Davis Mellar, Gamier Pamela
Cleveland Clinic Lerner School of Medicine Case, Western Reserve University, 9500 Euclid Avenue, T34, Cleveland, OH, 44195, USA.
Clinical Fellowship Program, Cleveland, OH, USA.
Curr Oncol Rep. 2015 Dec;17(12):55. doi: 10.1007/s11912-015-0481-x.
Constipation is common in the general population and for those on opioids and/or who are suffering from advanced cancer. Self-management consists of dietary changes, exercise, and laxatives. However, responses to self-management efforts are often inadequate to relieve the subjective and objective experience of constipation. Multiple new anti-constipating medications have recently been tested in randomized trials and the following are available commercially: probiotics, prucalopride, lubiprostone, linaclotide, elobixibat, antidepressants, methylnaltrexone, alvimopan, and naloxegol. This review will discuss the evidence-based benefits of these medications and outline an approach to managing constipation.
便秘在普通人群中很常见,对于使用阿片类药物的人以及/或者患有晚期癌症的人来说也是如此。自我管理包括饮食改变、运动和泻药。然而,自我管理措施的效果往往不足以缓解便秘的主观和客观体验。最近,多种新型抗便秘药物已在随机试验中进行了测试,以下几种已在市场上有售:益生菌、普芦卡必利、鲁比前列酮、利那洛肽、埃洛昔巴特、抗抑郁药、甲基纳曲酮、阿维莫潘和纳洛西醇。本综述将讨论这些药物基于证据的益处,并概述便秘的管理方法。