Home
Resources
Publications
Treatments for Constipation: A Review of Systematic Reviews [Internet]

Treatments for Constipation: A Review of Systematic Reviews [Internet]

PMID: 25535635

Abstract:

Constipation has many definitions and is often described differently depending on the population queried. Physicians may define constipation as a reduction in the frequency of bowel movements to fewer than three times per week while patients identify more with the symptoms associated with constipation such as difficulty passing stool, hard stool consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely. It can substantially affect quality of life and be debilitating. It is estimated that between 2% to 27% of the population are affected depending upon the definition of constipation used.
Several treatment options are available and include dietary or bulking agents, osmotic or stimulant laxatives, stool softeners, and 5-HT4 agonists. Bulking agents include soluble fibre (i.e. psyllium, ispaghula) and insoluble fibre (i.e. wheat bran), which, when taken with water, increase stool bulk and stool frequency. Osmotic laxatives (i.e. lactulose, polyethylene glycol [PEG], macrogol, milk of magnesia), are poorly absorbed by the gut and act as hyperosmolar agents, increasing the water content of stool and making the stool softer and easier to pass. Stimulant laxatives (i.e. sennosides, bisacodyl, sodium picosulfate) act on the intestinal mucosa, increasing water and electrolyte secretion and stimulating peristalsis. Stool softeners (i.e. docusate sodium or calcium) are thought to facilitate the mixing of aqueous and fatty substances and thereby soften the stool. The 5-HT4 agonists (i.e. prucalopride) stimulate peristalsis which increases colonic motility in individuals with non-neurogenic causes of constipation.
Considering the different causes and patient populations that may experience constipation, there are questions with regards to the efficacy and safety of the treatments available. A recent Rapid Review concluded there was a paucity of good quality of evidence to support the use of stool softeners for the management or prevention of constipation in adults in a hospital or long-term care setting. Docusate appeared to be no more effective than placebo for increasing stool frequency or softening stools and did not lessen symptoms associated with constipation. The purpose of this report is to review the available evidence for the safety and efficacy of stool softeners, laxatives, bulking agents and 5-HT4 agonists for the management of constipation in adults and children.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP517431	Sennosides		517-43-1	Price

As a specialist in analytical chemical Products, Alfa Chemistry offers consumers a wealth of raw materials and a full range of technologies and services.

QUICK LINKS

HEADQUARTERS

Tel:

Fax:

Email: