Related Experiment Videos
[Therapeutic options of chronic constipation]
H Krammer1, F Schlieger, M V Singer
1II. Medizinische Universitätsklinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim. h.krammer@med.ma.uni-heidelberg.de
Der Internist
|November 12, 2005
Summary
Chronic constipation affects 25% of Western populations, impacting quality of life. Treatment varies by type, including lifestyle changes, bulk-forming laxatives, osmotic agents like polyethylene glycol, and tegaserod for constipation relief.
Area of Science:
- Gastroenterology
- Pharmacology
Context:
- Chronic constipation is a prevalent gastrointestinal disorder affecting up to 25% of Western populations.
- Symptoms significantly reduce patients' quality of life and impose a substantial health burden.
Purpose:
- To review and summarize current therapeutic strategies for chronic constipation based on its type and severity.
- To evaluate the evidence supporting various treatment options for different constipation subtypes.
Summary:
- For normal transit constipation, lifestyle modifications and dietetic advice are suggested, though lacking strong validation.
- Bulk-forming laxatives (psyllium, probiotics) offer moderate evidence (Grade B), while osmotic laxatives like polyethylene glycol solutions have strong evidence (Grade A).
- Tegaserod (a 5-HT4 agonist) is effective (Grade A); slow-transit constipation may require osmotic and stimulant laxatives (polyethylene glycol - Grade A, bisacodyl - Grade C); outlet constipation benefits from bulk-forming agents, suppositories, and enemas.
Impact:
- Provides an evidence-based overview to guide clinical practice in managing chronic constipation.
- Highlights the varying efficacy of treatments across different constipation subtypes, aiding personalized patient care.
- Emphasizes the need for validated therapeutic approaches in managing this widespread condition.