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Cochrane Review: Osmotic and stimulant laxatives for the management of childhood constipation (Review).Cochrane系统评价:渗透性和刺激性泻药用于儿童便秘管理(综述)
Evid Based Child Health. 2013 Jan;8(1):57-109. doi: 10.1002/ebch.1893.
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Osmotic and stimulant laxatives for the management of childhood constipation.用于治疗儿童便秘的渗透性和刺激性泻药。
Cochrane Database Syst Rev. 2016 Aug 17;2016(8):CD009118. doi: 10.1002/14651858.CD009118.pub3.
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Interventions for treating constipation in pregnancy.孕期便秘的治疗干预措施。
Cochrane Database Syst Rev. 2015 Sep 4;2015(9):CD011448. doi: 10.1002/14651858.CD011448.pub2.
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Osmotic and stimulant laxatives for the management of childhood constipation.用于治疗儿童便秘的渗透性和刺激性泻药。
Cochrane Database Syst Rev. 2012 Jul 11(7):CD009118. doi: 10.1002/14651858.CD009118.pub2.
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Interventions for preventing postpartum constipation.预防产后便秘的干预措施。
Cochrane Database Syst Rev. 2015 Sep 18;2015(9):CD011625. doi: 10.1002/14651858.CD011625.pub2.
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Management of faecal incontinence and constipation in adults with central neurological diseases.成人中枢神经系统疾病患者大便失禁和便秘的管理
Cochrane Database Syst Rev. 2013 Dec 18(12):CD002115. doi: 10.1002/14651858.CD002115.pub4.
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Management of faecal incontinence and constipation in adults with central neurological diseases.成人中枢神经系统疾病患者粪便失禁和便秘的管理
Cochrane Database Syst Rev. 2014 Jan 13;2014(1):CD002115. doi: 10.1002/14651858.CD002115.pub5.
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Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge.综述文章:刺激性泻药会损害肠道吗?对现有知识的批判性分析。
Therap Adv Gastroenterol. 2024 Jun 16;17:17562848241249664. doi: 10.1177/17562848241249664. eCollection 2024.

PMID:25535635
Abstract

Constipation has many definitions and is often described differently depending on the population queried. Physicians may define constipation as a reduction in the frequency of bowel movements to fewer than three times per week while patients identify more with the symptoms associated with constipation such as difficulty passing stool, hard stool consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely. It can substantially affect quality of life and be debilitating. It is estimated that between 2% to 27% of the population are affected depending upon the definition of constipation used. Several treatment options are available and include dietary or bulking agents, osmotic or stimulant laxatives, stool softeners, and 5-HT4 agonists. Bulking agents include soluble fibre (i.e. psyllium, ispaghula) and insoluble fibre (i.e. wheat bran), which, when taken with water, increase stool bulk and stool frequency. Osmotic laxatives (i.e. lactulose, polyethylene glycol [PEG], macrogol, milk of magnesia), are poorly absorbed by the gut and act as hyperosmolar agents, increasing the water content of stool and making the stool softer and easier to pass. Stimulant laxatives (i.e. sennosides, bisacodyl, sodium picosulfate) act on the intestinal mucosa, increasing water and electrolyte secretion and stimulating peristalsis. Stool softeners (i.e. docusate sodium or calcium) are thought to facilitate the mixing of aqueous and fatty substances and thereby soften the stool. The 5-HT4 agonists (i.e. prucalopride) stimulate peristalsis which increases colonic motility in individuals with non-neurogenic causes of constipation. Considering the different causes and patient populations that may experience constipation, there are questions with regards to the efficacy and safety of the treatments available. A recent Rapid Review concluded there was a paucity of good quality of evidence to support the use of stool softeners for the management or prevention of constipation in adults in a hospital or long-term care setting. Docusate appeared to be no more effective than placebo for increasing stool frequency or softening stools and did not lessen symptoms associated with constipation. The purpose of this report is to review the available evidence for the safety and efficacy of stool softeners, laxatives, bulking agents and 5-HT4 agonists for the management of constipation in adults and children.

摘要