Chronic severe constipation

Andromanakos, Nikolaos; Pinis, Stamatis I.; Kostakis, Alkiviadis

doi:10.1097/meg.0000000000000288

Cited by 29 publications

(19 citation statements)

References 150 publications

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“…Despite previous studies that reported OIC occurring more frequently in women and patients aged ≥ 50 years, we did not observe correlations between sex or age and incidence of OIC. Rather, these earlier findings may have been the result of higher rates of chronic constipation in these patient subgroups and may not have been specific to OIC . The current study excluded patients with chronic constipation, thereby eliminating potential confounding effects of sex‐ or age‐related risk associated with chronic constipation.…”

Section: Discussionmentioning

confidence: 89%

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

et al. 2019

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This multicenter, prospective, observational cohort study assessed opioid induced constipation (OIC) in Japanese patients with cancer. Eligible patients had stable cancer and an ECOG PS of 0‐2. OIC incidence based on the Rome IV diagnostic criteria was determined by patient diary entries during the first 14 days of opioid therapy. The proportion of patients with OIC was calculated for each 1‐week period and the overall 2‐week study period. Secondary measurements of OIC included the Bowel Function Index (BFI) score (patient assessment administered by physician), spontaneous bowel movements (SBMs) per week (patient assessment), and physician assessments. Medication for constipation was allowed. Two hundred and twenty patients were enrolled. The mean morphine‐equivalent dose was 22 mg/day. By Rome IV criteria, the cumulative incidence of OIC was 56% (95% CI: 49.2%‐62.9%); week 1, 48% (95% CI: 40.8%‐54.6%); week 2, 37% (95% CI: 30.1%‐43.9%). The cumulative incidence of OIC was lower in patients who received prophylactic agents for constipation (48% [95% CI: 38.1%‐57.5%]) than in patients who did not (65% [95% CI: 55.0%‐74.2%]). The cumulative incidences of OIC were 59% (95% CI: 51.9%‐66.0%), 61% (95% CI: 54.3%‐68.1%), and 45% (95% CI: 38.0%‐51.8%) based on BFI scores, physician assessments, and SBM frequency, respectively. Frequency of BMs/week before starting opioids was the most influential factor for the occurrence of OIC. Utilization of prophylactic agents for constipation was associated with a modest effect on reducing the incidence of OIC. The incidences of OIC reported were variable depending on the diagnostic tool involved.

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Section: Discussionmentioning

confidence: 89%

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

et al. 2019

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“…The complete absence or a significant reduction in the number of ICCs in colon specimens resected from patients with STC has been reporeted in comparison with normal controls ( 6 ). In addition, a number of other pathophysiological abnormalities, including the degeneration of the myenteric plexus ganglia, the aberrant expression of smoothelin protein, and abnormalities of the enteric neurotransmitters may be associated with constipation ( 7 , 8 ). However, the mechanisms through which these numerous abnormalities contribute to the pathogenesis of constipation remain to be further elucidated.…”

Section: Introductionmentioning

confidence: 99%

Naringenin induces laxative effects by upregulating the expression levels of c-Kit and SCF, as well as those of aquaporin 3 in mice with loperamide-induced constipation

et al. 2017

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Constipation is a common affliction which causes discomfort and affects the quality of life of affected individuals. Naringenin (NAR), a natural flavonoid widely found in citrus fruits and tomatoes, has been reported to exhibit various pharmacological effects, such as anti-inflammatory, anti-atherogenic, anti-mutagenic, hepatoprotective and anticancer effects. Increasing evidence has indicated that NAR has potential for use in the treatment of constipation. Thus, the aim of this study was to evaluate the laxative effects of NAR in mice with loperamide-induced (Lop-induced) constipation. The data indicated that NAR relieved Lop-induced constipation in mice based on the changes of fecal parameters (numbers, weight and water content), the intestinal charcoal transit ratio and the histological alteration. ELISA revealed that NAR regulated the production levels of gastrointestinal metabolic components, such as motilin (MTL), gastrin (Gas), endothelin (ET), substance P (SP), acetylcholinesterase (AChE) and vasoactive intestinal peptide (VIP) in serum. The expression levels of enteric nerve-related factors, glial cell line-derived neurotrophic factor (GDNF), transient receptor potential vanilloid 1 (TRPV1), nitric oxide synthase (NOS), c-Kit, stem cell factor (SCF) and aquaporin 3 (AQP3) were examined by western blot analysis and RT-PCR analysis. The results of this study suggest that NAR relieves Lop-induced constipation by increasing the levels of interstitial cells of Cajal markers (c-Kit and SCF), as well as AQP3. Thus, NAR may be effective as a candidate in patients suffering from lifestyle-induced constipation.

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“…The pathogenic mechanisms for STC have been discussed. Several studies have suggested that propagating motor contractions are deficient in STC [12][13][14][15] and medical treatment usually aims at increasing intestinal secretion or stimulating and restoring motor function. Inflammatory and degenerative changes in myenteric ganglia as well as altered levels of enteric neurotransmitters have been discussed in the pathophysiology of STC [14].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome after segmental colonic resection for slow transit constipation

Tsimogiannis

Karlbom

Lundin

et al. 2019

Int J Colorectal Dis

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Purpose Colectomy with ileorectal anastomosis (IRA) is the most common surgical procedure for slow transit constipation (STC). A hemicolectomy has been suggested as an alternative to IRA with good short-term results. However, long-term results are unknown. The aim of this study was to evaluate the long-term results after hemicolectomy as a treatment for STC. Methods Fifty patients with STC were selected for right-or left-sided hemicolectomy after evaluation with colonic scintigraphy from 1993 to 2008. Living patients (n = 43) received a bowel function questionnaire and a questionnaire about patient-reported outcome. Results After a median follow-up of 19.8 years, 13 patients had undergone rescue surgery (n = 12) or used irrigation (n = 1) and were classified as failures. In all, 30 were evaluable for functional outcome and questionnaire data for 19 patients (due to 11 nonresponding) could be analysed. Two reported deterioration after several years and were also classified as failures. Median stool frequency remained increased from 1 per week at baseline to 5 per week at long-term follow-up (p = 0.001). Preoperatively, all patients used laxatives, whereas 12 managed without laxatives at long-term follow-up (p = 0.002). There was some reduction in other constipation symptoms but not statically significant. In the patients' global assessment, 10 stated a very good result, seven a good result and two a poor result. Conclusions Hemicolectomy for STC increases stool frequency and reduces laxative use. Long-term success rate could range between 17/50 (34%) and 35/50 (70%) depending on outcome among non-responders.

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Chronic severe constipation

Cited by 29 publications

References 150 publications

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

Naringenin induces laxative effects by upregulating the expression levels of c-Kit and SCF, as well as those of aquaporin 3 in mice with loperamide-induced constipation

Long-term outcome after segmental colonic resection for slow transit constipation

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