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Searching for a definition for pharmacologically refractory constipation: A systematic review
Alex Yu Sen Soh1, Jin-Yong Kang2,3, Kewin Tien Ho Siah1
1Department of Gastroenterology and Hepatology, National University Hospital, Singapore.
Journal of Gastroenterology and Hepatology
|September 30, 2017
Summary
A clear definition for pharmacologically refractory constipation is needed. This systematic review found no consensus on criteria, hindering evaluation of new treatments and invasive procedures for chronic constipation.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Chronic constipation management includes surgery and sacral nerve stimulation.
- Novel pharmacological agents are emerging for difficult-to-treat constipation.
Purpose of the Study:
- To systematically review and determine the criteria used to define pharmacologically refractory constipation.
- To identify the lack of a consistent definition for refractory constipation across studies.
Main Methods:
- A systematic review of literature from June 2005 to June 2015.
- Searches included PubMed, Cochrane, Scopus, and manual searches.
- Extracted data on definitions of refractory constipation and pharmacological treatments used.
Main Results:
- Sixty-one studies were included (48 surgical, 13 non-surgical).
- No universally accepted definition of refractory constipation exists.
- Lack of consensus on drug choice, order, dosage, and duration of treatment.
Conclusions:
- A precise definition of pharmacologically refractory constipation is essential.
- This definition is crucial before considering invasive treatments or evaluating new drugs.
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