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Misoprostol in the treatment of chronic refractory constipation: results of a long-term open label trial.
Aliment Pharmacol Ther 1997; 11(6):1059-66AP

Abstract

BACKGROUND

Misoprostol is known to be effective in stimulating intestinal transit both in healthy individuals and in patients with chronic constipation when evaluated in short-term trials. The aim of this study was to determine the utility of misoprostol in the long-term management of patients with chronic refractory constipation.

METHODS

Eighteen patients were offered misoprostol (600-2400 microg/day) as adjunctive therapy in an open-ended, non-blinded trial. All patients were encouraged to continue the drug for a minimum of 4 weeks, after which time the effect on bowel movement patterns was evaluated and continued use of misoprostol was offered to those patients who demonstrated a clinical benefit.

RESULTS

Six patients withdrew prior to 4 weeks because of side-effects. In the 12 patients who continued the treatment and were evaluated at 4 weeks, the mean interval between bowel movement frequency had decreased from a baseline of 11.25 to 4.8 days (P = 0.0004). Eight patients continued the long-term treatment, with sustained response seen in six. In a subset of patients (n = 4) the effect of single-dose misoprostol (400 microg) was evaluated compared to healthy controls (n = 5) on post-prandial segmental colonic motility. Misoprostol augmented the colonic motility response to a meal throughout the colon, and this was significantly greater in the left versus right colonic segments (P < 0.05).

CONCLUSIONS

Misoprostol can be effective as part of the long-term medical treatment of patients with chronic refractory constipation, but side-effects are observed at higher doses and can be a limiting factor. Part of misoprostol's action may be mediated through the augmentation of colonic motility, particularly of the left colon.

Authors+Show Affiliations

Division of Gastroenterology, University of Virginia Health Sciences Center, Charlottesville, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9663830

Citation

Roarty, T P., et al. "Misoprostol in the Treatment of Chronic Refractory Constipation: Results of a Long-term Open Label Trial." Alimentary Pharmacology & Therapeutics, vol. 11, no. 6, 1997, pp. 1059-66.
Roarty TP, Weber F, Soykan I, et al. Misoprostol in the treatment of chronic refractory constipation: results of a long-term open label trial. Aliment Pharmacol Ther. 1997;11(6):1059-66.
Roarty, T. P., Weber, F., Soykan, I., & McCallum, R. W. (1997). Misoprostol in the treatment of chronic refractory constipation: results of a long-term open label trial. Alimentary Pharmacology & Therapeutics, 11(6), pp. 1059-66.
Roarty TP, et al. Misoprostol in the Treatment of Chronic Refractory Constipation: Results of a Long-term Open Label Trial. Aliment Pharmacol Ther. 1997;11(6):1059-66. PubMed PMID: 9663830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Misoprostol in the treatment of chronic refractory constipation: results of a long-term open label trial. AU - Roarty,T P, AU - Weber,F, AU - Soykan,I, AU - McCallum,R W, PY - 1998/7/15/pubmed PY - 1998/7/15/medline PY - 1998/7/15/entrez SP - 1059 EP - 66 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 11 IS - 6 N2 - BACKGROUND: Misoprostol is known to be effective in stimulating intestinal transit both in healthy individuals and in patients with chronic constipation when evaluated in short-term trials. The aim of this study was to determine the utility of misoprostol in the long-term management of patients with chronic refractory constipation. METHODS: Eighteen patients were offered misoprostol (600-2400 microg/day) as adjunctive therapy in an open-ended, non-blinded trial. All patients were encouraged to continue the drug for a minimum of 4 weeks, after which time the effect on bowel movement patterns was evaluated and continued use of misoprostol was offered to those patients who demonstrated a clinical benefit. RESULTS: Six patients withdrew prior to 4 weeks because of side-effects. In the 12 patients who continued the treatment and were evaluated at 4 weeks, the mean interval between bowel movement frequency had decreased from a baseline of 11.25 to 4.8 days (P = 0.0004). Eight patients continued the long-term treatment, with sustained response seen in six. In a subset of patients (n = 4) the effect of single-dose misoprostol (400 microg) was evaluated compared to healthy controls (n = 5) on post-prandial segmental colonic motility. Misoprostol augmented the colonic motility response to a meal throughout the colon, and this was significantly greater in the left versus right colonic segments (P < 0.05). CONCLUSIONS: Misoprostol can be effective as part of the long-term medical treatment of patients with chronic refractory constipation, but side-effects are observed at higher doses and can be a limiting factor. Part of misoprostol's action may be mediated through the augmentation of colonic motility, particularly of the left colon. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/9663830/full_citation L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0269-2813&amp;date=1997&amp;volume=11&amp;issue=6&amp;spage=1059 DB - PRIME DP - Unbound Medicine ER -