Dataset Information

Effective Constipation Treatment Changes More Than Bowel Frequency: A Systematic Review and Meta-Analysis.

ABSTRACT:

Background/aims

The marketing of newer agents for treatment of constipation and irritable bowel syndrome with constipation (IBS-C) emphasize improvements in abdominal pain. However, it is not clear whether this observation reflects a unique visceral analgesic effect of these agents or is a general feature of effective laxation. We sought to determine the relationship between improvements in bowel frequency and decreases in abdominal pain in clinical trials of patients with constipation or IBS-C.

Methods

We searched "PubMed" and "Embase" databanks for clinical trials in patients with constipation or IBS-C, targeting publications that provided detailed data on bowel movement frequency and pain intensity before and after an intervention. We abstracted the results and performed meta-analytic and meta-regression analyses.

Results

Twenty-seven trials (16 constipation and 11 IBS) met entry criteria. Baseline weekly bowel movement frequency was low with 2.35 (2.07-2.64) with differences between constipation (2.00 [1.62-2.38]) and IBS-C (2.77 [2.40-3.14]; Q = 8.18; P = 0.002). Studies reported moderate pain levels (2.12 [1.81-2.42]) with comparable baseline levels in constipation (2.02 [1.63-2.42]) and IBS-C (2.35 [2.10-2.60]; Q = 1.92; P = 0.167). Treatments increased bowel frequency by 2.17 [1.88-2.47] and lowered pain ratings by 0.58 [0.49-0.68]. Meta-regression demonstrated a significant correlation between treatment-induced increases in bowel frequency and decreased pain ratings.

Conclusions

Our analysis suggests that reduction of abdominal pain observed in clinical trials of constipation and IBS-C is associated with laxation, and may not require specific drug mechanisms, thus arguing against a unique advantage of newer agents over traditional laxatives in the treatment of constipation and IBS-C.

SUBMITTER: Bielefeldt K

PROVIDER: S-EPMC4699720 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Publications

Effective Constipation Treatment Changes More Than Bowel Frequency: A Systematic Review and Meta-Analysis.

Bielefeldt Klaus K Levinthal David J DJ Nusrat Salman S

Journal of neurogastroenterology and motility 20160101 1

<h4>Background/aims</h4>The marketing of newer agents for treatment of constipation and irritable bowel syndrome with constipation (IBS-C) emphasize improvements in abdominal pain. However, it is not clear whether this observation reflects a unique visceral analgesic effect of these agents or is a general feature of effective laxation. We sought to determine the relationship between improvements in bowel frequency and decreases in abdominal pain in clinical trials of patients with constipation o ...[more]

PMID: 26717930

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Dataset Information

Effective Constipation Treatment Changes More Than Bowel Frequency: A Systematic Review and Meta-Analysis.

Background/aims

Methods

Results

Conclusions

Publications

Effective Constipation Treatment Changes More Than Bowel Frequency: A Systematic Review and Meta-Analysis.

Similar Datasets

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