Modern principles of constipation treatment
Abstract
The aim of review. To present up-to-date approach to prescription of laxatives at treatment of constipation.
Original positions. The laxatives are agents with the various mode of action. At incidentally developing constipation stimulative laxatives are most effective. Presence of рН-dependent coating due to which the active substance is delivered to the large intestine, and also predictive time of the effect onset and safety profile make dulcolax (Bisacodyl) an agent of choice among drugs of this group. At chronic constipation with necessity of prolonged treatment the best results of treatment are obtained at application of osmotic laxatives which in case of resistant constipation are prescribed in combination with stimulative purging.
Conclusion. Laxatives prescription should be differentiated with account of differences in mechanisms of their action.
References
1. Баранская Е.К. Запоры // Concilium Provisorum. – 2001. – Т. 1, № 4.
2. Маев И.В. Хронический запор // Лечащий врач. – 2001. – № 7. – С. 53–59.
3. Флетчер Р., Флетчер С., Вагнер Э. Клиническая эпидемиология. Основы доказательной медицины: Пер. с англ. – М.: Медиа Сфера, 1998. – 352 с.
4. Badiali D., Marcheggiano A., Pallone F. et al. Melanosis of the rectum in patients with chronic constipation // Dis. Colon Rectum. – 1985. – Vol. 28, N 4. – Р. 241–245.
5. Baker D.E. Lubiprostone: a new drug for the treatment of chronic idiopathic constipation // Rev. Gastroenterol. Disord. – 2007. – Vol. 7, N 4. – Р. 214–222.
6. Cash B.D., Lacy B.E. Systematic review: FDA-approved prescription medications for adults with constipation // Gastroenterol. Hepatol. – 2006. – N 2. – Р. 736–749.
7. Dennison C., Prasad M., Lloyd A. et al. The health-related quality of life and economic burden of constipation // Pharmacoeconomics. – 2005. – Vol. 23. – Р. 461–476.
8. Drossman D.A., Dumitrascu D.L. Rome III: New standard for functional gastrointestinal disorders // J. Gastrointestin. Liver Dis. – 2006. – Vol. 15, N 3. – Р. 237–241.
9. FDA Public Health Advisory: Tegaserod maleate (marketed as Zelnorm). – http://www.fda.gov/cder/drug/advisory/tegaserod.htm. Accessed April 30, 2007.
10. Ghoshal U.C. Review of pathogenesis and management of constipation // Trop. Gastroenterol. – 2007. – Vol. 28, N 3. – Р. 91–95.
11. Graham M.G., Mokrynski G. Evidence-based management of chronic constipation. – Source: Patient Care. – published: May 1. – 2007.
12. Green L. Using evidence-based medicine in clinical practice // Prim. Care. – 1998. – Vol. 25. – Р. 391–400.
13. Heyman S., Jones R., Scarlett Y. et al. Biofeedback treatment of constipation: a critical review // Dis. Colon Rectum. – 2003. – Vol. 46. – Р. 1208–1217.
14. Hinkel U., Schuijt C., Erckenbrecht J.F. OTC laxative use of sodium picosulfate в results of a pharmacy-based patient survey (cohort study) // Int. J. Clin. Pharmacol. Ther. – 2008. – Vol. 46, N 2. – Р. 89–95.
15. Hsieh C. Treatment of constipation in older adults // Am. Fam. Physician. – 2005. – Vol. 72. – Р. 2277–2284, 2285.
16. Kienzle-Horn S., Vix J.M., Schuijt C. et al. Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation // Curr. Med. Res. Opin. – 2007. – Vol. 23, N 4. – Р. 691–699.
17. Kienzle-Horn S., Vix J.M., Schuijt C. et al. Efficacy and safety of bisacodyl in the acute treatment of constipation: a double-blind, randomized, placebo-controlled study // Aliment. Pharmacol. Ther. – 2006. – Vol. 23, N 10. – Р. 1479–1488.
18. Lennard-Jones I.E. Clinical classification of constipation // Constipation / Eds. M.A. Camm, J.E. Lennard-Jones. – Wrightson Biomedical Publishing, 1994. – Р. 3–10.
19. Lidell E., Luepker R., Baigi A. et al. Medication usage among young adult women: a comparison between Sweden, the USA, and Greece // Nurs. Health Sci. – 2008. – Vol. 10, N 1. – Р. 4–10.
20. Longstreth G., Thompson W., Chey W. et al. Functional bowel disorders // Gastroenterology. – 2006. – Vol. 130. – Р. 1480–1491.
21. Mihaylov S., Stark C., McColl E. et al. Stepped treatment of older adults on laxatives. The STOOL trial // Health Technol. Assess. Rep. – 2008. – Vol. 12, N 13. – Р. 1–160.
22. Mьller-Lissner S. The difficult patient with constipation // Best Pract. Res. Clin. Gastroenterol. – 2007. – Vol. 21, N 3. – Р. 473–484.
23. Mьller-Lissner S., Kamm M., Scarpignato C., Wald A. Myths and misconceptions about chronic constipation // Am. J. Gastroenterol. – 2005. – Vol. 100. – Р. 232–242.
24. Parй P., Bridges R., Champion M. et al. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment // Can. J. Gastroenterol. – 2007. – Vol. 21 (suppl. B). – Р. 3–22.
25. Peppas G., Alexiou Vangelis G, Mourtzoukou E., Falagas E. Epidemiology of constipation in Europe and Oceania: a systematic review // BMC Gastroenterology. – 2008. – Vol. 8, N 5 doi:10.1186/1471–230X-8-5.
26. Rao S.S. Constipation: evaluation and treatment of colonic and anorectal motility disorders // Gastroenterol. Clin. North Am. – 2007. – Vol. 36, N 3. – Р. 687–711.
27. Xing J.H., Soffer E. Adverse effects of laxatives // Dis. Colon Rectum. – 2001. – Vol. 44. – Р. 1201–1209.
Review
For citations:
Livzan M.A. Modern principles of constipation treatment. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(2):70-74. (In Russ.)
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