Misoprostol is effective treatment for patients with severe chronic constipation

Soffer, Edy E.; Metcalf, Amanda M.; Launspach, Janice L.

doi:10.1007/bf02087539

Cited by 82 publications

(39 citation statements)

References 23 publications

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“…In adults, management may be more challenging than increased frequency and weight of bowel movements in adults with severe chronic constipation [44]. There have in children.…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

Are Constipated Children Different from Constipated Adults?

Solzi

Lorenzo²

1999

Dig Dis

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Constipation represents a diagnostic category of high prevalence both in children and adults, but with low disability and hospitalization rates. This review is written to be a relatively practical guide to physicians providing information for the evaluation and management of one of the most common chronic digestive disorders. In this article we emphasize the differences between constipation in children and adults. The approach to childhood constipation needs to focus on the behavioral nature of this disorder. Diagnostic techniques often used in constipated adults may not provide useful data when applied to children. Treatment of childhood constipation requires a team effort involving the physician, parents and child.

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“…In adults, management may be more challenging than increased frequency and weight of bowel movements in adults with severe chronic constipation [44]. There have in children.…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

Are Constipated Children Different from Constipated Adults?

Solzi

Lorenzo²

1999

Dig Dis

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“…Other drugs used in patients with constipation not responding to standard medications are: prostaglandin E 1 analogue, misoprostol [69], and microtubule formation inhibitor, colchicines [70]. It is important to remember that misoprostol cannot be used during pregnancy and should be used cautiously in reproductive age women who could become pregnant because of effects on uterine contractility and risk of abortion.…”

Section: Treating Other Functional Bowel Disordersmentioning

confidence: 99%

Pharmacological Treatment of the Irritable Bowel Syndrome and Other Functional Bowel Disorders

Mearin

2006

Digestion

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Functional digestive disorders constitute one of the main causes of consultation in gastroenterology and primary health care. Is still unclear whether therapy has to be aimed to the gut, to the neural pathways controlling bowel motility and perception, or to the processing mechanisms of symptoms and disease behaviour. It is conceivable that in the next future better understanding of functional bowel disorders pathophysiology will help us to tailor treatment for different patients. At the moment, subclassification of the diverse patterns of symptomatology allows to adjust new treatments for irritable bowel syndrome (IBS) according to the clinical predominance for each patient. The knowledge of motor and sensorial response to different stimuli in IBS patients and the pathways to the central nervous system is an important source of information for the development of new molecules. Fiber-enriched diet is frequently given for constipation-predominant IBS. Loperamide, antispasmodic drugs and tricyclic antidepressants are nowadays the basis for pharmacological treatment of diarrhea- predominant IBS. The scientific evidence supporting this therapeutical approach is however limited. Visceral analgesics and serotonin agonists and antagonists may play an important therapeutical role in the near future. However, it is not likely that one single treatment will help every functional bowel disorder patient and many of them will need a more complex approach with a multidisciplinary therapy (diet, psychotherapy, medications).

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“…Soffer et al did report in 1994, that in nine patients with RCC, misoprostol could be shown to signi®cantly increase the weight and frequency of bowel movements with an associated decrease in colonic transit time when administered during a 1-week trial. 16 It was not known, however, if this effect could be sustained over a long period or if the response was transitory. We found mixed results with our outpatient population.…”

Section: ±24mentioning

confidence: 99%

“…In a shortterm clinical trial colonic transit time decreased and faecal weight increased in patients with severe refractory chronic constipation (RCC) given misoprostol over 1 week. 16 However, there are no published data regarding the long-term clinical outcome of RCC patients treated with misoprostol. The aim of this study was to determine the short-and long-term effects of misoprostol in patients with severe RCC as demonstrated by post-prandial colonic myoelectical activity, colonic transit time and clinical response.…”

mentioning

confidence: 99%

Misoprostol in the treatment of chronic refractory constipation: results of a long‐term open label trial

Roarty

Weber

Soykan

et al. 1997

Aliment Pharmacol Ther

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Background:Misoprostol is known to be effective in stimulating intestinal transit both in healthy individuals and in patients with chronic constipation when evaluated in short‐term trials. The aim of this study was to determine the utility of misoprostol in the long‐term management of patients with chronic refractory constipation.Methods:Eighteen patients were offered misoprostol (600–2400 μg/day) as adjunctive therapy in an open‐ended, non‐blinded trial. All patients were encouraged to continue the drug for a minimum of 4 weeks, after which time the effect on bowel movement patterns was evaluated and continued use of misoprostol was offered to those patients who demonstrated a clinical benefit.Results:Six patients withdrew prior to 4 weeks because of side‐effects. In the 12 patients who continued the treatment and were evaluated at 4 weeks, the mean interval between bowel movement frequency had decreased from a baseline of 11.25 to 4.8 days (P=0.0004). Eight patients continued the long‐term treatment, with sustained response seen in six. In a subset of patients (n=4) the effect of single‐dose misoprostol (400 μg) was evaluated compared to healthy controls (n=5) on post‐prandial segmental colonic motility. Misoprostol augmented the colonic motility response to a meal throughout the colon, and this was significantly greater in the left versus right colonic segments (P < 0.05).Conclusions:Misoprostol can be effective as part of the long‐term medical treatment of patients with chronic refractory constipation, but side‐effects are observed at higher doses and can be a limiting factor. Part of misoprostol's action may be mediated through the augmentation of colonic motility, particularly of the left colon.

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Misoprostol is effective treatment for patients with severe chronic constipation

Cited by 82 publications

References 23 publications

Are Constipated Children Different from Constipated Adults?

Are Constipated Children Different from Constipated Adults?

Pharmacological Treatment of the Irritable Bowel Syndrome and Other Functional Bowel Disorders

Misoprostol in the treatment of chronic refractory constipation: results of a long‐term open label trial

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