Constipation Research Today is a free monthly online journal that collates and summarizes the latest research about Constipation, including details on infant, child, baby and toddler constipation, symptoms, causes, remedies.

Treatment of chronic constipation: current pharmacologic approaches and future directions.

Tack J, Müller-Lissner S

Division of Gastroenterology, University Hospital, Leuven, Belgium. jan.tack@med.kuleuven.be

Chronic constipation is a common condition that affects up to 27% of the population. Dietary and lifestyle measures are usually the first-line therapy, but if these fail to have an effect then a variety of prescription and consumer laxatives are available. Traditional laxatives include bulking agents, osmotic agents, stool softeners, and stimulants of the gastrointestinal tract. All have been found to be more effective than placebo at relieving symptoms of constipation, but these results have been obtained primarily in short (4-week) trials and no class of laxative has been shown to be superior to another. Traditional laxatives work in many, but not all, patients and some patients cannot cope with the side effects, unpleasant taste, the requirements of the dosing regimen, or the notion of dose increase. New enterokinetic agents that affect peristalsis through selective interaction with 5-hydroxytryptamine-4 receptors and novel agents acting on intestinal secretion could offer an alternative option for patients with chronic constipation who cannot get adequate relief from current laxatives.

Published 1 May 2009 in Clin Gastroenterol Hepatol, 7(5): 502-8; quiz 496.
Full-text of this article is available online (may require subscription).

Articles on Constipation published 14 April 2009:

Health related quality of life in children with constipation-associated fecal incontinence.   J Pediatr, 154(5): 749-53.

OBJECTIVES: With a disease-specific questionnaire, this study aimed to evaluate health-related quality of life (HRQoL) in children with constipation in association with clinical characteristics. STUDY DESIGN: Children with constipation-associated fecal incontinence (n = 114), 8 to 18 years, filled out the Defecation Disorder List at a Dutch tertiary hospital. Correlations and linear regression analysis between clinical characteristics and scores on emotional and social functioning were ... [Abstract] [Full-text]

Articles on Constipation published 31 March 2009:

New-onset constipation at acute stage after first stroke: incidence, risk factors, and impact on the stroke outcome.   Stroke, 40(4): 1304-9.

BACKGROUND AND PURPOSE: The prevalence of constipation after stroke varies from 30% to 60%. The incidence of new-onset constipation during the early stage of stroke remains uncertain. The present study was designed to investigate the prevalence of new-onset constipation, its risk factors, and its impact on stroke outcome in patients with their first stroke at acute stage. METHODS: This is a prospective cohort study of 154 patients admitted with their first stroke. New-onset constipation during ... [Abstract] [Full-text]

Cyclooxygenase-dependent alterations in substance P-mediated contractility and tachykinin NK1 receptor expression in the colonic circular muscle of patients with slow transit constipation.   J Pharmacol Exp Ther, 329(1): 282-9.

Tachykinins are important neurotransmitters regulating intestinal motility. Slow transit constipation (STC) represents an extreme colonic dysmotility with unknown etiology that predominantly affects women. We examined whether the tachykinin system is involved in the pathogenesis of STC. Isolated sigmoid colon circular muscle from female STC and control patients was studied using functional and quantitative reverse transcriptase-polymerase chain reaction methods. A possible alteration of ... [Abstract] [Full-text]

Articles on Constipation published 12 February 2009:

Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives.   Gut, 58(3): 357-65.

OBJECTIVE: To determine the efficacy, impact on quality of life (QOL) and safety of prucalopride, a selective, high-affinity 5-HT(4) receptor agonist, in patients with chronic constipation. METHODS: In this multicentre, randomised, placebo controlled, parallel-group, phase III study, patients with chronic constipation (two or fewer spontaneous complete bowel movements (SCBM)/week) received 2 mg or 4 mg prucalopride or placebo, once daily, for 12 weeks. The primary efficacy endpoint was the ... [Abstract] [Full-text]

Articles on Constipation published 4 February 2009:

Neuroimmune interaction and anorectal motility in children with food allergy-related chronic constipation.   Am J Gastroenterol, 104(2): 454-63.

OBJECTIVES: Food allergy is thought to trigger functional constipation in children but the underlying mechanisms are still unknown. Mast cells (MCs) and their relationship with nerve fibers (NFs) in the rectal mucosa, as well as anorectal motility, were studied in children with refractory chronic constipation before and after an elimination diet for cow's milk, egg, and soy proteins. METHODS: Thirty-three children (range: 1-10.8 years) underwent anorectal manometry and suction rectal biopsy ... [Abstract] [Full-text]

Articles on Constipation published 22 January 2009:

Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review.   Arch Dis Child, 94(2): 156-60.

As the evidence base supporting the use of laxatives in children is very limited, we undertook an updated systematic review to clarify the issue. A comprehensive literature search was carried out to identify randomised controlled trials of polyethylene glycol (PEG) versus either placebo or active comparator, in patients aged <18 years with primary chronic constipation. Outcomes were assessed as either global assessments of effectiveness or differences in defaecation rates. Seven qualifying ... [Abstract] [Full-text]

Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures.   Arch Dis Child, 94(2): 117-31.

INTRODUCTION: Constipation is a common complaint in children and early intervention with oral laxatives may improve complete resolution of functional constipation. However, most treatment guidelines are based on reviews of the literature that do not incorporate a quality assessment of the studies. OBJECTIVE: To investigate and summarise the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation. METHODS: The Medline and ... [Abstract] [Full-text]

Articles on Constipation published 19 January 2009:

Health utilization and cost impact of childhood constipation in the United States.   J Pediatr, 154(2): 258-62.

OBJECTIVE: To estimate the total health care utilization and costs for children with constipation in the United States. STUDY DESIGN: We analyzed data from 2 consecutive years (2003 and 2004) of the Medical Expenditure Panel Survey (MEPS), a nationally representative household survey. We identified children who either had been reported as constipated by their parents or had received a prescription for laxatives in a given year. Outcome measures were service utilization and expenditures. ... [Abstract] [Full-text]

© 2004-2009 Constipation Research Today. All Rights Reserved.