Management of Constipation - Bowel Cancer UK

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Are current laxative options effective?16–40% of those with constipation use laxativesSymptoms persist despite laxative use10080Patients with ongoing constipation symptoms (%)Use laxativeDo not use laxative6040200 US UK FR GE IT BR SKCountryApproximately 2000 adults each from: United States, US; United Kingdom, UK;France, FR; Germany, GE; Italy, IT; Brazil, BR; South Korea, SKWald et al. Aliment Pharmacol Ther 2008;28:917
Patients requirements of constipation treatments?Speed of effect• Ideally within 1 hour of taking pill• This gives patient predictabilityDuration of action• Want the effectiveness to last for a longer period of timeUsage frequency & Type• Desire a product that can be taken on a “as needed” acute basis ratherthan ones that need to be taken chronically (e.g. once daily dosing)• Prefer OTC products to Rx therapies• Prefer pill to other formulationsSide effect profileGentleness of treatment• Besides fast onset, the absence of side effects is of major importance.Compatibility is absolutely key and it is very important that side effectsdon’t occur outside the stomach region (e.g. headaches or dizziness)• There is a strong desire for gentle, but effective treatments, (i.e.homeopathic or herbal products). This is based on negative feelingstowards chemicals and the fear to damage the body by chemical drugsInformation and education• There is a high and unmet need for information and education17
Page 1 and 2: Constipation: new options for acomm
Page 5 and 6: Auto-intoxicationConstipation: the
Page 7 and 8: Effect of dietary fibre & exerciseN
Page 9 and 10: Role of fluid intake?7% develop con
Page 11 and 12: Bulking agentsDecreased total gut t
Page 13 and 14: Osmotic agents: LactuloseSlow trans
Page 15: StimulantsMore frequent bowel movem
Page 19: Chronic constipation:Symptoms in se
Page 22 and 23: Dispel mythsIs chronic constipation
Page 24 and 25: MythsDoes long-term use of laxative
Page 26 and 27: Emerging treatments“Prokinetics
Page 28 and 29: Emerging treatments: Medical probio
Page 30 and 31: Colonic 5-HT receptorsExtrinsicaffe
Page 32 and 33: PrucaloprideEffect on symptoms asso
Page 34 and 35: LinaclotideLembo et al NEJM 2011
Page 36 and 37: Optimal timing for attempted defaec
Page 38 and 39: Is biofeedback better than stimulan
Page 40 and 41: 75Biofeedback: Long Term BenefitsPr
Page 42: Transanal irrigationEvidence• Cli

Management of Constipation - Bowel Cancer UK

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