Chronic constipation in adults

McCallum, Iain; Ong, Sarah; Mercer-Jones, Mark

doi:10.1136/bmj.b831

Cited by 63 publications

(27 citation statements)

References 14 publications

(16 reference statements)

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“…Poor outcome is almost the norm if there is any significant psychological comorbidity [Kamm et al 1988]. The surgical management of pelvic floor evacuation disorders is beyond the scope of this review and has been recently reviewed [McCallum et al 2009]. …”

Section: Alternative Interventionsmentioning

confidence: 99%

Current management strategies and therapeutic targets in chronic constipation

Emmanuel

2010

Therap Adv Gastroenterol

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Constipated patients who are refractory to simple lifestyle interventions will usually resort to laxatives, whether prescribed or over the counter. Clinical trial evidence is scarce for older medications such as laxatives, especially with a condition as chronic and subjective as constipation. Newer polyethylene glycol-based laxatives have been investigated under rigorous clinical trial settings, but comparisons between different laxatives are not available. Newer prokinetic agents, targeting peristalsis, intestinal secretion and the colonic flora, have been developed for laxative refractory constipation. This review focuses on the evidence for each of these agents, and the relative indications for each of them.

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Section: Alternative Interventionsmentioning

confidence: 99%

Current management strategies and therapeutic targets in chronic constipation

Emmanuel

2010

Therap Adv Gastroenterol

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“…L'adoption d'une position dite en semi-squatting lors de la défécation favoriserait l'exonéra-tion [2]. L'enrichissement de la ration quotidienne en eau n'a pas d'efficacité démontrée et n'est pas recommandée [3,4]. Le maintien d'une activité physique n'aurait aucun effet bénéfique sur le transit.…”

Section: Règles Hygiénodiététiquesunclassified

Constipation de transit : les traitements ayant fait la preuve de leur efficacité

Zeitoun

Parades

2011

Colon Rectum

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La constipation de transit est une pathologie très fréquente, qu'elle soit isolée ou associée à une constipation terminale. Les règles hygiénodiététiques et même les traitements laxatifs qui constituent la pierre angulaire de la prise en charge reposent pourtant sur un niveau de preuve faible. De plus, le niveau d'insatisfaction vis-à-vis des laxatifs couramment prescrits demeure élevé chez ces patients. De nouveaux traitements pharmacologiques de la constipation ont récemment émergé, dotés d'une action entérokinétique iné-dite. Le prucalopride (Resolor ® ) sera le premier médicament de ce type disponible en France. D'autres sont attendus, et cette nouvelle gamme augure d'un probable changement Les cinq points utiles à la thérapeutique -Malgré la forte prévalence de la constipation de transit dans la population générale, le niveau de preuve concernant l'efficacité des traitements actuellement prescrits est limité ; -le bénéfice des mesures hygiénodiététiques est incertain et au mieux modeste ; -les laxatifs ont une efficacité démontrée dans le traitement de la constipation de transit mais de nombreux patients demeurent insatisfaits en raison d'effets indésirables et/ou d'une résolution seulement partielle de leurs symptômes ; -parmi les nouveaux traitements entérokinétiques ayant une efficacité démontrée, le prucalopride sera prochainement disponible avec une AMM en France ; -l'arrivée des nouveaux traitements pharmacologiques pourrait modifier durablement la stratégie recommandée de prise en charge de la constipation de transit. Les cinq références essentiellesPiche T, Dapoigny M, Bouteloup C, et al (2007) Recommendations for the clinical management and treatment of chronic constipation in adults. Gastroenterol Clin Biol 31:125-35 Camilleri M, Kerstens R, Rikx A, Vandeplassche L (2008) A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med 358:2344-54 Ford AC, Suares NC (2011) Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut 60:209-18 Tack J, Müller-Lissner S, Stanghellini V, et al (2011) Diagnosis and treatment of chronic constipation -a European perspective. Neurogastroenterol Motil 23:697-710 Lembo AJ, Schneier HA, Schiff SJ, et al (2011) Two Randomized Trials of Linaclotide for Chronic Constipation. N Engl J Med 365:527-36Ce que dit l'EBM -Les laxatifs traditionnels ont une efficacité démontrée dans la constipation en termes d'augmentation de la fréquence des selles ; -leur efficacité sur les symptômes associés à la constipation est plus controversée ; -à l'exception du polyéthylène glycol, l'efficacité à long terme des laxatifs comme traitement de la constipation chronique n'est pas établie, car le niveau de preuve est faible ; -le prucalopride, un agoniste des récepteurs 5-HT 4 , et la lubiprostone, un activateur des canaux chlore, ont une efficacité récemment démontrée en termes d'augmentation de la fréquence des selles et d'amélioration des symptômes liés à la constipation ; -la méthylnaltrexon...

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“…Constipation is a gastrointestinal motility disorder characterized by infrequent bowel movements, difficulty during defecation, and sensation of incomplete bowel evacuation [1,2]. Functional constipation is a prevalent and burdensome disorder that can generate considerable abdominal pain and distension, anorexia, and nausea.…”

Section: Introductionmentioning

confidence: 99%

Laxative Effects of Dietary Supplementation with Sujiaonori Algal Biomaterial in Japanese Adult Women with Functional Constipation: A Case Study

Ngatu

Ikeda

Watanabe

et al. 2017

JFB

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Constipation is a gastrointestinal motility disorder that represents a major health problem in Japan. Approximately 26% of young Japanese adult women are reported to have this complaint. We report on the health effects of daily intake of Sujiaonori algal biomaterial (SBM) on constipation on 12 Japanese adult women. Data are from a four-week dietary intervention study on the health effects of daily Sujiaonori supplementation on cardiovascular, skin, and gastrointestinal health in which 32 adult Japanese volunteers (age range: 20–54 years) participated. They underwent clinical and laboratory investigations, and completed two study questionnaires (the brief diet history questionnaire (BDHQ) and the current health questionnaire) before and after dietary intervention. Of the 12 women volunteers with functional constipation, there were six SBM-supplemented subjects who received 3 g of Sujiaonori powder twice daily during meal, whereas the six others (controls) were from the group of those who took 3 g of a power made of 70% corn starch and 30% Japanese spinach mixture. The analysis of data on daily nutrient intake showed no significant dietary changes for nutrients (minerals, proteins, fiber, fat) and calorie intake (except alcohol intake that was reduced) in both groups. In SBM group, a significant reduction of the proportion of women with constipation was observed (p < 0.001), whereas no significant change was noted within the control group (p > 0.05). When both groups were compared, SBM was more effective than the control product; 66.7% (4/6) of SBM-supplemented women had their constipation relieved, whereas only one control (16.7%) controls benefited from dietary intervention (p < 0.001). In addition, no adverse effect was reported in the SBM group, whereas two controls reported nausea at post-survey. These results suggest that Sujiaonori contains compounds that can improve gastrointestinal function and relieve constipation.

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Chronic constipation in adults

Cited by 63 publications

References 14 publications

Current management strategies and therapeutic targets in chronic constipation

Current management strategies and therapeutic targets in chronic constipation

Constipation de transit : les traitements ayant fait la preuve de leur efficacité

Laxative Effects of Dietary Supplementation with Sujiaonori Algal Biomaterial in Japanese Adult Women with Functional Constipation: A Case Study

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