Chronic constipation: Update on management

Hayat, Umar; Dugum, Mohannad; Garg, Samita

doi:10.3949/ccjm.84a.15141

Cited by 43 publications

(31 citation statements)

References 83 publications

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“…The benefits of stool softeners such as docusate sodium are unclear. Bulk‐forming, fiber‐based laxatives are generally not recommended for slow‐transit constipation such as that caused by anticholinergic effects.…”

Section: Specific Adverse Effectsmentioning

confidence: 99%

Management of common adverse effects of antipsychotic medications

2018

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The benefits of antipsychotic medications are sometimes obscured by their adverse effects. These effects range from relatively minor tolerability issues (e.g., mild sedation or dry mouth) to very unpleasant (e.g., constipation, akathisia, sexual dysfunction) to painful (e.g., acute dystonias) to disfiguring (e.g., weight gain, tardive dyskinesia) to life-threatening (e.g., myocarditis, agranulocytosis). Importantly, adverse effect profiles are specific to each antipsychotic medication and do not neatly fit into first- and second-generation classifications. This paper reviews management strategies for the most frequent side effects and identifies common principles intended to optimize net antipsychotic benefits. Only use antipsychotics if the indication is clear; only continue antipsychotics if a benefit is discernible. If an antipsychotic is providing substantial benefit, and the adverse effect is not life-threatening, then the first management choice is to lower the dose or adjust the dosing schedule. The next option is to change the antipsychotic; this is often reasonable unless the risk of relapse is high. In some instances, behavioral interventions can be tried. Finally, concomitant medications, though generally not desirable, are necessary in many instances and can provide considerable relief. Among concomitant medication strategies, anticholinergic medications for dystonias and parkinsonism are often effective; beta-blockers and anticholinergic medications are useful for akathisia; and metformin may lead to slight to moderate weight loss. Anticholinergic drops applied sublingually reduce sialorrhea. Usual medications are effective for constipation or dyslipidemias. The clinical utility of recently approved treatments for tardive dyskinesia, valbenazine and deutetrabenazine, is unclear.

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Section: Specific Adverse Effectsmentioning

confidence: 99%

Management of common adverse effects of antipsychotic medications

2018

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“…Excessive tension of the pubic-rectal muscle, by reducing the anorectal angle, may also result in hindered defecation and increases the need for displacement using a stronger abdominal compressor [43]. Similarly, in the case of voiding, excessive PFM tension may functionally hinder its initiation, resulting in the necessity of using the abdominal pressure [44]. This condition also favors the occurrence of constipation and, consequently, may increase the risk of hemorrhoids [44].…”

Section: Role Of Pelvic Floor Muscle In Continencementioning

confidence: 99%

“…Similarly, in the case of voiding, excessive PFM tension may functionally hinder its initiation, resulting in the necessity of using the abdominal pressure [44]. This condition also favors the occurrence of constipation and, consequently, may increase the risk of hemorrhoids [44]. Abuse of the abdominal press is also one of the factors increasing the risk of lowering within the pelvic organs [45].…”

Section: Role Of Pelvic Floor Muscle In Continencementioning

confidence: 99%

Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

Mazur-Biały

Kołomańska-Bogucka

Nowakowski

et al. 2020

JCM

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Urinary incontinence (UI) is a common health problem affecting quality of life of nearly 420 million people, both women and men. Pelvic floor muscle (PFM) training and other physiotherapy techniques play an important role in non-surgical UI treatment, but their therapeutic effectiveness is limited to slight or moderate severity of UI. Higher UI severity requires surgical procedures with preand post-operative physiotherapy. Given that nearly 30%-40% of women without dysfunction and about 70% with pelvic floor dysfunction are unable to perform a correct PFM contraction, therefore, it is particularly important to implement physiotherapeutic techniques aimed at early activation of PFM. Presently, UI physiotherapy focuses primarily on PFM therapy and its proper cooperation with synergistic muscles, the respiratory diaphragm, and correction of improper everyday habits for better pelvic organ support and continence. The purpose of this work is a systematic review showing the possibilities of using physiotherapeutic techniques in the treatment of UI in women with attention to the techniques of PFM activation. Evidence of the effectiveness of well-known (e.g., PFM training, biofeedback, and electrostimulation) and less-known (e.g., magnetostimulation, vibration training) techniques will be presented here regarding the treatment of symptoms of urinary incontinence in women.

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“…Differentiations in the composition of the intestinal microbiota have been confirmed when constipated patients and healthy controls have been evaluated in different studies and have shown that Lactobacillus may play an essential role in the pathogenesis of chronic constipation [83]. Lactobacillus species as probiotics could reduce the migrating myoelectric complex (MMC) period and speed up small intestinal transit.…”

Section: Management Of Chronic Constipationmentioning

confidence: 99%

New Progress Regarding the Use of Lactic Acid Bacteria as Live Delivery Vectors, Treatment of Diseases and Induction of Immune Responses in Different Host Species Focusing on Lactobacillus Species

Shonyela¹,

Wang²,

Yang³

et al. 2017

J Prob Health

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Lactobacillus species are non-spore-forming, Gram-positive bacteria and lactic acid producing bacteria (LAPB) that naturally inhabits the human and animal gastrointestinal and mouth organs. The aim of this review was to evaluate the new progress regarding the use of Lactobacillus species as live delivery vectors, prevention and treatment of pathogenic and metabolic diseases. Lactobacillus strains as probiotics have been extensively studied and have confirmed that they can absolutely improve performance as live delivery vectors, a treatment option of various diseases such as: hemorrhagic cecal coccidiosis in young poultry, Hypertension, avian flu, obesity, diabetes, Derzsy's disease or parvovirus infection, human immunodeficiency virus infections, irritable bowel syndrome, gastrointestinal disorders, Fungal infections, vaginal eubiosis, fish and shellfish species diseases.We give you an idea about that Lactobacillus species have been proficient in preventing and treating both disorders in animal models and some used for clinical trials. We present the most current studies on the use of Lactobacillus strains that had an impact on an effective immune response to a specific antigen because a variety of antigens have been expressed. Therefore Lactobacillus strains can be considered as good candidates because of its potential for diseases treatment and vaccine development as heterologous protein secretion to date.

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Chronic constipation: Update on management

Abstract: Managing chronic constipation involves identifying and treating secondary causes, instituting lifestyle changes, prescribing pharmacologic and nonpharmacologic therapies, and, occasionally, referring for surgery. Several new drugs have been approved, and others are in the pipeline.

Cited by 43 publications

References 83 publications

Management of common adverse effects of antipsychotic medications

Management of common adverse effects of antipsychotic medications

Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

New Progress Regarding the Use of Lactic Acid Bacteria as Live Delivery Vectors, Treatment of Diseases and Induction of Immune Responses in Different Host Species Focusing on Lactobacillus Species

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