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For:	Portalatin M, Winstead N. Medical management of constipation. Clin Colon Rectal Surg 2012;25:12-9. [PMID: 23449608 PMCID: PMC3348737 DOI: 10.1055/s-0032-1301754] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]

Number

Cited by Other Article(s)

Aoki Y, Kawasoe S, Kubozono T, Yoshimoto J, Kishi M, Kanouchi H, Suzuki S, Ohishi M. Association between defecation status and the habit of eating vinegar-based dishes in community-dwelling Japanese individuals: a cross-sectional study. Sci Rep 2025;15:10732. [PMID: 40155513 PMCID: PMC11953461 DOI: 10.1038/s41598-025-95618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 03/24/2025] [Indexed: 04/01/2025] Open

Hojo M, Shibuya T, Nagahara A. Management of Chronic Constipation: A Comprehensive Review. Intern Med 2025;64:7-15. [PMID: 37952945 PMCID: PMC11781917 DOI: 10.2169/internalmedicine.2867-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/21/2023] [Indexed: 11/14/2023] Open

Abbasi A, Emmanuel AV, Tayyab GUN, Shafique K, Kamani L, Nasir MB, Butt N, Sabir SH, Abid S, Rasool S, Akhter TS, Azam Z. Consensus Guidelines on Constipation in Adults in Pakistan. Pak J Med Sci 2024;40:2763-2768. [PMID: 39634870 PMCID: PMC11613393 DOI: 10.12669/pjms.40.11.9687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 09/30/2024] [Accepted: 10/18/2024] [Indexed: 12/07/2024] Open

Piotrowicz G, Ossowska-Dorosz B, Dorosz Ł, Kaszubowski MF, Małgorzewicz S, Stępień B, Rudnik A, Synowiecka A, Rydzewska G. Managing diverticula: dietary changes for a more comfortable life. PRZEGLAD GASTROENTEROLOGICZNY 2024;20:92-101. [PMID: 40191509 PMCID: PMC11966515 DOI: 10.5114/pg.2024.144982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/19/2024] [Indexed: 04/09/2025]

Ota T, Kuratani S, Masaki H, Ishizaki S, Seki H, Takebe T. Impact of chronic constipation symptoms on work productivity and daily activity: A large-scale internet survey. JGH Open 2024;8:e70042. [PMID: 39502164 PMCID: PMC11532788 DOI: 10.1002/jgh3.70042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/07/2024] [Accepted: 09/30/2024] [Indexed: 11/08/2024]

Abstract

Background and Aim

Chronic constipation negatively impacts work productivity and patients' quality of life. This retrospective study assessed the correlation between symptoms of chronic constipation and work/activity impairment with and without the use of laxative treatment.

Methods

This cross-sectional, observational, web-based survey was conducted using the Work Productivity and Activity Impairment-Chronic Constipation Questionnaire and included Japanese patients with chronic constipation receiving prescribed medication. Outcomes of interest included total work productivity and activity impairment and their correlation with constipation symptoms.

Results

Among the 2351 analyzed patients (mean [SD] age, 51.7 [13.8] years), 80.7% were females, 63.3% had a disease duration of ≥10 years, and 1424 were working. The averages of total activity impairment, total work productivity impairment, presenteeism, and absenteeism were 39.2%, 33.9%, 31.2%, and 5.0%, respectively. The annual work productivity loss per patient was estimated to be 1.343 million Japanese Yen. Symptoms that had a statistically significant positive correlation with total work impairment (P < 0.05) were abdominal discomfort/nausea, abdominal pain, abdominal bloating, and unpredictable defecation timing. Total activity impairment was significantly (P < 0.05) affected by abdominal discomfort/nausea, abdominal bloating, abdominal pain, incomplete defecation, unpredictable defecation timing, loss of defecation desire, and straining. Work productivity and daily activity had improved in 71.2% and 72.6% of patients, respectively, after they received treatment.

Conclusion

Symptoms of constipation, particularly abdominal symptoms and unpredictable defecation timing, can have a negative impact on work productivity and daily activity. Treatment focused on these symptoms may reduce the socio-economic burden of chronic constipation in Japan.

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Tao H, Liu L, Lu W, Ni Z, Chen X, Nahata MC, Peng L. The Effects of Prophylactic Laxative Use on Critically Ill Patients Requiring Mechanical Ventilation: A Retrospective Cohort Study. Diseases 2024;12:274. [PMID: 39589948 PMCID: PMC11593228 DOI: 10.3390/diseases12110274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 10/21/2024] [Accepted: 10/25/2024] [Indexed: 11/28/2024] Open

Ihara E, Manabe N, Ohkubo H, Ogasawara N, Ogino H, Kakimoto K, Kanazawa M, Kawahara H, Kusano C, Kuribayashi S, Sawada A, Takagi T, Takano S, Tomita T, Noake T, Hojo M, Hokari R, Masaoka T, Machida T, Misawa N, Mishima Y, Yajima H, Yamamoto S, Yamawaki H, Abe T, Araki Y, Kasugai K, Kamiya T, Torii A, Nakajima A, Nakada K, Fukudo S, Fujiwara Y, Miwa H, Kataoka H, Nagahara A, Higuchi K. Evidence-Based Clinical Guidelines for Chronic Constipation 2023. Digestion 2024;106:62-89. [PMID: 39159626 PMCID: PMC11825134 DOI: 10.1159/000540912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 08/10/2024] [Indexed: 08/21/2024]

Abstract

The Japan Gastroenterological Association published the first version of its clinical guidelines for chronic constipation 2023. Based on the latest evidence, these guidelines describe the definition, classification, diagnostic criteria, diagnostic testing methods, epidemiology, pathophysiology, and treatment of chronic constipation. They include flowcharts for both diagnosis and treatment of chronic constipation. In the treatment of chronic constipation, the first step involves differentiating between secondary forms, such as organic disease-associated constipation, systemic disease-associated constipation, and drug-induced constipation. The next step is to determine whether the chronic constipation stems from a motility disorder, a form of primary chronic constipation. For functional constipation and constipation-predominant irritable bowel syndrome, treatment should be initiated after evaluating symptoms like reduced bowel movement frequency type or defecation difficulty type. The first line of treatment includes the improvement of lifestyle habits and diet therapy. The first drugs to consider for oral treatment are osmotic laxatives. If these are ineffective, secretagogues and ileal bile acid transporter inhibitors are candidates. However, stimulant laxatives are exclusively designated for as-needed use. Probiotics, bulk-forming laxatives, prokinetics, and Kampo medicines, for which there is insufficient evidence, are considered alternative or complementary therapy. Providing the best clinical strategies for chronic constipation therapy in Japan, these clinical guidelines for chronic constipation 2023 should prove useful for its treatment worldwide. The Japan Gastroenterological Association published the first version of its clinical guidelines for chronic constipation 2023. Based on the latest evidence, these guidelines describe the definition, classification, diagnostic criteria, diagnostic testing methods, epidemiology, pathophysiology, and treatment of chronic constipation. They include flowcharts for both diagnosis and treatment of chronic constipation. In the treatment of chronic constipation, the first step involves differentiating between secondary forms, such as organic disease-associated constipation, systemic disease-associated constipation, and drug-induced constipation. The next step is to determine whether the chronic constipation stems from a motility disorder, a form of primary chronic constipation. For functional constipation and constipation-predominant irritable bowel syndrome, treatment should be initiated after evaluating symptoms like reduced bowel movement frequency type or defecation difficulty type. The first line of treatment includes the improvement of lifestyle habits and diet therapy. The first drugs to consider for oral treatment are osmotic laxatives. If these are ineffective, secretagogues and ileal bile acid transporter inhibitors are candidates. However, stimulant laxatives are exclusively designated for as-needed use. Probiotics, bulk-forming laxatives, prokinetics, and Kampo medicines, for which there is insufficient evidence, are considered alternative or complementary therapy. Providing the best clinical strategies for chronic constipation therapy in Japan, these clinical guidelines for chronic constipation 2023 should prove useful for its treatment worldwide.

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Affiliation(s)

Eikichi Ihara Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Noriaki Manabe Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hidenori Ohkubo Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Naotaka Ogasawara Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Haruei Ogino Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Kazuki Kakimoto Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Motoyori Kanazawa Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hidejiro Kawahara Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Chika Kusano Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Shiko Kuribayashi Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Akinari Sawada Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Tomohisa Takagi Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Shota Takano Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Toshihiko Tomita Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Toshihiro Noake Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Mariko Hojo Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Ryota Hokari Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Tatsuhiro Masaoka Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Tomohiko Machida Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Noboru Misawa Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Yoshiyuki Mishima Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hiroshi Yajima Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Sayuri Yamamoto Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hiroshi Yamawaki Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Tatsuya Abe Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Yasumi Araki Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Kunio Kasugai Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Takeshi Kamiya Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Akira Torii Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Atsushi Nakajima Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Koji Nakada Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Shin Fukudo Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Yasuhiro Fujiwara Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hiroto Miwa Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Hiromi Kataoka Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Akihito Nagahara Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan
Kazuhide Higuchi Guidelines Committee for Creating and Evaluating the “Evidence-Based Clinical Guidelines for Chronic Constipation 2023, The Japanese Gastroenterological Association, Bunkyo-ku, Japan

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Yang WC, Zeng BS, Liang CS, Hsu CW, Su KP, Wu YC, Tu YK, Lin PY, Stubbs B, Chen TY, Chen YW, Shiue YL, Zeng BY, Suen MW, Hung CM, Wu MK, Tseng PT. Efficacy and acceptability of different probiotic products plus laxatives for pediatric functional constipation: a network meta-analysis of randomized controlled trials. Eur J Pediatr 2024;183:3531-3541. [PMID: 38806862 PMCID: PMC11263257 DOI: 10.1007/s00431-024-05568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 05/30/2024]

Abstract

The prevalence of pediatric constipation ranges from 0.7 to 29.6% across different countries. Functional constipation accounts for 95% of pediatric constipation, and the efficacy of pharmacotherapy is limited, with a success rate of 60%. Several randomized controlled trials (RCTs) have shown the benefits of probiotic supplements in treating this condition. However, the reported strains of probiotics varied among the RCTs. We aimed to compare the efficacy and acceptability of different probiotic supplements for pediatric functional constipation. The current frequentist model-based network meta-analysis (NMA) included RCTs of probiotic supplements for functional constipation in children. The primary outcome was changes in bowel movement or stool frequency; acceptability outcome was all-cause discontinuation. Nine RCTs were included (N = 710; mean age = 5.5 years; 49.4% girls). Most probiotic products, used either alone or combined with laxatives, were associated with significantly better improvement in bowel movement or stool frequency than placebo/control. Protexin plus laxatives (standardized mean difference (SMD) = 1.87, 95% confidence interval (95% CI) = 0.85 to 2.90) were associated with the greatest improvement in bowel movement or stool frequency among all the investigated probiotic products. For the single probiotic interventions, only Lactobacillus casei rhamnosus Lcr35 was associated with significant efficacy compared to placebo/control treatments (SMD = 1.37, 95% CI: 0.32 to 2.43). All the investigated probiotic products had fecal incontinence and patient drop-out rates similar to those of placebo/control treatments. Conclusion: The results of our NMA support the application of an advanced combination of probiotics and laxatives for pediatric functional constipation if there is no concurrent contraindication. Registration: PROSPERO (CRD42022298724). What is Known: • Despite of the high prevalence of pediatric constipation, which ranges from 0.7% to 29.6%, the efficacy of pharmacotherapy is limited, with a success rate of 60%. Several randomized controlled trials (RCTs) have shown the benefits of probiotic supplements in treating this condition. However, the reported strains of probiotics varied among the RCTs. The widely heterogeneous strains of probiotics let the traditional meta-analysis, which pooled all different strains into one group, be nonsense and insignificant. What is New: • By conducting a comprehensive network meta-analysis, we aimed to compare the efficacy and acceptability of different strains of probiotic supplements for pediatric functional constipation. Network meta-analysis of nine randomized controlled trials revealed that the most probiotic products, used either alone or combined with laxatives, were associated with significantly better improvement in bowel movement or stool frequency than placebo/control. Protexin plus laxatives was associated with the greatest improvement in bowel movement or stool frequency among all the investigated probiotic products. For the single probiotic interventions, only Lactobacillus casei rhamnosus Lcr35 was associated with significant efficacy compared to placebo/control treatments. All the investigated probiotic products had fecal incontinence and patient drop-out rates similar to those of placebo/control treatments.

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Affiliation(s)

Wei-Chieh Yang Department of Pediatrics, Ping An Medical Clinic, Tainan, Taiwan
Bing-Syuan Zeng Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
Chih-Sung Liang Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
Chih-Wei Hsu Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Kuan-Pin Su Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan An-Nan Hospital, China Medical University, Tainan, Taiwan
Yi-Cheng Wu Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
Yu-Kang Tu Institute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
Pao-Yen Lin Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Brendon Stubbs Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK Positive Ageing Research Institute (PARI), Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
Tien-Yu Chen Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
Yen-Wen Chen Prospect Clinic for Otorhinolaryngology & Neurology, No. 252, Nanzixin Road, Nanzi District, Kaohsiung City, 81166, Taiwan
Yow-Ling Shiue Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
Bing-Yan Zeng Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
Mein-Woei Suen Department of Psychology, College of Medical and Health Science, Asia University, 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan. Gender Equality Education and Research Center, Asia University, Taichung, Taiwan. Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Chao-Ming Hung Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan. School of Medicine, College of Medicine, I-Shou University, No. 1, Sec. 1, Xuecheng Rd., Dashu Dist., Kaohsiung City, 840301, Taiwan.
Ming-Kung Wu Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Ping-Tao Tseng Department of Psychology, College of Medical and Health Science, Asia University, 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan. Prospect Clinic for Otorhinolaryngology & Neurology, No. 252, Nanzixin Road, Nanzi District, Kaohsiung City, 81166, Taiwan. Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.

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Kessoku T, Matsumoto M, Misawa N, Tsuda M, Miura Y, Uchida A, Toriumi Y, Onodera T, Arima H, Kawamoto A, Sugama J, Matsushima M, Kato M, Manabe N, Tamai N, Sanada H, Nakajima A. Expert Consensus Document: An Algorithm for the Care and Treatment of Patients with Constipation Based on Ultrasonographic Findings in the Rectum. Diagnostics (Basel) 2024;14:1510. [PMID: 39061648 PMCID: PMC11276071 DOI: 10.3390/diagnostics14141510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/25/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open

Affiliation(s)

Takaomi Kessoku Department of Palliative Medicine and Gastroenterology, International University Health and Welfare Narita Hospital, 852, Hatakeda, Narita 286-0124, Japan; Department of Gastroenterology, International University Health and Welfare Graduate School of Medicine, 4-3, Kozunomori, Narita 286-0048, Japan Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; Department of Internal Medicine, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Kanagawa, Yokohama 221-0835, Japan
Masaru Matsumoto School of Nursing, Ishikawa Prefectural Nursing University, 1-1 Gakuendai, Kahoku 929-1210, Japan; (M.M.); (H.S.)
Noboru Misawa Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;
Momoko Tsuda Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, 18-16, Kawahara-cho, Hakodate 041-8512, Japan; Department of Gastroenterology, Sapporo Cancer Screening Center, Public Interest Foundation Hokkaido Cancer Society, 1-15, Kita-26 Higashi-14, Higashi-ku, Sapporo 065-0026, Japan;
Yuka Miura Research Center for Implementation Nursing Science Initiative, Fujita Health University, Aichi 470-1192, Japan; (Y.M.); (J.S.)
Ayaka Uchida Department of Laboratory, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Yokohama 221-0835, Japan; (A.U.); (Y.T.)
Yuki Toriumi Department of Laboratory, Yokohama Clinic, Kanagawa Dental University, 3-31-6 Tsuruya-cho, Yokohama 221-0835, Japan; (A.U.); (Y.T.)
Tomoyuki Onodera Department of Clinical Laboratory, National Hospital Organization Hakodate National Hospital, Hokkaido 041-8512, Japan;
Hiromi Arima Department of Radiological Technology, Coloproctology Center Takano Hospital, Kumamoto 862-0971, Japan;
Atsuo Kawamoto Division of Ultrasound and Department of Diagnostic Imaging, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan;
Junko Sugama Research Center for Implementation Nursing Science Initiative, Fujita Health University, Aichi 470-1192, Japan; (Y.M.); (J.S.)
Makoto Matsushima Matsushima Hospital Proctology Center, 9-11, Honcho, Tobe, Nishi-Ward, Yokohama 220-0041, Japan;
Mototsugu Kato Department of Gastroenterology, Sapporo Cancer Screening Center, Public Interest Foundation Hokkaido Cancer Society, 1-15, Kita-26 Higashi-14, Higashi-ku, Sapporo 065-0026, Japan;
Noriaki Manabe Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama 700-8505, Japan;
Nao Tamai Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama 236-0027, Japan;
Hiromi Sanada School of Nursing, Ishikawa Prefectural Nursing University, 1-1 Gakuendai, Kahoku 929-1210, Japan; (M.M.); (H.S.)
Atsushi Nakajima Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;

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Gordon M, Grafton-Clarke C, Rajindrajith S, Benninga MA, Sinopoulou V, Akobeng AK. Treatments for intractable constipation in childhood. Cochrane Database Syst Rev 2024;6:CD014580. [PMID: 38895907 PMCID: PMC11190639 DOI: 10.1002/14651858.cd014580.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]

Abstract

BACKGROUND

Constipation that is prolonged and does not resolve with conventional therapeutic measures is called intractable constipation. The treatment of intractable constipation is challenging, involving pharmacological or non-pharmacological therapies, as well as surgical approaches. Unresolved constipation can negatively impact quality of life, with additional implications for health systems. Consequently, there is an urgent need to identify treatments that are efficacious and safe.

OBJECTIVES

To evaluate the efficacy and safety of treatments used for intractable constipation in children.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, and two trials registers up to 23 June 2023. We also searched reference lists of included studies for relevant studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing any pharmacological, non-pharmacological, or surgical treatment to placebo or another active comparator, in participants aged between 0 and 18 years with functional constipation who had not responded to conventional medical therapy.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Our primary outcomes were symptom resolution, frequency of defecation, treatment success, and adverse events; secondary outcomes were stool consistency, painful defecation, quality of life, faecal incontinence frequency, abdominal pain, hospital admission for disimpaction, and school absence. We used GRADE to assess the certainty of evidence for each primary outcome.

MAIN RESULTS

This review included 10 RCTs with 1278 children who had intractable constipation. We assessed one study as at low risk of bias across all domains. There were serious concerns about risk of bias in six studies. One study compared the injection of 160 units botulinum toxin A (n = 44) to unspecified oral stool softeners (n = 44). We are very uncertain whether botulinum toxin A injection improves treatment success (risk ratio (RR) 37.00, 95% confidence interval (CI) 5.31 to 257.94; very low certainty evidence, downgraded due to serious concerns with risk of bias and imprecision). Frequency of defecation was reported only for the botulinum toxin A injection group (mean interval of 2.6 days). The study reported no data for the other primary outcomes. One study compared erythromycin estolate (n = 6) to placebo (n = 8). The only primary outcome reported was adverse events, which were 0 in both groups. The evidence is of very low certainty due to concerns with risk of bias and serious imprecision. One study compared 12 or 24 μg oral lubiprostone (n = 404) twice a day to placebo (n = 202) over 12 weeks. There may be little to no difference in treatment success (RR 1.29, 95% CI 0.87 to 1.92; low certainty evidence). We also found that lubiprostone probably results in little to no difference in adverse events (RR 1.05, 95% CI 0.91 to 1.21; moderate certainty evidence). The study reported no data for the other primary outcomes. One study compared three-weekly rectal sodium dioctyl sulfosuccinate and sorbitol enemas (n = 51) to 0.5 g/kg/day polyethylene glycol laxatives (n = 51) over a 52-week period. We are very uncertain whether rectal sodium dioctyl sulfosuccinate and sorbitol enemas improve treatment success (RR 1.33, 95% CI 0.83 to 2.14; very low certainty evidence, downgraded due to serious concerns with risk of bias and imprecision). Results of defecation frequency per week was reported only as modelled means using a linear mixed model. The study reported no data for the other primary outcomes. One study compared biofeedback therapy (n = 12) to no intervention (n = 12). We are very uncertain whether biofeedback therapy improves symptom resolution (RR 2.50, 95% CI 1.08 to 5.79; very low certainty evidence, downgraded due to serious concerns with risk of bias and imprecision). The study reported no data for the other primary outcomes. One study compared 20 minutes of intrarectal electromotive botulinum toxin A using 2800 Hz frequency and botulinum toxin A dose 10 international units/kg (n = 30) to 10 international units/kg botulinum toxin A injection (n = 30). We are very uncertain whether intrarectal electromotive botulinum toxin A improves symptom resolution (RR 0.96, 95% CI 0.76 to 1.22; very low certainty evidence) or if it increases the frequency of defecation (mean difference (MD) 0.00, 95% CI -1.87 to 1.87; very low certainty evidence). We are also very uncertain whether intrarectal electromotive botulinum toxin A has an improved safety profile (RR 0.20, 95% CI 0.01 to 4.00; very low certainty evidence). The evidence for these results is of very low certainty due to serious concerns with risk of bias and imprecision. The study did not report data on treatment success. One study compared the injection of 60 units botulinum toxin A (n = 21) to myectomy of the internal anal sphincter (n = 21). We are very uncertain whether botulinum toxin A injection improves treatment success (RR 1.00, 95% CI 0.75 to 1.34; very low certainty evidence). No adverse events were recorded. The study reported no data for the other primary outcomes. One study compared 0.04 mg/kg oral prucalopride (n = 107) once daily to placebo (n = 108) over eight weeks. Oral prucalopride probably results in little or no difference in defecation frequency (MD 0.50, 95% CI -0.06 to 1.06; moderate certainty evidence); treatment success (RR 0.96, 95% CI 0.53 to 1.72; moderate certainty evidence); and adverse events (RR 1.15, 95% CI 0.94 to 1.39; moderate certainty evidence). The study did not report data on symptom resolution. One study compared transcutaneous electrical stimulation to sham stimulation, and another study compared dietitian-prescribed Mediterranean diet with written instructions versus written instructions. These studies did not report any of our predefined primary outcomes.

AUTHORS' CONCLUSIONS

We identified low to moderate certainty evidence that oral lubiprostone may result in little to no difference in treatment success and adverse events compared to placebo. Based on moderate certainty evidence, there is probably little or no difference between oral prucalopride and placebo in defecation frequency, treatment success, or adverse events. For all other comparisons, the certainty of the evidence for our predefined primary outcomes is very low due to serious concerns with study limitations and imprecision. Consequently, no robust conclusions could be drawn.

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Lee JH, Kim GB, Han K, Jung EJ, Suh HJ, Jo K. Efficacy and safety of galacto-oligosaccharide in the treatment of functional constipation: randomized clinical trial. Food Funct 2024;15:6374-6382. [PMID: 38787732 DOI: 10.1039/d4fo00999a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]

Whorwell P, Lange R, Scarpignato C. Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge. Therap Adv Gastroenterol 2024;17:17562848241249664. [PMID: 38887508 PMCID: PMC11181897 DOI: 10.1177/17562848241249664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/08/2024] [Indexed: 06/20/2024] Open

Yamamoto S, Ohashi W, Yamaguchi Y, Igari H, Koshino A, Sugiyama T, Nagao K, Tamura Y, Izawa S, Mano M, Ebi M, Usami J, Hamano K, Izumi J, Wakita Y, Funaki Y, Ogasawara N, Sasanabe R, Sasaki M, Maekawa M, Kasugai K. Factors Associated with Defecation Satisfaction among Japanese Adults with Chronic Constipation. J Clin Med 2024;13:3216. [PMID: 38892926 PMCID: PMC11172833 DOI: 10.3390/jcm13113216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open

Affiliation(s)

Sayuri Yamamoto Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Wataru Ohashi Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute 480-1195, Japan
Yoshiharu Yamaguchi Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Hiroki Igari Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Akira Koshino Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Tomoya Sugiyama Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Kazuhiro Nagao Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Yasuhiro Tamura Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Shinya Izawa Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Mamiko Mano Division of Sleep Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Masahide Ebi Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Jun Usami Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Koichi Hamano Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Junko Izumi Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Yoshinori Wakita Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Yasushi Funaki Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Naotaka Ogasawara Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Ryujiro Sasanabe Division of Sleep Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Makoto Sasaki Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan
Masato Maekawa Division of General Medicine, Aichi Medical University, Nagakute 480-1195, Japan
Kunio Kasugai Division of Gastroenterology, Aichi Medical University, Nagakute 480-1195, Japan

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Seo M, Bae JH. Nonpharmacologic Treatment of Chronic Constipation. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2024;83:191-196. [PMID: 38783620 DOI: 10.4166/kjg.2024.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]

Narrowe AB, Lemons JMS, Mahalak KK, Firrman J, den Abbeele PV, Baudot A, Deyaert S, Li Y, Yu L(L, Liu L. Targeted remodeling of the human gut microbiome using Juemingzi (Senna seed extracts). Front Cell Infect Microbiol 2024;14:1296619. [PMID: 38638830 PMCID: PMC11024242 DOI: 10.3389/fcimb.2024.1296619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open

Abstract

The genus Senna contains globally distributed plant species of which the leaves, roots, and seeds have multiple traditional medicinal and nutritional uses. Notable chemical compounds derived from Senna spp. include sennosides and emodin which have been tested for antimicrobial effects in addition to their known laxative functions. However, studies of the effects of the combined chemical components on intact human gut microbiome communities are lacking. This study evaluated the effects of Juemingzi (Senna sp.) extract on the human gut microbiome using SIFR® (Systemic Intestinal Fermentation Research) technology. After a 48-hour human fecal incubation, we measured total bacterial cell density and fermentation products including pH, gas production and concentrations of short chain fatty acids (SCFAs). The initial and post-incubation microbial community structure and functional potential were characterized using shotgun metagenomic sequencing. Juemingzi (Senna seed) extracts displayed strong, taxon-specific anti-microbial effects as indicated by significant reductions in cell density (40%) and intra-sample community diversity. Members of the Bacteroidota were nearly eliminated over the 48-hour incubation. While generally part of a healthy gut microbiome, specific species of Bacteroides can be pathogenic. The active persistence of the members of the Enterobacteriaceae and selected Actinomycetota despite the reduction in overall cell numbers was demonstrated by increased fermentative outputs including high concentrations of gas and acetate with correspondingly reduced pH. These large-scale shifts in microbial community structure indicate the need for further evaluation of dosages and potential administration with prebiotic or synbiotic supplements. Overall, the very specific effects of these extracts may offer the potential for targeted antimicrobial uses or as a tool in the targeted remodeling of the gut microbiome.

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Kumar KP, Wilson JL, Nguyen H, McKay LD, Wen SW, Sepehrizadeh T, de Veer M, Rajasekhar P, Carbone SE, Hickey MJ, Poole DP, Wong CHY. Stroke Alters the Function of Enteric Neurons to Impair Smooth Muscle Relaxation and Dysregulates Gut Transit. J Am Heart Assoc 2024;13:e033279. [PMID: 38258657 PMCID: PMC11056134 DOI: 10.1161/jaha.123.033279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]

Abstract

BACKGROUND

Gut dysmotility is common after ischemic stroke, but the mechanism underlying this response is unknown. Under homeostasis, gut motility is regulated by the neurons of the enteric nervous system that control contractile/relaxation activity of muscle cells in the gut wall. More recently, studies of gut inflammation revealed interactions of macrophages with enteric neurons are also involved in modulating gut motility. However, whether poststroke gut dysmotility is mediated by direct signaling to the enteric nervous system or indirectly via inflammatory macrophages is unknown.

METHODS AND RESULTS

We examined these hypotheses by using a clinically relevant permanent intraluminal midcerebral artery occlusion experimental model of stroke. At 24 hours after stroke, we performed in vivo and ex vivo gut motility assays, flow cytometry, immunofluorescence, and transcriptomic analysis. Stroke-induced gut dysmotility was associated with recruitment of muscularis macrophages into the gastrointestinal tract and redistribution of muscularis macrophages away from myenteric ganglia. The permanent intraluminal midcerebral artery occlusion model caused changes in gene expression in muscularis macrophages consistent with an altered phenotype. While the size of myenteric ganglia after stroke was not altered, myenteric neurons from post-permanent intraluminal midcerebral artery occlusion mice showed a reduction in neuronal nitric oxide synthase expression, and this response was associated with enhanced intestinal smooth muscle contraction ex vivo. Finally, chemical sympathectomy with 6-hydroxydopamine prevented the loss of myenteric neuronal nitric oxide synthase expression and stroke-induced slowed gut transit.

CONCLUSIONS

Our findings demonstrate that activation of the sympathetic nervous system after stroke is associated with reduced neuronal nitric oxide synthase expression in myenteric neurons, resulting in impaired smooth muscle relaxation and dysregulation of gut transit.

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Affiliation(s)

Kathryn Prame Kumar Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Jenny L. Wilson Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Huynh Nguyen Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Liam D. McKay Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Shu Wen Wen Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Tara Sepehrizadeh Monash Biomedical ImagingMonash UniversityClaytonVictoriaAustralia
Michael de Veer Monash Biomedical ImagingMonash UniversityClaytonVictoriaAustralia
Pradeep Rajasekhar Centre for Dynamic ImagingWalter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
Simona E. Carbone Drug Discovery Biology, Faculty of Pharmacy and Pharmaceutical SciencesMonash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleVictoriaAustralia
Michael J. Hickey Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia
Daniel P. Poole Drug Discovery Biology, Faculty of Pharmacy and Pharmaceutical SciencesMonash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleVictoriaAustralia
Connie H. Y. Wong Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash Medical CentreMonash UniversityClaytonVictoriaAustralia

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Dey K, Sheth M, Anand S, Archana G, Raval S. Daily consumption of galactooligosaccharide gummies ameliorates constipation symptoms, gut dysbiosis, degree of depression and quality of life among sedentary university teaching staff: A double-blind randomized placebo control clinical trial. Indian J Gastroenterol 2023;42:839-848. [PMID: 37751049 DOI: 10.1007/s12664-023-01435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 09/27/2023]

Abstract

BACKGROUND

Functional constipation affects approximately 10% of the Indian population and may reduce the quality of life (QOL) and increase gut dysbiosis. PURPOSE OF STUDY: The study aimed at assessing the impact of galactooligosaccharide (GOS) gummy supplementation on gut health, depression status and QOL of constipated subjects.

METHODS

A double-blind placebo control clinical trial (CTRI/2021/10/037474) was conducted on sedentary constipated adults (n = 35), who were split into an experimental group (n = 17) and a control group (n = 18), supplemented with 10 g GOS and sugar gummies, respectively, for 30 days. Relative abundance of fecal gut microbes, including Bifidobacterium, Lactobacillus, Clostridium and Bacteroides and phyla Bacteroidetes and Firmicutes using real-time polymerase chain reaction and short-chain fatty acids, was analyzed pre and post supplementation. Constipation profile was studied using Rome IV criteria and the Bristol stool chart. Depression status was studied using the Becks Depression Inventory. The QOL was assessed using patient assessment of constipation.

RESULTS

GOS gummy supplementation increased Bifidobacterium and Lactobacillus by 1230% and 322%, respectively, (p < 0.001; p < 0.01) with reduced Clostridium by 63%, phylum Firmicutes by 73% and Bacteroidetes by 85% (p < 0.01). The GOS-supplemented group demonstrated a higher F/B ratio (4.2) indicating improved gut health (p < 0.01) with reduced gut dysbiosis and constipation severity. GOS gummies enhanced acetic acid and butyric acid levels compared to the control group (p < 0.01; p < 0.001). Post supplementation, there was 40% reduction in depression (p < 0.01) and 22% improvement in QOL (p < 0.05).

CONCLUSIONS

This research validates the predicted beneficial benefits of short-term GOS consumption on constipation profile, gut microflora, depression status and quality of life of constipated subjects.

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Bunting C, Smith E, Dunham F, Simpson S, Truter P. Adult patients with constipation presenting to the emergency department: Can care be improved? Emerg Med Australas 2023;35:991-997. [PMID: 37424397 DOI: 10.1111/1742-6723.14278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]

Domingo-Fernández D, Gadiya Y, Mubeen S, Bollerman TJ, Healy MD, Chanana S, Sadovsky RG, Healey D, Colluru V. Modern drug discovery using ethnobotany: A large-scale cross-cultural analysis of traditional medicine reveals common therapeutic uses. iScience 2023;26:107729. [PMID: 37701812 PMCID: PMC10494464 DOI: 10.1016/j.isci.2023.107729] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023] Open

Ajabnoor G, Eldakhakhny B, Hashim KT, Alzahrani MM, Eskandarani R, AlQusaibi B, Alqarni AK, Alsulaimani NM, Dahlan M, Enani S, Almoghrabi Y, Alamoudi AA, Alhozali A, Elsamanoudy A. The Effect of Chronic Laxative Use on Lipid Profile and HbA1c: A Hospital-Based Retrospective Study. Cureus 2023;15:e45055. [PMID: 37829969 PMCID: PMC10567100 DOI: 10.7759/cureus.45055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open

Abstract

BACKGROUND

Laxatives are over-the-counter medications used as a treatment for constipation. The lipid-lowering effect of the long-term use of laxatives has been proposed.

AIM

To investigate the possible impact of the chronic use of laxatives on serum lipid profile, body mass index (BMI), and hemoglobin A1c (HbA1c).

METHODS

An observational retrospective cohort study was conducted to analyze data related to patients who received laxatives for six or 12 months or more in the KAUH database system. BMI, weight, cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and HbA1c data were collected retrospectively from hospital records for three time points: baseline, six months, and 12 months of laxative treatment from the starting date for each patient.

RESULTS

A total of 106 patients' records fulfilled the inclusion criteria, 46 (43%) males with a mean age of 66 and 60 (57%) females with a mean age of 63. A significant decrease in plasma cholesterol and low-density lipoprotein-cholesterol (LDL-C) levels was observed in those who used laxatives for 12 months. Furthermore, an overall BMI and ALT reduction was seen in the combined. On the other hand, HbA1c levels appeared to improve in the combined group but not statistically significant. The change in the cholesterol level could be observed in patients receiving statin treatment and those without, with no statistical significance between the two groups.

CONCLUSION

Chronic laxative use for 12 months or more is associated with a decreased total and LDL-C level with no significant effect on high-density lipoprotein-cholesterol (HDL-C) levels. Additionally, there was a significant reduction in BMI and ALT. This effect is more prominent with combined therapy. Further multicentric studies on larger sample sizes are recommended to confirm our findings.

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Do JE, Tucker J, Parange A, Hoang VM, Juszczyk K, Murphy EMA. Are we using best practice to guide laxative use in post-partum patients with obstetric anal sphincter injuries - A retrospective review. Eur J Obstet Gynecol Reprod Biol 2023;288:78-82. [PMID: 37453346 DOI: 10.1016/j.ejogrb.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]

Taylor EP, Vellozzi-Averhoff C, Vettese T. Care Throughout the Journey-The Interaction Between Primary Care and Palliative Care. Clin Geriatr Med 2023;39:379-393. [PMID: 37385690 DOI: 10.1016/j.cger.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]

Mansi S, Bahia G, Patel D, Dorfman L, El-Chammas K, Fei L, Liu C, Santucci NR, Graham K, Kaul A. High amplitude propagated contractions with Glycerin versus Bisacodyl: A within-subject comparison in children undergoing colonic manometry. Neurogastroenterol Motil 2023;35:e14544. [PMID: 37096635 PMCID: PMC10701597 DOI: 10.1111/nmo.14544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/24/2022] [Accepted: 01/24/2023] [Indexed: 04/26/2023]

Aydinli A, Karadağ S. "Effects of abdominal massage applied with ginger and lavender oil for elderly with constipation: A randomized controlled trial". Explore (NY) 2023;19:115-120. [PMID: 36058824 DOI: 10.1016/j.explore.2022.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]

Lafcı D, Kaşikçi M. The effect of aroma massage on constipation in elderly individuals. Exp Gerontol 2023;171:112023. [PMID: 36372282 DOI: 10.1016/j.exger.2022.112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]

Evaluations of the in vivo laxative effects of aqueous root extracts of Euclea racemosa L. in mice. Metabol Open 2022;17:100222. [PMID: 36606022 PMCID: PMC9807816 DOI: 10.1016/j.metop.2022.100222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open

Dasgupta NR. Care of Patients With Transthyretin Amyloidosis: the Roles of Nutrition, Supplements, Exercise, and Mental Health. Am J Cardiol 2022;185 Suppl 1:S35-S42. [PMID: 36549789 DOI: 10.1016/j.amjcard.2022.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 12/24/2022]

Woradulayapinij W, Pothiluk A, Nualsanit T, Yimsoo T, Yingmema W, Rojanapanthu P, Hong Y, Baek SJ, Treesuppharat W. Acute oral toxicity of damnacanthal and its anticancer activity against colorectal tumorigenesis. Toxicol Rep 2022;9:1968-1976. [PMID: 36518435 PMCID: PMC9742955 DOI: 10.1016/j.toxrep.2022.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022] Open

Ma W, Drew DA, Staller K. The Gut Microbiome and Colonic Motility Disorders: A Practical Framework for the Gastroenterologist. Curr Gastroenterol Rep 2022;24:115-126. [PMID: 35943661 PMCID: PMC10039988 DOI: 10.1007/s11894-022-00847-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 10/15/2022]

Seyrafian S, Sebghatollahi V, Bastani B. Hyponatremia-induced generalized seizure after taking polyethylene glycol for colon preparation-A case report and brief review of the literature. Clin Case Rep 2022;10:e6247. [PMID: 36052026 PMCID: PMC9413866 DOI: 10.1002/ccr3.6247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/06/2022] Open

Hoang Anh T, Nguyen PA, Duong A, Chiu IJ, Chou CL, Ko YC, Chang TH, Huang CW, Wu MS, Liao CT, Hsu YH. Contact Laxative Use and the Risk of Arteriovenous Fistula Maturation Failure in Patients Undergoing Hemodialysis: A Multi-Center Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022;19:ijerph19116842. [PMID: 35682426 PMCID: PMC9180587 DOI: 10.3390/ijerph19116842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]

Affiliation(s)

Trung Hoang Anh International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Nephro-Urology and Dialysis Center, Bach Mai Hospital, Ha Noi 100000, Vietnam
Phung-Anh Nguyen Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei 110, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 330, Taiwan
Anh Duong Macquarie Business School, Macquarie University, Sydney, NSW 2109, Australia;
I-Jen Chiu Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan; (I.-J.C.); (M.-S.W.) Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; TMU-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan
Chu-Lin Chou Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; TMU-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan National Defense Medical Center, Division of Nephrology, Department of Medicine, Tri-Service General Hospital, Taipei 110, Taiwan Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Hsin Kuo Min Hospital, Taoyuan City 330, Taiwan
Yu-Chen Ko Division of Cardiovascular Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan;
Tzu-Hao Chang Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan; (T.-H.C.); (C.-W.H.)
Chih-Wei Huang Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan; (T.-H.C.); (C.-W.H.) International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
Mai-Szu Wu Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan; (I.-J.C.); (M.-S.W.) Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; TMU-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan
Chia-Te Liao Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan; (I.-J.C.); (M.-S.W.) Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; TMU-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan Correspondence: (C.-T.L.); (Y.-H.H.); Tel.: +886-2-2249-0088 (ext. 2736) (C.-T.L.)
Yung-Ho Hsu Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan; (I.-J.C.); (M.-S.W.) Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; TMU-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Hsin Kuo Min Hospital, Taoyuan City 330, Taiwan Correspondence: (C.-T.L.); (Y.-H.H.); Tel.: +886-2-2249-0088 (ext. 2736) (C.-T.L.)

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Claudin-17 Deficiency in Mice Results in Kidney Injury Due to Electrolyte Imbalance and Oxidative Stress. Cells 2022;11:cells11111782. [PMID: 35681477 PMCID: PMC9180152 DOI: 10.3390/cells11111782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open

Oni S, Akinlabi A, Bamisaye A, Ojo J. Physico-chemical and nutraceutical properties of Cola lepidota seed oil. PHYSICAL SCIENCES REVIEWS 2022. [DOI: 10.1515/psr-2021-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]

Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Peláez C, Pentieva K, Thies F, Tsabouri S, Vinceti M, Bresson JL, Siani A. Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. EFSA J 2022;20:e07259. [PMID: 35464873 PMCID: PMC9016720 DOI: 10.2903/j.efsa.2022.7259] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open

Abstract

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver scientific advice related to nutrient profiling for the development of harmonised mandatory front‐of‐pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. This Opinion is based on systematic reviews and meta‐analyses of human studies on nutritionally adequate diets, data from the Global Burden of Disease framework, clinical practice guidelines, previous EFSA opinions and the priorities set by EU Member States in the context of their Food‐Based Dietary Guidelines and associated nutrient/food intake recommendations. Relevant publications were retrieved through comprehensive searches in PubMed. The nutrients included in the assessment are those likely to be consumed in excess or in inadequate amounts in a majority of European countries. Food groups with important roles in European diets have been considered. The Panel concludes that dietary intakes of saturated fatty acids (SFA), sodium and added/free sugars are above, and intakes of dietary fibre and potassium below, current dietary recommendations in a majority of European populations. As excess intakes of SFAs, sodium and added/free sugars and inadequate intakes of dietary fibre and potassium are associated with adverse health effects, they could be included in nutrient profiling models. Energy could be included because a reduction in energy intake is of public health importance for European populations. In food group/category‐based nutrient profiling models, total fat could replace energy in most food groups owing to its high‐energy density, while the energy density of food groups with low or no fat content may be well accounted for by the inclusion of (added/free) sugars. Some nutrients may be included in nutrient profiling models for reasons other than their public health importance, e.g. as a proxy for other nutrients of public health importance, or to allow for a better discrimination of foods within the same food category.

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Mechanisms of Action of Current Pharmacologic Options for the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation. Am J Gastroenterol 2022;117:S6-S13. [PMID: 35354770 DOI: 10.14309/ajg.0000000000001687] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/31/2022] [Indexed: 12/11/2022]

Kongdang P, Pruksakorn D, Koonrungsesomboon N. Preclinical experimental models for assessing laxative activities of substances/products under investigation: a scoping review of the literature. Am J Transl Res 2022;14:698-717. [PMID: 35273679 PMCID: PMC8902583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]

Abstract

Constipation is a common gastrointestinal problem worldwide. Its impact on health can range from an unpleasant problem to being seriously troublesome. When lifestyle modification fails to deal with constipation, laxatives are the mainstay of therapy. There are several types of laxatives currently available; however, there still remains a need for better laxatives because certain currently available laxatives are not appropriate for or accessible to some patients. Preclinical experiments to study the laxative potential of substances/products of interest are vital to improving that situation. The selection of appropriate experimental models for assessing the laxative activities of substances/products under investigation is crucial to achieving valid and meaningful results. This article provides a scoping review of the literature, outlining, and summarizing models currently being used in preclinical experiments assessing the laxative activities of substances/products under investigation. The review includes both screening models, e.g., the isolated organ bath system, in vivo fecal assessment and intestinal transit assay, and confirmation models, e.g., in vivo constipation models. Chemical substances/drugs used to induce constipation in in vivo constipation models, e.g., loperamide, diphenoxylate, montmorillonite, and clonidine, as well as standard laxative agents used as a positive control in experimental models, e.g., bisacodyl, carbachol, lactulose, sodium picosulfate, castor oil, phenolphthalein, and yohimbine, are described in detail. The purpose of this article is to assist researchers in the design and implementation of preclinical experimental models for assessing laxative activities of substances/products under investigation to achieve valid and meaningful preclinical results prior to experimentation in humans.

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Khuituan P, Huipao N, Jeanmard N, Thantongsakul S, Promjun W, Chuthong S, Tipbunjong C, Peerakietkhajorn S. Sargassum plagiophyllum Extract Enhances Colonic Functions and Modulates Gut Microbiota in Constipated Mice. Nutrients 2022;14:496. [PMID: 35276855 PMCID: PMC8838385 DOI: 10.3390/nu14030496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 12/11/2022] Open

Affiliation(s)

Pissared Khuituan Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand; (P.K.); (N.H.); (C.T.) Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.)
Nawiya Huipao Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand; (P.K.); (N.H.); (C.T.) Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.)
Nilobon Jeanmard Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.) Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
Sitthiwach Thantongsakul Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.) Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
Warittha Promjun Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.) Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
Suwarat Chuthong Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.) Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand
Chittipong Tipbunjong Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand; (P.K.); (N.H.); (C.T.) Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.)
Saranya Peerakietkhajorn Gut Biology and Microbiota Research Unit, Prince of Songkla University, Songkhla 90110, Thailand; (N.J.); (S.T.); (W.P.); (S.C.) Division of Biological Science, Faculty of Science, Prince of Songkla University, Songkhla 90110, Thailand

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Mahfouz IA, Asali F, Ziara FMI, Samara B, Qudsieh S, Al-Rshoud F. Enema Administration During Labor: Pregnant Women's Perspective and Knowledge. SAGE Open Nurs 2022;8:23779608221139148. [DOI: 10.1177/23779608221139148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022] Open

Abstract Introduction Current evidence does not support the routine use of rectal enemas (REs) because they have not been associated with reduced rates of puerperal infection, degree of perineal tear, or duration of labor. A recent literature review recognized knowledge gaps regarding the uses of RE during labor including women's perceptions, pain, and satisfaction. Objectives To report pregnant women's knowledge, attitudes, perceptions, pain, and satisfaction associated with the use of RE during labor. Methods A prospective study was conducted between 20 October 2019 and 20 October 2020. Women were included if they were 37 weeks or more pregnant, had a viable pregnancy, were admitted in labor, and had an RE. Characteristic data and data about knowledge, perceptions, attitudes, pain, and satisfaction associated with its use were recorded. Women were regrouped based on their level of knowledge into low- and high-level groups. Attitudes, perceptions, inconveniences, pain, and satisfaction were regrouped into two categories: low and high on the Likert scale. Results A total of 300 women were recruited, with means (SD) for age and gestational age of 27.8 (4.8) years, and 40 (1.1) weeks, respectively, and 45.7% were knowledgeable or very knowledgeable, 76% had a positive attitude, and 88.7% perceived enemas as important. The mean scores (SD) for pain and satisfaction as measured on visual analogue scales were 1.5 (1.8) and 5.4 (1.8), respectively. Women with high knowledge about RE were older and multiparous. Recruited women were more likely to report lower inconvenience and pain scores and higher satisfaction scores (all P<.05). Conclusion Most recruited women were knowledgeable about REs, perceived them as important, and expressed a positive attitude toward their administration. The low levels of inconvenience, pain, and complications and the high satisfaction rates may be used when counseling women about when an RE is required during labor. Collapse

Ali R, Irfan M, Akram U, Vaince M, Hassan K, Maqsood A, Aslam A, Amaan N, Qamar A, Memon S. Efficacy of Natural Formulation Containing Activated Charcoal, Calcium Sennosides, Peppermint Oil, Fennel Oil, Rhubarb Extract, and Purified Sulfur (Nucarb®) in Relieving Constipation. Cureus 2021;13:e18419. [PMID: 34725578 PMCID: PMC8555919 DOI: 10.7759/cureus.18419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/05/2022] Open

Han C, Liu Y, Fan H, Li D, Guo N. Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy - A Meta-Analysis and Systematic Review. Clin Epidemiol 2021;13:907-919. [PMID: 34629905 PMCID: PMC8495145 DOI: 10.2147/clep.s324193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022] Open

Abstract

Cancer pain is a common problem in clinical cancer therapy. Opioid analgesia is one of the most effective drugs for pain relief with satisfying performance besides the side effect of opioid-induced constipation (OIC). Acupuncture, as a Chinese traditional non-invasive intervention, has been applied to clinical cancer pain management and functional constipation therapy. However, only a few studies have adopted this treatment for OIC patients. Due to limited numbers of investigated subjects and variability of application methods, including treatment apparatus, acupoints, durations, and sessions, the interpretation of acupuncture’s therapy effects from single-site randomized clinical trials (RCT) is limited. Therefore, we conducted a meta-analysis by collecting published data from Pubmed, Embase, Cochrane library, and Web of Science. Five RCTs focusing on the application of acupuncture with or without medication in OIC patients were included. An overall remission rate of 86.8% in the acupuncture-treated group was achieved, higher than the control group (78.9%; RR, 1.10, 95% CI [1.03, 1.18]). The symptom scores, reporting on defecation frequency, defecation straining, abdominal pain, defection time, and stool property, in acupuncture groups were lower than control groups with a standardized mean difference (SMD) of −2.21 [−4.15, −0.27]. The quality of life (QOL) for patients in the acupuncture treated group increased compared to the control group with reduced PAC-QOL scores (SMD, −1.02 [−1.78, −0.26]). Referring to the effects from pure acupuncture treatment (SMD, −0.43 [−0.83, −0.03]), the co-intervention of acupuncture and drugs (SMD, −1.77 [−2.51, −1.02]) improved the life quality of patients more remarkably (P < 0.05). Overall, our data confirmed the therapeutic effects of acupuncture in the treatment of OIC. The co-intervention of acupuncture with drugs improves the outcomes of OIC patients better than a single strategy. Combined therapy with both medicine and acupuncture has insightful potential for future clinical cancer patient management on constipation problems.

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Corsetti M, Landes S, Lange R. Bisacodyl: A review of pharmacology and clinical evidence to guide use in clinical practice in patients with constipation. Neurogastroenterol Motil 2021;33:e14123. [PMID: 33751780 PMCID: PMC8596401 DOI: 10.1111/nmo.14123] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 12/13/2022]

Kumar H, Kaur G, Gupta K. Alterations induced in the micellization behavior of dioctyl sodium sulfosuccinate in the presence of imidazolium-based surface-active ionic liquids in aqueous medium. J DISPER SCI TECHNOL 2021. [DOI: 10.1080/01932691.2021.1950009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]

Wibowo DA, Nailufar F, Tjandrawinata RR. Antidiarrheal Effect of DLBS1Y62, a Bioactive Fraction of Uncaria gambir Roxb. Dried Sap Extract, in Wistar Rats. J Exp Pharmacol 2021;13:669-675. [PMID: 34290534 PMCID: PMC8289365 DOI: 10.2147/jep.s299001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/06/2021] [Indexed: 11/25/2022] Open

Duboc H, Coffin B, Siproudhis L. Disruption of Circadian Rhythms and Gut Motility: An Overview of Underlying Mechanisms and Associated Pathologies. J Clin Gastroenterol 2021;54:405-414. [PMID: 32134798 PMCID: PMC7147411 DOI: 10.1097/mcg.0000000000001333] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]

Pieber TR, Svehlikova E, Mursic I, Esterl T, Wargenau M, Sartorius T, Pauly L, Schwejda-Guettes S, Neumann A, Faerber V, Stover JF, Gaigg B, Kuchinka-Koch A. Blood glucose response after oral lactulose intake in type 2 diabetic individuals. World J Diabetes 2021;12:893-907. [PMID: 34168736 PMCID: PMC8192256 DOI: 10.4239/wjd.v12.i6.893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/07/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023] Open

Abstract

BACKGROUND

Lactulose is approved for the symptomatic treatment of constipation, a gastrointestinal (GI) complication common in individuals with diabetes. Lactulose products contain carbohydrate impurities (e.g., lactose, fructose, galactose), which occur during the lactulose manufacturing process. These impurities may affect the blood glucose levels of individuals with type 2 diabetes mellitus (T2DM) using lactulose for the treatment of mild constipation. A previous study in healthy subjects revealed no increase in blood glucose levels after oral lactulose intake. However, it is still unclear whether the intake of lactulose increases blood glucose levels in individuals with diabetes.

AIM

To evaluate the blood glucose profile after oral lactulose intake in mildly constipated, non-insulin-dependent subjects with T2DM in an outpatient setting.

METHODS

This prospective, double-blind, randomized, controlled, single-center trial was conducted at the Clinical Research Center at the Medical University of Graz, Austria, in 24 adult Caucasian mildly constipated, non-insulin-dependent subjects with T2DM. Eligible subjects were randomized and assigned to one of six treatment sequences, each consisting of four treatments stratified by sex using an incomplete block design. Subjects received a single dose of 20 g or 30 g lactulose (crystal and liquid formulation), water as negative control or 30 g glucose as positive control. Capillary blood glucose concentrations were measured over a period of 180 min post dose. The primary endpoint was the baseline-corrected area under the curve of blood glucose concentrations over the complete assessment period [AUC_{baseline_c (0-180 min)}]. Quantitative comparisons were performed for both lactulose doses and formulations vs water for the equal lactulose dose vs glucose, as well as for liquid lactulose vs crystal lactulose. Safety parameters included GI tolerability, which was assessed at 180 min and 24 h post dose, and adverse events occurring up to 24 h post dose.

RESULTS

In 24 randomized and analyzed subjects blood glucose concentration-time curves after intake of 20 g and 30 g lactulose were almost identical to those after water intake for both lactulose formulations despite the different amounts of carbohydrate impurities (≤ 3.0% for crystals and approx. 30% for liquid). The primary endpoint [AUC_{baseline_c (0-180 min)}] was not significantly different between lactulose and water regardless of lactulose dose and formulation. Also with regard to all secondary endpoints lactulose formulations showed comparable results to water with one exception concerning maximum glucose level. A minor increase in maximum blood glucose was observed after the 30 g dose, liquid lactulose, in comparison to water with a mean treatment difference of 0.63 mmol/L (95% confidence intervals: 0.19, 1.07). Intake of 30 g glucose significantly increased all blood glucose endpoints vs 30 g liquid and crystal lactulose, respectively (all P < 0.0001). No differences in blood glucose response were observed between the different lactulose formulations. As expected, lactulose increased the number of bowel movements and was generally well tolerated. Subjects experienced only mild to moderate GI symptoms due to the laxative action of lactulose.

CONCLUSION

Blood glucose AUC_{baseline_c (0-180 min)} levels in mildly constipated, non-insulin dependent subjects with T2DM are not affected by the carbohydrate impurities contained in 20 g and 30 g crystal or liquid lactulose formulations.

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Gordon M, Grafton-Clarke C, Rajindrajith S, Benninga MA, Sinopoulou V, Akobeng AK. Treatments for intractable constipation in childhood. Hippokratia 2021. [DOI: 10.1002/14651858.cd014580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]

Senna Versus Magnesium Oxide for the Treatment of Chronic Constipation: A Randomized, Placebo-Controlled Trial. Am J Gastroenterol 2021;116:152-161. [PMID: 32969946 DOI: 10.14309/ajg.0000000000000942] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022]

Farmer AD, Wood E, Ruffle JK. An approach to the care of patients with irritable bowel syndrome. CMAJ 2020;192:E275-E282. [PMID: 32179536 DOI: 10.1503/cmaj.190716] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open

Ahn Y, Hong GS, Lee JH, Lee CW, Kim SO. Ischemic colitis after enema administration: Incidence, timing, and clinical features. World J Gastroenterol 2020;26:6442-6454. [PMID: 33244204 PMCID: PMC7656214 DOI: 10.3748/wjg.v26.i41.6442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/05/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023] Open

Khatri DK, Choudhary M, Sood A, Singh SB. Anxiety: An ignored aspect of Parkinson’s disease lacking attention. Biomed Pharmacother 2020;131:110776. [DOI: 10.1016/j.biopha.2020.110776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 12/25/2022] Open