1
|
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
Abstract
Background: Constipation causes substantial morbidity worldwide. Methods: This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel Syndrome Quality of Life (IBS-QOL-J) instrument. We also examined the relationship among laxative type, Bristol Stool Form Scale (BSFS) scores, and treatment cost. Finally, we examined differences in satisfaction scores according to laxative type, treatment type, treatment cost, and BSFS score. Results: IBS-QOL-J was higher among those taking salt and/or irritation laxatives. Those paying >JPY 5000 (USD 50.00) had the lowest IBS-QOL-J. IBS-QOL-J was significantly lower among those with a BSFS score of 1 or 2 (severe constipation). Conclusions: This study's findings suggest that a variety of factors, including treatment type and cost, are associated with defecation satisfaction. Those who had hard stools, used multiple laxatives, or spent more on treatment were less satisfied. Future strategies should target therapies that do not require multiple laxatives with lower treatment costs. Adequate defecation with a small number of appropriate laxatives at minimal cost appears to improve defecation satisfaction. It is desirable to identify appropriate laxatives and improve dietary habits and exercise routines. It is also necessary to stop blindly increasing laxative usage and properly diagnose constipation disorders such as anatomical abnormalities other than functional constipation.
Collapse
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
| |
Collapse
|
2
|
Lacy BE, Delfini R, Fladung B, Lange R. Prevalence and patterns of laxative use in subjects with self-reported constipation: results from a multinational digestive health survey. Therap Adv Gastroenterol 2024; 17:17562848241232605. [PMID: 38445248 PMCID: PMC10913501 DOI: 10.1177/17562848241232605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/17/2024] [Indexed: 03/07/2024] Open
Abstract
Background Constipation is characterized by symptoms of straining, hard stool, difficult evacuation, and infrequent bowel movements. Online surveys provide valuable information about patients' perspectives, symptoms, management, treatment satisfaction, and risk factors. Methods This survey explored subject experiences involving 20 gastrointestinal (GI) conditions. In total, 20,099 respondents in seven countries with varied cultural and socioeconomic backgrounds participated. Post hoc analysis of 'self-reported constipation' and related symptoms experienced within the past 6 months and the last episode of constipation provided data on prevalence, demographics, frequency and duration of episodes and related symptoms, impact on quality of life (QoL), management with or without laxatives, and resulting treatment satisfaction. Results In total, 10,425 subjects reported constipation within 6 months and 2637 at the last episode. Prevalence was highest in females and younger adults. Most subjects reported various coexisting GI symptoms. Almost 80% of 6865 episodes reported by 5337 subjects occurred every 2-3 months to every 2-3 weeks. A higher frequency of constipation correlated with a greater impact on QoL. On a 10-point scale, the mean impact was 6.4. More than 90% of respondents had episodes ranging from 1 day to 1 week. More than 90% took action; 16% used laxatives, of whom 80.3% were satisfied. Conclusion Constipation, a highly prevalent disorder, spans cultures and socioeconomic classes. Its chronic recurrence has a significant impact on QoL, resulting in symptom self-management in >90% of subjects. Significantly higher satisfaction rates in subjects treated with than without laxatives reflect subjects' reports that self-reported constipation can be treated effectively with laxatives.
Collapse
Affiliation(s)
- Brian E. Lacy
- Division of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Bernward Fladung
- Freelance Medical Advisor, Linnich, Germany
- Régis Delfini is currently affiliated to Boehringer Ingelheim, Ingelheim, Germany
| | - Robert Lange
- Industriepark Hoechst, Building K 607, 65929 Frankfurt am Main, Germany
| |
Collapse
|
3
|
Camilleri E, Blundell R, Cuschieri A. Deciphering the anti-constipation characteristics of palm dates ( Phoenix dactylifera): a review. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2023. [DOI: 10.1080/10942912.2022.2153865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Emma Camilleri
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Imsida, Malta
| | - Renald Blundell
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Imsida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Andrea Cuschieri
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Imsida, Malta
| |
Collapse
|
4
|
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.
Collapse
Affiliation(s)
- Ghada Ajabnoor
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
- Food, Nutrition, and Lifestyle Research Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, SAU
- Department of Clinical Biochemistry, King Abdulaziz University Hospital, Jeddah, SAU
| | - Basmah Eldakhakhny
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
- Food, Nutrition, and Lifestyle Research Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, SAU
| | - Kamal T Hashim
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | | | | | | | | | - Mansour Dahlan
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Sumia Enani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, SAU
| | - Yousef Almoghrabi
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Aliaa A Alamoudi
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Amani Alhozali
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Ayman Elsamanoudy
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, EGY
| |
Collapse
|
5
|
Neyrinck AM, Rodriguez J, Taminiau B, Herpin F, Cani PD, Daube G, Bindels LB, Delzenne NM. Constipation Mitigation by Rhubarb Extract in Middle-Aged Adults Is Linked to Gut Microbiome Modulation: A Double-Blind Randomized Placebo-Controlled Trial. Int J Mol Sci 2022; 23:ijms232314685. [PMID: 36499011 PMCID: PMC9738964 DOI: 10.3390/ijms232314685] [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: 10/07/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Gut microbiota alterations are intimately linked to chronic constipation upon aging. We investigated the role of targeted changes in the gut microbiota composition in the relief of constipation symptoms after rhubarb extract (RE) supplementation in middle-aged volunteers. Subjects (95% women, average 58 years old) were randomized to three groups treated with RE at two different doses determined by its content of rhein (supplementation of 12.5 mg and 25 mg per day) vs. placebo (maltodextrin) for 30 days. We demonstrated that daily oral supplementation of RE for 30 days was safe even at the higher dose. Stool frequency and consistency, and perceived change in transit problem, transit speed and difficulty in evacuating, investigated by validated questionnaires, were improved in both groups of RE-treated volunteers compared to placebo. Higher abundance of Lachnospiraceae (mainly Roseburia and Agathobacter) only occurred after RE treatment when present at low levels at baseline, whereas an opposite shift in short-chain fatty acid (SCFA) levels was observed in both RE-treated groups (increase) and placebo (decrease). Fecal Lachnospiraceae and SCFA were positively correlated with stool consistency. This study demonstrates that RE supplementation promotes butyrate-producing bacteria and SCFA, an effect that could contribute to relieving chronic constipation in middle-aged persons.
Collapse
Affiliation(s)
- Audrey M. Neyrinck
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Julie Rodriguez
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Bernard Taminiau
- Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | | | - Patrice D. Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
- WELBIO-Walloon Excellence in Life Sciences and Biotechnology, WELBIO Department, WEL Research Institute, 1300 Wavre, Belgium
| | - Georges Daube
- Fundamental and Applied Research for Animal and Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
| | - Laure B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Nathalie M. Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
- Correspondence:
| |
Collapse
|
6
|
Rahmadi M, Ardianto C, Nurhan AD, Chasanah RA, Krismonika DI, Puspitasari AD, Suprapti B, Segaran S, Phan CW, Khotib J. Bisacodyl overcomes morphine-induced constipation by decreasing colonic Aquaporin-3 and Aquaporin-4 expression. RESEARCH RESULTS IN PHARMACOLOGY 2022. [DOI: 10.3897/rrpharmacology.8.82242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Morphine is an opioid prescribed to treat aches and pains. However, morphine often causes opioid-induced constipation (OIC). Aquaporin (AQP) transporters, especially AQP3 and AQP4, play an essential role in mediating constipation. Bisacodyl is a common laxative used to treat constipation. To date, the effects of bisacodyl on AQP3 and AQP4 expression and the role this interaction plays in constipation are unclear. This study aimed to determine the effects of bisacodyl on AQP3 and AQP4 expression in mice after induction of constipation with morphine.
Materials and methods: The laxative effects of bisacodyl on both acute and chronic morphine-induced constipation were determined. Fecal water content, colonic bead expulsion, and colonic mRNA levels for AQP3 and AQP4 mRNA were measured.
Results and discussion: The administration of morphine to mice resulted in decreased fecal water content, longer bead expulsion times, and increased AQP3 and AQP4 mRNA levels in the colon. Meanwhile, bisacodyl administration prevented the morphine-induced changes in fecal water content, bead expulsion time, and AQP3 and AQP4 mRNA levels in the colons of mice.
Conclusion: This study suggests that bisacodyl may prevent morphine-induced constipation by preventing morphine-induced increases in AQP3 and AQP4 expression in the colon.
Graphical abstract:
Collapse
|
7
|
Laxatives are associated with poorer polysomnography-derived sleep quality. Neurol Sci 2022:1-7. [PMID: 35723037 DOI: 10.1017/cjn.2022.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
8
|
Ooba N, Takahashi Y, Nagamura M, Takahashi M, Ushida M, Kawakami E, Kimura M, Sato T, Tokuyoshi J, Miyazaki C, Shimada M. Safety of elobixibat and lubiprostone in Japanese patients with chronic constipation: a retrospective cohort study. Expert Opin Drug Saf 2021; 20:1553-1558. [PMID: 34281471 DOI: 10.1080/14740338.2021.1952980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND We aimed to discuss and compare reported adverse reactions and drug add-ons associated with elobixibat and lubiprostone use in chronic constipation treatment, as the safety of these drugs has not been well examined in post-marketing clinical settings. RESEARCH DESIGN AND METHODS In this retrospective cohort study, using records of community pharmacies in Japan, we identified new users of elobixibat and lubiprostone. The Japan Pharmaceutical Association sent questionnaires regarding baseline and event data to community pharmacists. The incidence of events and hazard ratio (HR) associated with the study drugs were evaluated. RESULTS New users of elobixibat (n = 979) and lubiprostone (n = 829) were identified (mean age: 74 and 77 years; females: 59% and 53%, respectively). Although the crude risk ratio of adverse events for elobixibat was 0.79 (95% confidence interval: 0.63-0.99), there was no significant difference in the HR for any of the common events, including drug add-ons (n ≥ 5), compared with those for lubiprostone. CONCLUSION No new safety concerns have been raised in relation to elobixibat and lubiprostone use for treating chronic constipation, although the HR of different events varied. Further larger-scale study is needed as the estimates for events of small numbers were unstable.
Collapse
Affiliation(s)
- Nobuhiro Ooba
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
| | | | - Marina Nagamura
- Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan
| | | | | | | | - Masaomi Kimura
- Department of Computer Science and Engineering, Shibaura Institute of Technology, Tokyo, Japan
| | - Tsugumichi Sato
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | | | | | | |
Collapse
|