Evaluation and Treatment of Patients With Constipation

Stern, Todd; Davis, Andrew M.

doi:10.1001/jama.2015.16995

Cited by 22 publications

(16 citation statements)

References 7 publications

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“…Guidelines for the management of constipation in patients with synucleinopathies are lacking . Constipation management includes nonpharmacological approaches, removal of aggravating factors (e.g., opioids), fiber supplements, stool softeners, and pharmacotherapy (Fig.…”

Section: Swallowing and Gastrointestinal Dysfunctionmentioning

confidence: 99%

Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies

2018

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Dysfunction of the autonomic nervous system afflicts most patients with Parkinson disease and other synucleinopathies such as dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure, reducing quality of life and increasing mortality. For example, gastrointestinal dysfunction can lead to impaired drug pharmacodynamics causing a worsening in motor symptoms, and neurogenic orthostatic hypotension can cause syncope, falls, and fractures. When recognized, autonomic problems can be treated, sometimes successfully. Discontinuation of potentially causative/aggravating drugs, patient education, and nonpharmacological approaches are useful and should be tried first. Pathophysiology-based pharmacological treatments that have shown efficacy in controlled trials of patients with synucleinopathies have been approved in many countries and are key to an effective management. Here, we review the treatment of autonomic dysfunction in patients with Parkinson disease and other synucleinopathies, summarize the nonpharmacological and current pharmacological therapeutic strategies including recently approved drugs, and provide practical advice and management algorithms for clinicians, with focus on neurogenic orthostatic hypotension, supine hypertension, dysphagia, sialorrhea, gastroparesis, constipation, neurogenic overactive bladder, underactive bladder, and sexual dysfunction. © 2018 International Parkinson and Movement Disorder Society.

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Section: Swallowing and Gastrointestinal Dysfunctionmentioning

confidence: 99%

Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies

2018

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“…1 Considering changes in diet and ongoing psychological and social stress, the prevalence of constipation has increased on an annual basis and affected between 11% and 20% of the general population, 1 and this has had a serious impact on human health and quality of life. 2 While numerous drugs (such as bulk laxatives, permeable cathartic, lubricating laxative, and so on) for the treatment of constipation are available, long-term use typically leads to related side effects, such as drug tolerance, dependence, and so on. 3 In recent years, we have come to acknowledge that probiotics and food ingredients may alleviate these intestinal motility obstruction symptoms and thus contribute to alleviating constipation.…”

Section: Introductionmentioning

confidence: 99%

The edible Lactobacillus paracasei X11 with Konjac glucomannan promotes intestinal motility in zebrafish

Zhang

Zhou

et al. 2021

Neurogastroenterology Motil

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Background: Constipation is a gastrointestinal symptom with high incidence rate and large number of patients. It is becoming one of the urgent medical problems. Poor intestinal motility is one of the important causes of constipation. Current drug treatments for constipation are associated with many side effects; thus, it is necessary to study more effective treatment methods and potential mechanism.Methods: A zebrafish model of intestinal motility obstruction was established by loperamide hydrochloride to evaluate the effect of probiotic, food ingredients, and combination on intestinal peristalsis according to intestinal peristalsis frequency counts.The gastrointestinal survival ability of the best probiotics was evaluated by surface hydrophobicity, self-aggregation, acid and bile salt tolerance, and gastrointestinal transit tolerance. Interactions between probiotics and food ingredients were studied in vivo and in vitro. The expression of 5-HT was detected by ELISA and fluorescence immunoassay, and 5-HT related genes were detected by RT-PCR.

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“…Constipation is a common health problem and a predisposing factor for many conditions with high death rates. With changes in diet structure and the influence of psychological and social factors in recent years, the incidence of constipation has shown a clear upward trend, which has seriously affected human health and quality of life [ 1 ]. Irritant drugs are generally used to promote defecation, but this treatment has side effects [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Bifidobacterium adolescentis Exerts Strain-Specific Effects on Constipation Induced by Loperamide in BALB/c Mice

Wang

et al. 2017

IJMS

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Constipation is one of the most common gastrointestinal complaints worldwide. This study was performed to determine whether Bifidobacterium adolescentis exerts inter-strain differences in alleviating constipation induced by loperamide in BALB/c mice and to analyze the main reasons for these differences. BALB/c mice underwent gavage with B. adolescentis (CCFM 626, 667, and 669) once per day for 17 days. The primary outcome measures included related constipation indicators, and the secondary outcome measures were the basic biological characteristics of the strains, the concentration changes of short-chain fatty acids in feces, and the changes in the fecal flora. B. adolescentis CCFM 669 and 667 relieved constipation symptoms by adhering to intestinal epithelial cells, growing quickly in vitro and increasing the concentrations of propionic and butyric acids. The effect of B. adolescentis on the gut microbiota in mice with constipation was investigated via 16S rRNA metagenomic analysis. The results revealed that the relative abundance of Lactobacillus increased and the amount of Clostridium decreased in the B. adolescentis CCFM 669 and 667 treatment groups. In conclusion, B. adolescentis exhibits strain-specific effects in the alleviation of constipation, mostly due to the strains’ growth rates, adhesive capacity and effects on the gut microbiome and microenvironment.

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Evaluation and Treatment of Patients With Constipation

Cited by 22 publications

References 7 publications

Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies

Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies

The edible Lactobacillus paracasei X11 with Konjac glucomannan promotes intestinal motility in zebrafish

Bifidobacterium adolescentis Exerts Strain-Specific Effects on Constipation Induced by Loperamide in BALB/c Mice

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