Effectiveness of Laxatives in the Elderly - NIHR Health Technology ...

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Results
TABLE 5 contd Summary of RCTs of prevention and treatment of constipation in the elderly
Study Class of Study Trial Results: Comments
(country) laxative population, description, bowel movements (methodological
sample size follow-up per week, and score)
other outcomes
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Treatment of constipation – RCTs comparing laxative with placebo or normal diet
Rajala et al, Bulk Hospitalised patients Treatment: Yoghurt 5.8 vs. 4.5 (p = 0.3). Double-blind
1988 n = 51 + bran, 150 ml Abdominal pain and (described)
(Finland) Mean age 78 years twice daily overall symptoms Drop-outs = 33%
Control: Yoghurt improved in treated (4)
2 weeks group. Also less need
for laxatives
Marchesi, Stimulant Hospitalised patients Treatment: Cascara, 6.0 vs. 3.4 (p < 0.05). Drop-outs
1982 n = 28 2400 mg, + boldo, Consistency improved not stated
(Italy) Mean age 71 years 500 mg, four times in treated group (3)
daily
Control: Placebo
3 weeks
Stern, 1966 Stimulant Nursing-home Treatment: Prucara, Overall improvement Double-blind
(USA) patients 2 tablets twice daily in consistency, control (described)
n = 25 Control: Placebo over frequency in 88% Drop-outs
Mean age > 71 years 3 weeks of treated group vs. not stated
0% of controls. (3)
Few side-effects
Hyland & Foran, Softener Hospitalised patients Treatment: DSS, 3.3 vs. 2.5 (p = 0.06). Double-blind
1968 n = 40 100 mg three Overall symptom (described)
(UK) Mean age > 60 years times daily improvement Drop-outs = 60%
Control: Placebo significantly greater (4)
4 weeks with treatment
(p < 0.05)
Sanders, 1978 Osmotic Nursing-home Treatment: 4.9 vs. 3.6 (p = 0.1). Drop-outs = 22%
(USA) patients Lactulose, 30 ml Reduction in five (3)
n = 45 four times daily symptoms significantly
Mean age 85 years Control: Placebo greater with lactulose
12 weeks (p = 0.04)
Vanderdonckt Osmotic Nursing-home Treatment: Number of bowel Stated to be
et al, 1990 patients Lactitol, 20 g movements increased double-blind
(Belgium) n = 43 four times daily with treatment Drop-outs = 2%
Mean age 84 years Control: Placebo (p < 0.001). (6)
4 weeks Consistency improved
with treatment
(p < 0.001).
Less abdominal pain
(NS) and less need for
laxatives (p < 0.05)
Agiolax ® = Plantaginis ovata, 2.6 g, + isphagula, 0.11 g, + senna, 0.62 g
Lunelax ® = Ispaghula, 3.3 g, + senna, 25 mg
Laxamucil ® = Plantain, 800 mg/g, + sorbitol, 190 mg/g
Dorbanex ® = Danthron + poloxalkol
Golytely ® = Sodium, 125 mmol/l, + potassium, 10 mmol/l, + sulphate, 80 mmol/l, + bicarbonate, 20 mmol/l, + polyethylene glycol, 80 mmol/l
Boldo = Chilean bark extract (folk remedy)
DCS, dioctyl calcium sulphosuccinate; DSS, dioctyl sodium sulphosuccinate; NS, not significant
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