastric adenocarcinoma: are predictive diagnostics and targeted preventive measures possible?

Sjödahl

Lagergren

2010

EPMA Journal

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The incidence of gastric cancer has witnessed major changes over the past decades. Until recently, gastric cancer was a common malignancy in most countries. A striking decline in incidence in most Western populations has occurred since the 1970s, and elucidating the detailed causes for this trend can potentially be of great value for targeted preventive measures. Furthermore, it can add to the understanding of malignant disease and prevention in general. Moreover, the absolute number of cases worldwide is predicted to increase during many years to come. Gastric cancer is typically diagnosed at an advanced stage in symptomatic patients, and there are often no effective curative or palliative or therapeutic options. This fact highlights the need for research aiming to increase our understanding of the etiology of this cancer, facilitating the design of successful targeted preventive strategies for different populations. The future outlook in terms of decreasing gastric cancer deaths would be to identify such intelligent diagnostic tools. In this article, we present a summary of the epidemiology of gastric cancer, with special focus on its etiology.

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“…Laxatives are used (and abused) in more severe cases. Unabsorbed mono- and disaccharides, such as lactulose, lactitol, mannitol or sorbitol, are osmotic agents able to increase intraluminal bulk and stimulate colonic peristalsis [64]. Low doses of polyethylene glycol have also been used to successfully treat patients with slow-transit constipation [65, 66].…”

Section: Treating Other Functional Bowel Disordersmentioning

confidence: 99%

Pharmacological Treatment of the Irritable Bowel Syndrome and Other Functional Bowel Disorders

Mearin

2006

Digestion

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Functional digestive disorders constitute one of the main causes of consultation in gastroenterology and primary health care. Is still unclear whether therapy has to be aimed to the gut, to the neural pathways controlling bowel motility and perception, or to the processing mechanisms of symptoms and disease behaviour. It is conceivable that in the next future better understanding of functional bowel disorders pathophysiology will help us to tailor treatment for different patients. At the moment, subclassification of the diverse patterns of symptomatology allows to adjust new treatments for irritable bowel syndrome (IBS) according to the clinical predominance for each patient. The knowledge of motor and sensorial response to different stimuli in IBS patients and the pathways to the central nervous system is an important source of information for the development of new molecules. Fiber-enriched diet is frequently given for constipation-predominant IBS. Loperamide, antispasmodic drugs and tricyclic antidepressants are nowadays the basis for pharmacological treatment of diarrhea- predominant IBS. The scientific evidence supporting this therapeutical approach is however limited. Visceral analgesics and serotonin agonists and antagonists may play an important therapeutical role in the near future. However, it is not likely that one single treatment will help every functional bowel disorder patient and many of them will need a more complex approach with a multidisciplinary therapy (diet, psychotherapy, medications).

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The Laxative Effects of Lactulose in Normal and Constipated Subjects

Cited by 84 publications

References 0 publications

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool

Epidemiological aspects of gastric adenocarcinoma: are predictive diagnostics and targeted preventive measures possible?

Pharmacological Treatment of the Irritable Bowel Syndrome and Other Functional Bowel Disorders

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