Therapeutic Effects of Prebiotics on Constipation: A Schematic Review

2020 ◽  
Vol 15 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Suleyman Uraz ◽  
Veysel Tahan
Keyword(s):  
Chronic Constipation ◽  
English Language ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Gastrointestinal Disorder ◽  
Therapeutic Effects ◽  
Idiopathic Constipation ◽  
Surgical Interventions ◽  
Chronic Idiopathic Constipation ◽  
Cognitive Therapies

Constipation is a highly prevalent functional gastrointestinal disorder that may significantly affect the quality of life and health care costs. Treatment for constipation has been broadly reviewed by cognitive therapies, medications, and surgical interventions. Gut microbiota such as Bifidobacterium, Clostridium, Bacteroidetes, and Lactobacilli have been demonstrated in functional gastrointestinal disorders and prebiotics to play a role in augmenting their presence. Prebiotics are ingredients in foods that remain undigested, stimulating the bacteria. There are a variety of prebiotics; however, there exists only a handful of studies that describe their efficacy for chronic constipation. The purpose of this study is to review the available literature on the utility of different commercially available prebiotics in patients with functional and chronic idiopathic constipation. To fulfil the objectives of the study, published articles in the English language on databases such as Pubmed, Ovid Medline, and EMBASE were searched. The terms prebiotics, constipation, chronic constipation, functional constipation were used. We reviewed and included 21 randomized controlled trials exploring the role of prebiotics in constipated adults. Prebiotics are effective treatments for chronic idiopathic constipation and showed improvement in the stool consistency, number of bowel moments and bloating. Although which prebiotic formulary would promote improved symptoms of constipation is still not clear.

scholarly journals Clinical and economic profile of prucalopride in the treatment of chronic constipation in women

2012 ◽  
Vol 13 (3) ◽  
pp. 105-120
Author(s):  
Vincenzo Stanghellini ◽  
Mario Eandi
Keyword(s):  
Chronic Constipation ◽  
Previous Treatment ◽  
Pharmacological Profile ◽  
Idiopathic Constipation ◽  
Chronic Idiopathic Constipation ◽  
Eu Countries ◽  
Common Disorder ◽  
Economic Profile ◽  
High Doses ◽  
The Eu

Chronic constipation is a common disorder, especially in women. Options available for different subgroups of constipation are limited and in most cases unsatisfactory. The most severe forms of chronic constipation often require the use of laxatives in high doses or the use of invasive therapies. The introduction of a new drug, such as prucalopride, active in promoting intestinal transit, can help to improve the therapy of patients with chronic idiopathic constipation who have not found relief from previous treatment with laxatives. In this review, after a brief discussion of pathophysiology and pharmacotherapy of chronic constipation, we evaluate the pharmacological profile, therapeutic and cost of prucalopride, recently authorized in the EU countries and also available in Italy for the treatment of chronic constipation in women who did not benefit from the use of laxatives

scholarly journals Lessons learned: Chronic idiopathic constipation patient experiences with over-the-counter medications

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243318
Author(s):  
Brian E. Lacy ◽  
Elizabeth P. Shea ◽  
Machelle Manuel ◽  
Jessica L. Abel ◽  
Hancheng Jiang ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Gastrointestinal Disorder ◽  
Patient Experiences ◽  
Lessons Learned ◽  
Limited Information ◽  
Idiopathic Constipation ◽  
Over The Counter ◽  
Chronic Idiopathic Constipation ◽  
Abdominal Symptoms ◽  
Patient Reported

Introduction Chronic idiopathic constipation (CIC) is a prevalent functional gastrointestinal disorder diagnosed based on patient-reported symptoms and the absence of structural gastrointestinal abnormalities. Individuals with CIC typically institute dietary changes and use stool softeners or over-the-counter (OTC) laxatives, possibly at the direction of a healthcare provider, before prescription medications for CIC are initiated. Although highly prevalent, there is limited information regarding CIC patient experiences with OTC medications. Methods This post-hoc analysis used patient-reported data from a questionnaire administered during patient screening for a prospective linaclotide Phase 3b clinical trial in patients with CIC (N = 1482 screened). The questionnaire asked patients to report their experiences with OTC CIC medications over the preceding 6 months. Results Among patients with screening responses (N = 1423), most were female (85%) and white (66%), with a mean age of 48.9 years. A high proportion of patients had used one or more OTC medications (70% had ≥1 OTC; 19% had ≥3 OTCs), with the majority being bisacodyl (33%) and polyethylene glycol (30%). The most commonly cited reason for stopping an OTC medication was insufficient symptom relief (17–40%). The majority of patients taking OTC medications reported no or little satisfaction with the medication’s effect on their constipation (62%) and CIC-specific abdominal symptoms (78%). Many patients had little to no confidence in bowel movement (BM) frequency after taking OTC medications and their confidence in their ability to predict BM timing was also low (49–81% not at all confident). Conclusions Treatment effects on individual CIC symptoms, predictability of bowel habits, and satisfaction with treatment are all important factors for healthcare providers and patients to consider when establishing an effective treatment regimen for CIC. Trial registration number NCT01642914

scholarly journals Linaclotide: A New Option for the Treatment of Irritable Bowel syndrome with Constipation and Chronic Idiopathic Constipation in Adults

2013 ◽  
Vol 6 ◽  
pp. CGast.S10550 ◽  
Author(s):  
Colleen H. Parker ◽  
Yuhong Yuan ◽  
Louis Wing Cheong Liu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Gastrointestinal Disorders ◽  
Cochrane Central Register ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Idiopathic Constipation ◽  
Chronic Idiopathic Constipation ◽  
Central Register ◽  
Water Secretion ◽  
Irritable Bowel

Chronic idiopathic constipation (CC) and irritable bowel syndrome with predominant constipation (IBS-C) are the 2 most common conditions among functional gastrointestinal disorders. Despite current multiple therapeutic options, treatment remains challenging and dissatisfactory to many patients. Linaclotide is a novel therapeutic agent, which is a guanylate cyclase receptor agonist that stimulates water secretion from the intestinal epithelium by promoting chloride and bicarbonate efflux into the lumen through activation of the cystic fibrosis transmembrane conductance regulator. Clinical trials have demonstrated that linaclotide is effective, safe and well tolerated in patients with CC and IBS-C. This review article highlights the mechanism of action of linaclotide, reviews published literature based on a search of databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL), up to February 2013, and compares its utility with other currently available agents.

Surgical Interventions for Functional Constipation: An Update

2020 ◽  
Vol 30 (05) ◽  
pp. 413-419
Author(s):  
Alejandra Vilanova-Sanchez ◽  
Marc A. Levitt
Keyword(s):  
Sacral Nerve Stimulation ◽  
Botulinum Toxin Injection ◽  
Colonic Motility ◽  
Rectal Biopsy ◽  
Functional Constipation ◽  
Contrast Enema ◽  
Idiopathic Constipation ◽  
Surgical Interventions ◽  
Surgical Options ◽  
Intestinal Diversion

AbstractChronic idiopathic constipation, also known as functional constipation, is defined as difficult and infrequent defecation without an identifiable organic cause. Medical management with laxatives is effective for the majority of constipated children. However there is a subset of patients who may need evaluation by a surgeon. As constipation progresses, it can lead to fecal retention and rectal and sigmoid distension, which impairs normal colorectal motility. Surgical interventions are influenced by the results of: a rectal biopsy, transit studies, the presence of megacolon/megarectum on contrast enema, the degree of soiling/incontinence, anorectal manometry findings, and colonic motility evaluation. In this review, we describe the different surgical options available (intestinal diversion, antegrade enemas, sacral nerve stimulation, colonic resections, and Botulinum toxin injection) and provide guidance on how to choose the best procedure for a given patient.

scholarly journals An update on prucalopride in the treatment of chronic constipation

2017 ◽  
Vol 10 (11) ◽  
pp. 877-887 ◽  
Author(s):  
Anam Omer ◽  
Eamonn M.M. Quigley
Keyword(s):  
Chronic Constipation ◽  
Colonic Motility ◽  
Gastrointestinal Disorder ◽  
The United States ◽  
Colonic Transit ◽  
Lifestyle Modifications ◽  
Idiopathic Constipation ◽  
Cardiac Side Effects ◽  
Significant Impairment ◽  
Irritable Bowel

Chronic constipation (CC) is a highly prevalent and often under-appreciated gastrointestinal disorder associated with significant impairment in quality of life. Symptoms of constipation are typically present for a number of years prior to a patient seeking help. Lifestyle modifications followed by, or coupled with, over-the-counter laxatives represent the initial treatment option; however, relief for many is limited and dissatisfaction rates for these approaches remain high. Over recent years, therefore, considerable effort has been exerted on the development of novel pharmacological approaches. Two major targets have emerged, motility and secretion. Research on the former led to the development of a number of prokinetic agents capable of stimulating colonic motility and, thus, accelerating colonic transit. Of these, earlier prototypes such as cisapride and tegaserod, though effective, were ultimately withdrawn due to cardiovascular adverse events due in part to receptor non-selectivity. Highly selective serotonergic receptor agonists have since emerged which appear to be equally effective in stimulating gut motility but are devoid of cardiac side effects. One such agent is prucalopride, which has now been approved for the management of chronic idiopathic constipation in several countries, but not in the United States. Multiple multicenter, randomized placebo-controlled clinical trials have demonstrated superiority for prucalopride compared to placebo in the short to medium term in relieving the major symptoms of constipation in both men and women across a broad spectrum of ages, ethnicities and geographic locations. To date, prucalopride has enjoyed a favorable safety profile and there have been no signals to suggest arrythmogenicity. Efficacy over longer periods of treatment remains to be confirmed. Evidence for efficacy in other forms of constipation, such as opioid-induced constipation and that related to Parkinson’s disease is beginning to emerge; its status in the management of constipation-predominant irritable bowel syndrome or foregut motility disorders, such as gastroparesis, remains to be established.

scholarly journals Transanal Irrigation for Refractory Chronic Idiopathic Constipation: Patients Perceive a Safe and Effective Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Kevin J. Etherson ◽  
Ian Minty ◽  
Iain M. Bain ◽  
Jeremy Cundall ◽  
Yan Yiannakou
Keyword(s):  
Significant Proportion ◽  
Functional Constipation ◽  
Well Being ◽  
Bowel Dysfunction ◽  
Symptom Improvement ◽  
Efficacy And Safety ◽  
Idiopathic Constipation ◽  
Chronic Idiopathic Constipation ◽  
Duration Of Therapy ◽  
Transanal Irrigation

Background. Transanal irrigation (TAI) can successfully treat neurogenic bowel dysfunction (NBD), but patient perception of its use in chronic idiopathic constipation (CIC) is unknown. Objective. To evaluate patient perceptions of the efficacy and safety of TAI for CIC and whether there are predictive factors of perceived treatment response. Methods. Prospective data collection of baseline physiology and symptom severity; retrospective evaluation of efficacy and safety perceptions using a snapshot survey. All patients fulfilling the Rome III criteria for functional constipation with chronic idiopathic aetiology were included. The main outcome measure was the duration of patients’ usage of TAI. Results. 102 patients reported 21,476 irrigations over 119 patient years, with a mean duration of therapy use of 60.5 weeks [SD 73.2 : SE 7.3]. Overall symptom improvement included general well-being (65%), rectal clearance (63%), bloating (49%), abdominal pain (48%), and bowel frequency (42%). 68 patients (67%) were “moderately better” or “very much better” on a satisfaction question. Reported complications were minor. No correlation was demonstrated between duration of therapy use and baseline measures. Conclusion. A significant proportion of CIC sufferers use TAI as a long-term or bridging therapy and perceive it as safe. This therapy demands a prospective investigation of efficacy and safety.

scholarly journals Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

2021 ◽  
Vol 31 (3) ◽  
pp. 7-16
Author(s):  
I. V. Maev ◽  
A. N. Kazyulin ◽  
Yu. A. Kucheryavy ◽  
S. V. Cheryomushkin ◽  
A. Yu. Goncharenko ◽  
...  
Keyword(s):  
Functional Gastrointestinal Disorders ◽  
Diagnostic Algorithm ◽  
Functional Constipation ◽  
Gastrointestinal Disorder ◽  
Diagnostic Value ◽  
Diagnostic Methods ◽  
Rectal Sensation ◽  
Choice Of Treatment ◽  
Balloon Expulsion ◽  
Functional Defecation Disorders

Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology.

Correction of functional constipation in patients with limited mobility after stroke

2019 ◽  
Vol 1 (6) ◽  
pp. 53-55
Author(s):  
M. S. Turchina ◽  
M. V. Bukreeva ◽  
L. Yu. Korolyova ◽  
Zh. E. Annenkova ◽  
L. G. Polyakov
Keyword(s):  
Quality Of Life ◽  
Chronic Constipation ◽  
Functional Constipation ◽  
Cerebrovascular Diseases ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Limited Mobility ◽  
Complete Restoration ◽  
The World

Currently, the problem of early rehabilitation of stroke patients is important, since in terms of the prevalence of cerebrovascular diseases and disability after suffering a stroke, Russia is one of the first places in the world. The complex of medical rehabilitation of such patients should provide for the early and most complete restoration of all body functions, patient education for lost skills, re-socialization of the patient and improvement of the quality of life. One of the factors contributing to a significant reduction in the quality of life after a stroke is the development of chronic constipation. The article reflects the modern methods of correction of chronic constipation in patients with limited mobility.

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