scholarly journals Recommendations on Chronic Constipation (Including Constipation Associated with Irritable Bowel Syndrome) Treatment

2007 ◽  
Vol 21 (suppl b) ◽  
pp. 3B-22B ◽  
Author(s):  
Pierre Paré ◽  
Ronald Bridges ◽  
Malcolm C Champion ◽  
Subhas C Ganguli ◽  
James R Gray ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Health Care Professionals ◽  
Chronic Constipation ◽  
Clinical Care ◽  
Treatment Algorithm ◽  
Treatment Recommendations ◽  
Lifestyle Changes ◽  
Bulking Agents ◽  
Consensus Group ◽  
Irritable Bowel

While chronic constipation (CC) has a high prevalence in primary care, there are no existing treatment recommendations to guide health care professionals. To address this, a consensus group of 10 gastroenterologists was formed to develop treatment recommendations. Although constipation may occur as a result of organic disease, the present paper addresses only the management of primary CC or constipation associated with irritable bowel syndrome. The final consensus group was assembled and the recommendations were created following the exact process outlined by the Canadian Association of Gastroenterology for the following areas: epidemiology, quality of life and threshold for treatment; definitions and diagnostic criteria; lifestyle changes; bulking agents and stool softeners; osmotic agents; prokinetics; stimulant laxatives; suppositories; enemas; other drugs; biofeedback and behavioural approaches; surgery; and probiotics. A treatment algorithm was developed by the group for CC and constipation associated with irritable bowel syndrome. Where possible, an evidence-based approach and expert opinions were used to develop the statements in areas with insufficient evidence. The nature of the underlying pathophysiology for constipation is often unclear, and it can be tricky for physicians to decide on an appropriate treatment strategy for the individual patient. The myriad of treatment options available to Canadian physicians can be confusing; thus, the main aim of the recommendations and treatment algorithm is to optimize the approach in clinical care based on available evidence.

scholarly journals Recommendations on Chronic Constipation (including Constipation Associated with Irritable Bowel Syndrome) Treatment

2007 ◽  
Vol 21 (suppl b) ◽  
pp. 3B-22B ◽  
Author(s):  
Pierre Paré ◽  
Ronald Bridges ◽  
Malcolm Champion ◽  
Subhas C Ganguli ◽  
James R Gray ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Health Care Professionals ◽  
Chronic Constipation ◽  
Clinical Care ◽  
Treatment Algorithm ◽  
Treatment Recommendations ◽  
Lifestyle Changes ◽  
Bulking Agents ◽  
Consensus Group ◽  
Irritable Bowel

While chronic constipation (CC) has a high prevalence in primary care, there are no existing treatment recommendations to guide health care professionals. To address this, a consensus group of 10 gastroenterologists was formed to develop treatment recommendations. Although constipation may occur as a result of organic disease, the present paper addresses only the management of primary CC or constipation associated with irritable bowel syndrome. The final consensus group was assembled and the recommendations were created following the exact process outlined by the Canadian Association of Gastroenterology for the following areas: epidemiology, quality of life and threshold for treatment; definitions and diagnostic criteria; lifestyle changes; bulking agents and stool softeners; osmotic agents; prokinetics; stimulant laxatives; suppositories; enemas; other drugs; biofeedback and behavioural approaches; surgery; and probiotics. A treatment algorithm was developed by the group for CC and constipation associated with irritable bowel syndrome. Where possible, an evidence-based approach and expert opinions were used to develop the statements in areas with insufficient evidence. The nature of the underlying pathophysiology for constipation is often unclear, and it can be tricky for physicians to decide on an appropriate treatment strategy for the individual patient. The myriad of treatment options available to Canadian physicians can be confusing; thus, the main aim of the recommendations and treatment algorithm is to optimize the approach in clinical care based on available evidence.

scholarly journals EFFICACY AND SAFETY OF INTESTINAL SECRETAGOGUES FOR CHRONIC CONSTIPATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 55 (suppl 1) ◽  
pp. 2-12 ◽  
Author(s):  
Juan Sebastian LASA ◽  
María Josefina ALTAMIRANO ◽  
Luis Florez BRACHO ◽  
Silvina PAZ ◽  
Ignacio ZUBIAURRE
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chronic Constipation ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Spontaneous Bowel Movement ◽  
Intention To Treat ◽  
Mesh Terms ◽  
Bowel Movements ◽  
Irritable Bowel ◽  
Therapeutic Alternatives

ABSTRACT BACKGROUND: Intestinal secretagogues have been tested for the treatment of chronic constipation and constipation-predominant irritable bowel syndrome. The class-effect of these type of drugs has not been studied. OBJECTIVE: To determine the efficacy and safety of intestinal secretagogues for the treatment of chronic constipation and constipation-predominant irritable bowel syndrome. METHODS: A computer-based search of papers from 1966 to September 2017 was performed. Search strategy consisted of the following MESH terms: intestinal secretagogues OR linaclotide OR lubiprostone OR plecanatide OR tenapanor OR chloride channel AND chronic constipation OR irritable bowel syndrome. Data were extracted as intention-to-treat analyses. A random-effects model was used to give a more conservative estimate of the effect of individual therapies, allowing for any heterogeneity among studies. Outcome measures were described as Relative Risk of achieving an improvement in the symptom under consideration. RESULTS: Database Search yielded 520 bibliographic citations: 16 trials were included for analysis, which enrolled 7658 patients. Twelve trials assessed the efficacy of intestinal secretagogues for chronic constipation. These were better than placebo at achieving an increase in the number of complete spontaneous bowel movements per week [RR 1.87 (1.24-2.83)], at achieving three or more spontaneous bowel movements per week [RR 1.56 (1.31-1.85)] and at inducing spontaneous bowel movement after medication intake [RR 1.49 (1.07-2.06)]. Similar results were observed when assessing the efficacy of intestinal secretagogues on constipation-predominant irritable bowel syndrome based on the results of six trials. CONCLUSION: Intestinal secretagogues are useful and safe therapeutic alternatives for the treatment of constipation-related syndromes.

scholarly journals Sexual Abuse in Irritable Bowel Syndrome: To Ask or Not to Ask – That Is the Question

2002 ◽  
Vol 16 (11) ◽  
pp. 801-805 ◽  
Author(s):  
Alexandra Ilnyckyj ◽  
Charles N Bernstein
Keyword(s):  
Irritable Bowel Syndrome ◽  
Current Practice ◽  
Treatment Recommendations ◽  
Opinion Leaders ◽  
Management Approach ◽  
Abuse History ◽  
Ethical Context ◽  
Canadian Association ◽  
Male Patients ◽  
Irritable Bowel

BACKGROUND: Irritable bowel syndrome (IBS) is a common and costly disorder in Canada. The paucity of medical treatment underscores the importance of examining every element of the management approach. Data exist supporting an increased prevalence of abuse among individuals with IBS. Importantly, the pathophysiology underlying the link between abuse and IBS is increasingly understood. Treatment recommendations by opinion leaders support an abuse inquiry. However, many clinicians view abuse inquiry as an ethical dilemma.METHOD: Canadian gastroenterologists were surveyed to determine current practice patterns and to identify barriers to inquiry. Barriers cited by clinicians were explored within an ethical context.RESULTS: Abuse inquiry is not universally practised in Canada. Fifty-four per cent of the membership of Canadian Association of Gastroenterologists responded to the survey. They reported inquiring into abuse histories in approximately 50% of patients with IBS. The frequency of inquiry declined when male patients were considered. The primal barriers cited were time constraints (25%), personal comfort with abuse issues (25%) and lack of resources for addressing the abuse (33%). Importantly, only a minority (10%), cited abuse history as irrelevant to the management of the patient.INTERPRETATION: Physicians identify significant barriers to pursuing an inquiry into abuse. However, a minority cited ‘clinical irrelevance’ as a primal barrier, the implicit statement being that the abuse history has clinical relevance. This view is consistent with opinion leaders and published treatment recommendations. Therefore, by not inquiring into the abuse history, physicians are not fulfilling their ethical responsibility to the patient. Physicians need to resolve their barriers to inquiry. Furthermore, they need to familiarize themselves with treatment recommendations and include this review in their consultation.

scholarly journals The Irritable Bowel: A Pathological or a Psychological Syndrome?

1988 ◽  
Vol 81 (12) ◽  
pp. 718-720 ◽  
Author(s):  
D Waxman
Keyword(s):  
Irritable Bowel Syndrome ◽  
Antidepressant Medication ◽  
Bulking Agents ◽  
Case Histories ◽  
Treatment Regimens ◽  
Symptoms Of Depression ◽  
Bowel Symptoms ◽  
Irritable Bowel

The irritable bowel syndrome is discussed together with some of its theories, methods of investigation and various treatment regimens. Eight case histories are reported. In each patient, symptoms appeared to be precipitated by situations interpreted by that patient as stressful. A programme of prospective desensitization using hypnosis is described. Where symptoms of depression were additionally present, antidepressant medication was prescribed. This was subsequently phased out as and when indicated. Where patients had been taking antidiarrhoeal or antispasmodic drugs, various stool bulking agents or benzodiazepines, these were also slowly discontinued as treatment progressed. Cases were followed up from 3 months to 12 years. In 2 cases recurrence of symptoms was again successfully treated. There was no recurrence of any of the bowel symptoms in any other patient. The results support the view that the irritable bowel syndrome is psychogenic in origin.

Sign in / Sign up

Export Citation Format

Share Document