Latest & greatest articles for constipation

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Top results for constipation

21. Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis

Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis Opioids are increasingly prescribed in the West and have deleterious GI consequences. Pharmacological therapies to treat opioid-induced constipation (OIC) are available, but their relative efficacy is unclear. We performed a systematic review and network meta-analysis to address this deficit in current knowledge.We searched MEDLINE, EMBASE, EMBASE Classic

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2018 EvidenceUpdates

22. Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials

Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials Two identical, phase 3, randomized, double-blind, placebo-controlled trials evaluated the efficacy and safety of plecanatide in patients with irritable bowel syndrome with constipation (IBS-C).Adults meeting Rome III criteria for IBS-C were randomized (1:1:1) to placebo or plecanatide (3 or 6 mg) for 12 weeks. The primary efficacy end (...) across both studies. All secondary end points (stool frequency/consistency, straining, abdominal symptoms) showed statistically significant improvements compared with placebo. The most common AE was diarrhea (3 mg, 4.3%; 6 mg, 4.0%; placebo, 1.0%). Discontinuation due to diarrhea was infrequent (3 mg, 1.2%; 6 mg, 1.4%; placebo, 0).Plecanatide significantly improved both abdominal pain and constipation symptoms of IBS-C with minimal associated side effects and high levels of tolerability.

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2018 EvidenceUpdates

23. Management of constipation in patients with Parkinson’s disease (PubMed)

Management of constipation in patients with Parkinson’s disease A considerable body of research has recently emerged around nonmotor symptoms in Parkinson's disease (PD) and their substantial impact on patients' well-being. A prominent example is constipation which occurs in up to two thirds of all PD-patients thereby effecting psychological and social distress and consequently reducing quality of life. Despite the significant clinical relevance of constipation, unfortunately little knowledge (...) exists on effective treatments. Therefore this systematic review aims at providing a synopsis on clinical effects and safety of available treatment options for constipation in PD. For this purpose, three electronic databases (MEDLINE, EMBASE, PsycINFO) were searched for experimental and quasi-experimental studies investigating the efficacy/effectiveness of interventions in the management of PD-associated constipation. Besides, adverse events were analyzed as secondary outcome. In total, 18

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2018 NPJ Parkinson's disease

24. Efficacy and Safety of Daikenchuto for Constipation and Dose-Dependent Differences in Clinical Effects (PubMed)

Efficacy and Safety of Daikenchuto for Constipation and Dose-Dependent Differences in Clinical Effects Daikenchuto (DKT) is a Kampo medicine used for the treatment of constipation. In this study, we evaluated the effectiveness of DKT against constipation.Thirty-three patients administered DKT for constipation were selected and divided into low-dose (7.5 g DKT; n = 22) and high-dose (15 g DKT; n = 11) groups. We retrospectively evaluated weekly defaecation frequency, side effects, and clinical (...) ) and second (P = 0.0101) weeks, respectively. There was no significant change in clinical laboratory values.We suggest that DKT increases defaecation frequency and is safe for treating constipation.

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2018 International journal of chronic diseases

25. Efficacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis

Efficacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the efficacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs

2018 EvidenceUpdates

26. The Cost Effectiveness of Lubiprostone in Chronic Idiopathic Constipation (PubMed)

The Cost Effectiveness of Lubiprostone in Chronic Idiopathic Constipation The objective of this study was to evaluate the cost effectiveness of lubiprostone, prucalopride, placebo and immediate referral to secondary care in chronic idiopathic constipation (CIC) in an economic model that was used by the UK National Institute for Health and Care Excellence (NICE) in developing guidance.We developed a cohort state-transition model to reflect the treatment pathway in CIC from the UK NHS

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2018 PharmacoEconomics open

27. Effects of Interferential Electrical Stimulation Plus Pelvic Floor Muscles Exercises on Functional Constipation in Children: A Randomized Clinical Trial

Effects of Interferential Electrical Stimulation Plus Pelvic Floor Muscles Exercises on Functional Constipation in Children: A Randomized Clinical Trial Functional constipation is a common condition in children. We assessed the effectiveness of combined interferential (IF) electrical stimulation and pelvic floor muscle (PFM) exercises on functional constipation in children.We conducted a single-center, double-blind randomized clinical trial study during 2014-2017 in Tehran, Iran. Ninety (...) children, aged 5-13 years, who fulfilled Rome III criteria were enrolled and randomly assigned into two treatment groups. Case group (n=45) underwent IF electrical stimulation and PFM exercises, whereas the control group (n=45) received PFM exercises plus sham stimulation. A complete bowel habit diary (with concerning data on the frequency of defecation per week, stool form, and the number of fecal soiling episodes), a constipation score questionnaire, and a visual pain score were recorded before

2018 EvidenceUpdates

28. Constipation

Constipation Constipation - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Constipation Last reviewed: February 2019 Last updated: October 2018 Summary A detailed history and physical examination, including a digital rectal examination, is the first step in the evaluation of constipation. Diagnostic evaluation may include a colonoscopy if indicated, colonic transit study, anorectal manometry, and a balloon expulsion (...) study. Initial treatment consists of lifestyle modification and laxatives. Medical treatment should be tailored to the underlying aetiology. Patients who do not respond to medical treatment may need specialised evaluation for pelvic floor dysfunction and biofeedback therapy. Surgery is only rarely indicated. Definition Chronic constipation is a polysymptomatic heterogeneous disorder. Patients define constipation on the basis of excessive straining, a sense of incomplete evacuation, failed or lengthy

2018 BMJ Best Practice

29. Constipation in children

Constipation in children Constipation in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Constipation in children Last reviewed: February 2019 Last updated: February 2019 Summary Childhood constipation is typically characterised by infrequent bowel evacuations, large stools, and difficult or painful defecation. Symptoms may result from low fibre, poor nutrient, and/or insufficient water intake, which leads (...) to excessive hardening of the stool. This often starts as an acute problem but can progress to faecal impaction and chronic constipation. Particularly in young children, any cause of painful defecation may provoke active withholding. Withholding may worsen the constipation and lead to a vicious cycle. Duration of constipation and amount of stool burden may depend on capacity of the child's rectum, the degree of megarectum, and other factors including rectal sensory function. After faecal disimpaction

2018 BMJ Best Practice

30. Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer

Randomized Phase III and Extension Studies of Naldemedine in Patients With Opioid-Induced Constipation and Cancer Purpose Opioid-induced constipation (OIC) is a frequent and debilitating adverse effect (AE) of opioids-common analgesics for cancer pain. We investigated the efficacy and safety of a peripherally acting μ-opioid receptor antagonist, naldemedine (S-297995), for OIC, specifically in patients with cancer. Patients and Methods This phase III trial consisted of a 2-week, randomized

2017 EvidenceUpdates

31. Use of polyethylene glycol in functional constipation and fecal impaction.

Use of polyethylene glycol in functional constipation and fecal impaction. The objective of this study was to evaluate in an analytical and descriptive manner the evidence published so far on the use of polyethylene glycol (PEG), with or without electrolytes, in the management of functional constipation and the treatment of fecal impaction.Search on MEDLINE, EMBASE and Cochrane databases until May 2016 of all publications adjusted to the following terms: constipation AND/OR fecal impaction (...) ), psyllium (one), tegaserod (one), prucalopride (one), paraffin oil (one), fiber combinations (one) and Descurainia sophia (one).Polyethylene glycol with or without electrolytes is more efficacious than placebo for the treatment of functional constipation, either in adults or in pediatric patients, with great safety and tolerability. These preparations constitute the most efficacious osmotic laxatives (more than lactulose) and are the first-line treatment for functional constipation in the short and long

2017 Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

32. Low-Dose Linaclotide (72 mug) for Chronic Idiopathic Constipation: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial

Low-Dose Linaclotide (72 mug) for Chronic Idiopathic Constipation: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial Linaclotide is a guanylate cyclase-C agonist approved in the United States, Canada, and Mexico at a once-daily 145-μg dose for the treatment of chronic idiopathic constipation (CIC); a once-daily 72-μg dose for CIC recently received FDA approval. The trial objective was to evaluate the efficacy and safety of a 72-μg linaclotide dose in CIC patients.This double-blind

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2017 EvidenceUpdates

33. Naloxegol (Moventig) and opioid-induced constipation. Its abdominal adverse effects are probably as troublesome as constipation

Naloxegol (Moventig) and opioid-induced constipation. Its abdominal adverse effects are probably as troublesome as constipation Prescrire IN ENGLISH - Spotlight ''Naloxegol (Moventig°) and opioid-induced constipation. Its abdominal adverse effects are probably as troublesome as constipation'', 1 October 2017 {1} {1} {1} | | > > > Naloxegol (Moventig°) and opioid-induced constipation. Its abdominal adverse effects are probably as troublesome as constipation Spotlight Every month, the subjects (...) in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Naloxegol (Moventig°) and opioid-induced constipation. Its abdominal adverse effects are probably as troublesome as constipation FEATURED REVIEW Naloxegol tablets have been authorised in the European Union for adults with troublesome opioid-induced constipation despite laxative therapy. Does naloxegol relieve discomfort in these patients? What

2017 Prescrire

34. Constipation

Constipation Constipation | ONS Hello [ Name ] ! Renew Membership: Hello [ Name ] ! Renew Membership: Menu Search Constipation is defined as the decreased passage of stool characterized by infrequent bowel movements, hard stool, sensation of abdominal bloating or cramping, straining with bowel movements, and feeling of incomplete evacuation. Constipation can be a symptom of the cancer itself because of pressure that can partially or totally occlude the bowel. Constipation also can occur because (...) of problems of immobility or dehydration as a result of cancer treatment that directly affects the bowel or innervation of the gastrointestinal tract and as a result of medication. Opioid-induced constipation is a problem in patients who require opioids for pain management. The incidence of constipation among patients with cancer has not been well defined. In the palliative care population, prevalence of 40%–64% has been reported, and the symptom can be as high as 70%–100% among hospitalized patients

2017 Oncology Nursing Society Putting Evidence into Practice (PEP)

35. Methylnaltrexone bromide for treating opioid-induced constipation (terminated appraisal)

Methylnaltrexone bromide for treating opioid-induced constipation (terminated appraisal) Meth Methylnaltre ylnaltrex xone bromide for treating one bromide for treating opioid-induced constipation (terminated opioid-induced constipation (terminated appr appraisal) aisal) T echnology appraisal guidance Published: 23 August 2017 nice.org.uk/guidance/ta468 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Contents Contents (...) Advice 3 Methylnaltrexone bromide for treating opioid-induced constipation (terminated appraisal) (TA468) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 3Advice Advice NICE is unable to make a recommendation about the use in the NHS of methylnaltrexone bromide for treating opioid-induced constipation because no evidence submission was received from Swedish Orphan Biovitrum Ltd. The company has confirmed

2017 National Institute for Health and Clinical Excellence - Technology Appraisals

36. Phase IIb, Randomized, Double-Blind, Placebo-Controlled Study of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients With Cancer

Phase IIb, Randomized, Double-Blind, Placebo-Controlled Study of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients With Cancer Purpose This randomized, double-blind, multicenter study aimed to determine the dose of naldemedine, a peripherally-acting μ-opioid receptor antagonist, for future trials by comparing the efficacy and safety of three doses of naldemedine versus placebo in patients with cancer and opioid-induced constipation. Methods Patients ≥ 18 years old (...) with cancer, an Eastern Cooperative Oncology Group performance status ≤ 2, who had been receiving a stable regimen of opioid analgesics for ≥ 2 weeks, had at least one constipation symptom despite laxative use, and no more than five spontaneous bowel movements (SBMs) during the past 14 days, were randomly assigned (1:1:1:1) to oral, once-daily naldemedine 0.1, 0.2, or 0.4 mg, or placebo, for 14 days. The primary end point was change in SBM frequency per week from baseline during the treatment period

2017 EvidenceUpdates

37. Symproic (naldemedine) Tablets - For the treatment of opioid-induced constipation

Symproic (naldemedine) Tablets - For the treatment of opioid-induced constipation Symproic (naldemedine) Tablets U.S. Department of Health and Human Services Search FDA Submit search Symproic (naldemedine) Tablets Symproic Company: Shionogi Inc. Application No.: 208854 Approval Date: 03/23/2017 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date

2017 FDA - Drug Approval Package

38. Lactobacillus casei rhamnosus Lcr35 in the Management of Functional Constipation in Children: A Randomized Trial

Lactobacillus casei rhamnosus Lcr35 in the Management of Functional Constipation in Children: A Randomized Trial To assess the effectiveness of Lactobacillus casei rhamnosus Lcr35 (Lcr35) in the management of functional constipation in children.A randomized, double-blind, placebo-controlled trial was conducted in 94 children aged <5 years with functional constipation according to the Rome III criteria. Children were assigned to receive Lcr35 (8 × 108 colony-forming units, n = 48) or placebo (n (...) in the frequency of defecation from baseline to week 4 in both the placebo group (median [IQR] 2.0 [1.0, 2.0] to 6.0 [4.0, 9.0], P < .001) and in the Lcr35 group (2.0 [1.0, 2.0] to 4.0 [3.0, 5.0], P < .001), but the defecation frequency in the placebo group was significantly greater than that in the Lcr35 group at weeks 1, 2, 3, and 4.Lcr35 as a sole treatment was not more effective than placebo in the management of functional constipation in children <5 years. This study adds to current recommendations

2017 EvidenceUpdates

39. CRACKCast E032 – Constipation

CRACKCast E032 – Constipation CRACKCast E032 - Constipation - CanadiEM CRACKCast E032 – Constipation In , by Adam Thomas March 23, 2017 This episode of CRACKCast cover’s Rosen’s Chapter 32, Constipation 1 . Constipation is a common presenting symptoms in the ER in our geriatric population, and a good approach can help prevent unnecessary testing. Shownotes – Rosen’s in Perspective Constipation as lots of different definitions: straining hard/infrequent stools pain during BMs, *Always have (...) the patient define what they mean by constipation* Chronic constipation > 3 months Constipation + inability to pass flatus = obstipation Constipation is most common in Women Elderly low SES high BMIs low fiber sedentaryism multiple medication GI tract normally sees 10 L of fluids and secretions. The small intestine absorbs all but 500 ml The colon uses these residues from the ileum to ferment and salvage nutrients and water. Stool evacuation and transport depends on: Neurotransmitters Colonic reflexes

2017 CandiEM

40. Plecanatide (Trulance) - Chronic Idiopathic Constipation (CIC)

Plecanatide (Trulance) - Chronic Idiopathic Constipation (CIC) Trulance (plecanatide) Tablets U.S. Department of Health and Human Services Search FDA Submit search Trulance (plecanatide) Tablets Trulance Company: Synergy Pharmaceuticals Inc. Application No.: 208745 Approval Date: 01/19/2017 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date

2017 FDA - Drug Approval Package