Constipation Assessment Research Articles

Efektivitas Masase Abdomen terhadap Pencegahan Konstipasi pada Pasien Stroke

This study aims to identify the effectiveness of abdominal massage in preventing constipation in stroke patients. The method used is a quasi-experimental two-group pretest-posttest. The sampling technique was conducted by consecutive sampling using the Constipation Assessment Scale (CAS) instrument. The results showed an effect of abdominal massage on the prevention of constipation in stroke patients (p = 0.001) and after the procedure (p = 0.001). In conclusion, abdominal massage is effective in preventing constipation.
 Keywords: Abdomen, Constipation, Massage, Stroke

A descriptive study of high resolution total colonic intracavitary manometry and colonic transit test in the diagnostic efficacy of functional constipation in Chinese patients

BackgroundThis study was to observe the diagnostic efficacy of high resolution total colonic intracavitary manometry (HRCM) vs colonic transit test (CTT) in the assessment of functional constipation (FC) in Chinese patients.MethodsSeventy-nine cases of patients with severe FC who were admitted and received colon resection between July 2016 and July 2019 at the Tianjin Union Medical Center were retrospectively reviewed. Before operation, all patients received CTT at outpatient service, followed by HRCM at ward. The resected tissues were subject to histological observation, which was used to determine the diagnostic efficacy of HRCM vs CTT.ResultsThe accuracy of CTT for the FC diagnosis was 69.6% (55/79), and the false negative ratio was 30.4%. The accuracy of HRCM for the FC diagnosis was 81.0% (64/79), and the false negative ratio was 19.0% (15/79). Twelve patients showed normal characteristics after CTT but abnormal after HRCM. In contrast, only 4 showed normal after HRCM but abnormal after CTT. In addition, among the 79 patients 12 were detected normal by both CTT and HRCM.ConclusionHRCM can be more suitable to assess FC compared with CTT, while CTT is still indispensable for HRCM to diagnose FC.

Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial

BackgroundConstipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly. ObjectiveThis study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life. Design, setting, participants and interventionThis double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks. Main outcome measuresConstipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire. ResultsA total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group. ConclusionAlthough both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood. Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).

CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE CONSTIPATION SCORING SYSTEM FOR THE BRAZILIAN POPULATION.

Beyond Rome IV Criteria, the assessment of functional constipation in clinical practice can also be obtained by the Constipation Scoring System (CSS). By accessing the CSS, health professionals are able to measure this dysfunction, guiding initial therapeutic approach and post-treatment response. In addition, the CSS enables the standardization of results concerning functional constipation research. To promote translation, cross-cultural adaptation and validation of the CSS for the Brazilian population. To attain the score in Portuguese, the adaptation was accomplished in four steps (translation, back translation, application and adjustments). Afterward, the validation and adaptation to the Brazilian population was performed through test-retest. For adults, the convergent validity of the Brazilian version of the CSS showed a significant correlation to the Rome IV Criteria evinced by the positive Spearman correlation (r2) of 0.816 (P<0.001). Between the test-retest responses, the translated version of the score had a Cronbach's Alpha of 0.972. A high level of internal consistency was also obtained when each item of the questionnaire was assessed separately, revealing an adequate internal reliability. The CSS was well adapted and accepted by the Brazilian population, demonstrating the linguistic and psychometric validity of this Portuguese version of the score.

The effect of abdominal massage on the severity of constipation in elderly patients hospitalized with fractures: A randomized clinical trial

BackgroundThere is significant interest in the use of complementary therapies to control or reduce the severity of constipation. AimThe aim of this study was to determine the effect of abdominal massage on the severity of constipation in elderly patients with fractures. MethodsIn this randomized clinical trial, 60 elderly patients admitted to an Iranian orthopedic referral hospital who were suffering from constipation were randomly assigned to intervention and control groups. For the intervention group, abdominal massage was performed for 3 days, twice a day, for 15 minutes. Both groups were assessed using the Constipation Assessment Scale (CAS) and the Bristol Stool Scale (BSS). ResultsA statistically significant difference was observed between the two groups in BSS scores (p < 0.05). The mean CAS scores in the intervention group decreased from 10.74 to 4.51 after intervention and in the control group, it decreased from 10.20 to 7.37. There was a statistically significant difference in CAS scores between the two groups (p < 0.05). ConclusionThe results of the study showed the positive effect of abdominal massage on stool consistency and reduction of severity constipation.

A Prospective, Real-World, Multinational Study of Naloxegol for Patients with Cancer Pain Diagnosed with Opioid-Induced Constipation-The NACASY Study.

Simple SummaryPrescription opioid pain medications help ease pain, but they also cause some unwanted side effects such as constipation. In this study we evaluated the safety and efficacy of naloxegol used to treat constipation that is caused by opioids. We found that naloxegol improved constipation and quality of life in patients with cancer-related pain and opioid-induced constipation.The Naloxegol Cancer Study (NACASY) was a multinational European study aimed to evaluate the 4-week safety and efficacy of naloxegol in a real-world setting in patients with cancer pain diagnosed with opioid-induced constipation. The primary safety endpoint was the incidence of adverse events leading to study discontinuation. We recruited 170 patients who received at least one dose of naloxegol (i.e., safety population). Out of 170 patients, 20 (11.8%, 95%CI 6.9–16.6) discontinued the study due to adverse events, and, of them, 12 (7.1%, 95%CI 3.2–10.9%) were study discontinuations due to naloxegol-related adverse events. From 76 patients subjects who had completed both 4 weeks of treatment and 28 days of the diary, 55 patients (72.4%, 95% CI 62.3–82.4%) were regarded as responders (i.e., showed ≥3 bowel-movements per week and an increase of ≥1 bowel-movement over baseline) to naloxegol treatment. The Patient Assessment of Constipation—Quality of Life Questionnaire total score and all its subscales improved from baseline to 4 weeks of follow up. Our findings support and provide new evidence about the beneficial effect of naloxegol in terms of improvement of constipation and quality-of-life in patients with cancer-related pain and opioid-induced constipation and show a safety profile consistent with previous pivotal and real-world studies.

Integrative Literature Review on Constipation Assessment Methods in Pediatric Cancer Patients

Introduction: Constipation is a common problem experienced by many pediatric cancer patients, as a side-effect of opioid therapy, chemotherapy drugs and lifestyle changes secondary to the disease process. Aim: The aim of this study is analyze the available knowledge on the constipation assessment methods in pediatric oncology to understand which ones are the advantages from each scale reported in the literature, and to find out if there is a shared method. Methods: An integrative review was performed. The electronic databases MEDLINE, CINHAL, and COCHRANE (The Cochrane Database) were searched for articles that explored assessment methods for constipation in pediatric cancer patients. Then both the bibliographies and related citations of the whole articles selected have been analyzed. There was no limitation by language or publication dates, but there was age limitation (Child: birth – 18 years) in PUBMED database. The literature search was performed in September 2020. Results: Seventeen articles have been selected, all in English. Seven of those were concerned with the pediatric population, while the other ten did not specify an age, relating to both adults and pediatrics alike. All the assessment methods proposed were compared, and those developed for pediatrics have been analyzed. Conclusion: What emerges from the review of the literature is the current lack of a shared method that allows for the assessment of constipation in pediatric oncology patients, there being, as yet no univocal and concurring opinions on the method for the evaluation of constipation. The review showed the need for further studies in this field to raise awareness and increase knowledge.

Clinical practice guideline on the evaluation and management of chronic constipation for Chinese adults (2022 edition)

Chinese Society of Colorectal Surgery firstly issued guidelines on the chronic constipation in 2008, which played a positive role in the standardization of chronic constipation surgery in China. In recent years, some progress has been made in the basic and clinical researches on chronic constipation. But in terms of clinical practice, there is still a lack of gold standard and high-level clinical research evidence, and surgeons have no authoritative reference in preoperative evaluation, operation selection and efficacy evaluation. In order to further standardize the diagnostic assessment and surgical treatment of chronic constipation, it is necessary to update the guidelines. Based on the published literatures combined with the clinical experience of experts, the "Clinical practice guideline on the evaluation and management of chronic constipation for Chinese adults (2022 edition)" has been formulated, which aims at the common problems in constipation assessment and treatment, is problem-oriented, and puts forward rationalization suggestions on the basis of evidence. It is expected to contribute to the learning and practice on constipation for Chinese surgeons and other relevant medical practitioners, and improve the overall diagnosis and treatment level of constipation surgery in China.

Bowel management in multiple sclerosis

Jane Young explores considerations in the assessment and management of constipation and faecal incontinence.

A Study to Assess the Effect of Nursing Interventions on Selected Minor Ailments Among Antenatal Primigravida Women in Selected Areas

Introduction: Minor ailments are common throughout pregnancy due to the physiological and psychological changes in women’s bodies. Constipation and foot edema are quite common ailments during pregnancy. As during pregnancy women’s increased weight pressures will also increase to the ankles, knees, and feet. To reduce selected minor ailments selected nursing interventions were provided in this study. Aim: To evaluate the effect of nursing interventions on selected minor ailments among antenatal primigravida women in selected areas. Methods and Material: Quasi-experimental pre-test post-test control group design was adapted. The study was conducted among antenatal primigravida women with selected minor ailments. 60 samples were selected using non-probability purposive sampling and data collection was done by using demographic variables, Pitting Edema Scale &amp; Modified Constipation Assessment Scale. Nursing interventions provided to the experimental group. No intervention to control group. Results: The study findings showed that antenatal foot and leg exercises and consumption of fibrous fruits led to improvement in foot edema and constipation in the experimental group as compared to the control group who do not get any nursing interventions. Conclusion: Study concluded that selected nursing interventions were significantly effective in the improvement of foot edema and constipation among antenatal primigravida women.

A national cross-sectional survey of constipation in patients attending cancer centres in Ireland

Background: The prevalence of constipation in patients with cancer is estimated at 50-90%. It is often associated with pain, anorexia, nausea and vomiting and impacts negatively on quality of life. Despite its common occurrence, it is often poorly recognised and treated by healthcare professionals. Methods: A national cross-sectional survey was conducted in Ireland to describe constipation prevalence and severity in patients attending cancer centres and to evaluate management efficacy. In-patients or patients attending day oncology wards in any of the country’s eight designated cancer centres were eligible to participate. Participants were shown the Bristol Stool Chart and answered questions regarding stool appearance and sensation of incomplete defecation; they completed the Constipation Assessment Scale. Data on pain character and intensity, opioid use, and prescribed and over-the-counter laxative use were collected. Data were summarised using descriptive statistics. Significance of variations for continuous data were determined using t-tests. Conditional ordered logistic regression was undertaken to determine factors associated with constipation. Results: The dataset comprised 491 patients. 24.8% had been reviewed by specialist palliative care; 14.5% by the anaesthetic pain team. In total, 42.2% of respondents were taking step 2 or step 3 opioids. Constipation prevalence was 67.6%; 19.4% of patients had Constipation Assessment Scale scores indicating severe constipation. A total of 46% of the respondents were not taking any laxatives. Of those who were taking laxatives, 54.8% reported constipation symptoms. While opioid use was strongly associated with participants reporting higher scores, this association was not seen in those patients receiving specialist palliative care. Conclusions: Constipation remains a clinical problem in Irish cancer centres. Despite increased opioid use, patients receiving specialist palliative care were more likely to take laxatives and reported less constipation. Specialist palliative care practice should be studied in order to identify what are the transferable ‘ingredients’ of effective constipation management.

Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer?

Simple SummaryThe frequent use of opioid in-home palliative care settings is associated with a high incidence of opioid-induced constipation (OIC) that can significantly worsen a cancer patient’s quality of life. Laxative therapy is the first-line in OIC treatment, and although its application is recommended from the beginning of opioid therapy, in most cases it does not resolve the symptoms. Naloxegol is the specific target therapy for opioid-induced constipation. To our knowledge this is the first study aimed at evaluating the impact of a naloxegol therapy on the quality of life of advanced cancer patients with a short or very short life expectancy in a home palliative setting.This observational study aims to evaluate the efficacy of naloxegol therapy in resolving opioid-induced constipation (OIC) and in improving the quality of life in a home palliative care cancer setting. Advanced cancer patients with OIC (Rome IV criteria) not relieved by laxatives started a naloxegol therapy 25 mg/day for 4 weeks. Quality of life was evaluated by Patient Assessment of Constipation Quality-of-Life (PAC-QoL) at day 0 and day 28; background pain by Numerical Rating Scale, number of weekly spontaneous bowel movements and Bowel Function Index (BFI) were evaluated at day 0 and every week. Seventy-eight patients who completed the 4-week study improved all four PAC-QoL dimensions (physical and psychological discomfort, worries/concerns and satisfaction level). Weekly spontaneous bowel movements increased and BFI improved. Background pain reduced after seven days and remained lower during the following weeks. Seventy-two patients dropped out the study before day 28 with a reduced survival compared to patients completing the study. Even in these patients, an improvement of bowel function was observed after two weeks. Naloxegol was effective in improving the quality of life, resolving OIC and reducing overall pain in patients with advanced cancer.

Effect of Face-to-Face and Multimedia Methods of Education on Children’s Constipation Severity

Background: Constipation is a common problem among children. The aim of this study was to compare the effect of face-to-face and multimedia education on the severity of functional constipation in children. Methods: It was a two-group pre-test post-test quasi-experimental study that was carried out at the Specialized Clinics of Pediatrics affiliated with the Arak University of Medical Sciences, Arak, Iran. The sample consisted of 96 eligible children in the age range of 6 to 12 years that were randomly assigned to face-to-face (n=48) and multimedia (n=48) groups. Functional constipation was detected by Rome ΙΙΙ criteria. Data were collected by a demographic characteristics form and the Constipation Assessment Scale (CAS) before intervention and one month later in both groups. In the face-to-face group, education was provided using two 15-min training sessions in the form of a lecture in the presence of the mother. The multimedia training group received a 15-min training video. Both groups were given a pamphlet. The data were analyzed by Fisher’s exact test, independent t-test, and paired t-test using SPSS version 16. Results: There was no significant difference between the groups’ constipation severity before the intervention (P=0.12). There was a significant difference between the mean score of constipation severity between the face-to-face (P=0.01) and multimedia (P=0.001) groups before and after the intervention. However, the mean±SD score of constipation severity after the intervention was 7.05±1.79 in the face-to-face group and 5.91±1.69 in the multimedia group (p=0.001). Conclusion: The results of this study showed that both educational interventions reduced the severity of constipation in children. However, multimedia training was more effective than face-to-face education so that it reduced the severity of constipation to a greater extent.

A national cross-sectional survey of constipation in patients attending cancer centres in Ireland.

Background: The prevalence of constipation in patients with cancer is estimated at 50-90%. It is often associated with pain, anorexia, nausea and vomiting and impacts negatively on quality of life. Despite its common occurrence, it is often poorly recognised and treated by healthcare professionals. Methods: A national cross-sectional survey was conducted in Ireland to describe constipation prevalence and severity in patients attending cancer centres and to evaluate management efficacy. In-patients or patients attending day oncology wards in any of the country's eight designated cancer centres were eligible to participate. Participants were shown the Bristol Stool Chart and answered questions regarding stool appearance and sensation of incomplete defecation; they completed the Constipation Assessment Scale. Data on pain character and intensity, opioid use,and prescribed and over-the-counter laxative use were collected. Data were summarised using descriptive statistics. Significance of variations for continuous data were determined using t-tests. Conditional ordered logistic regression was undertaken to determine factors associated with constipation. Results: The dataset comprised 491 patients. 24.8% had been reviewed by specialist palliative care; 14.5% by the anaesthetic pain team. In total, 42.2% of respondents were taking step 2 or step 3 opioids. Constipation prevalence was 67.6%; 19.4% of patients had Constipation Assessment Scale scores indicating severe constipation. A total of 46% of the respondents were not taking any laxatives. Of those who were taking laxatives, 54.8% reported constipation symptoms. While opioid use was strongly associated with participants reporting higher scores, this association was not seen in those patients receiving specialist palliative care. Conclusions: Constipation remains a clinical problem in Irish cancer centres. Despite increased opioid use, patients receiving specialist palliative care were more likely to take laxatives and reported less constipation. Specialist palliative care practice should be studied in order to identify what are the transferable 'ingredients' of effective constipation management.

The Effect of Abdominal Massage with Extra-Virgin Olive Oil on Constipation among Elderly Individuals: A Randomized Controlled Clinical Trial.

ABSTRACTBackground: Constipation is one of the most prevalent problems during old age. Abdominal massage is a complementary method in controlling constipation. This study is conducted with the aim of determining the effect of abdominal massage with extra-virgin olive oil on constipation among the elderly.Methods: In this single-blind randomized controlled clinical trial, 54 old individuals in Shiraz nursing homes during November 2018-March 2019 were selected randomly and then allocated to three groups of 18, based on block randomization. The first group underwent abdominal massage with olive oil for five consecutive days (each day one time for 15 minutes). The second group underwent abdominal massage with water similar to the first group. No specific intervention was applied to the control group. All three groups received their medical treatment. The constipation scores were examined using constipation assessment scale (CAS) before the intervention and on the sixth day. Data analysis was done through SPSS 22 using Chi-square, paired t-test, and ANOVA. P<0.05 was considered as the level of statistical significance.Results: There were no statistically significant differences among the three groups before the intervention. The results demonstrated that the mean score of constipation further decreased in the olive oil group (5.62±1.89 to 2.06±0.99) (P≤0.001) than the massage with water (5.05±1.25 to 3.11±0.99) (P=0.02), and the control group (4.44±1.38 to 5.22±1.35) (P=0.006).Conclusion: Due to the greater effectiveness of abdominal massage with extra-virgin olive oil, the use of this method is recommended in treatment of constipation among the elderly.Trial Registration Number: IRCT20180923041101N

Antipsychotic-induced gastrointestinal hypomotility and the alteration in gut microbiota in patients with schizophrenia

AimGut microbiota play an important role in the pathogenesis of gut hypomotility and are critical for the production of the intestinal immune system and the maintenance of the intestinal homeostasis. Patients with psychotic disorders are at a high risk of antipsychotic-induced constipation. However, the mechanisms might be more than neurotransmission properties of antipsychotics. MethodsWe recruited a total of 45 patients with constipation according to Rome IV criteria and objective test for colonic motility and the other 45 gender- and age-matching patients without constipation and investigated their differences in composition of gut microbiota. The demographic and serum metabolic indices were collected. The subjective constipation assessment scale (CAS) and the Bristol stool classification (BSS) were also used to evaluate the degree of constipation in both groups. The fecal samples were analysed using the 16S rRNA gene sequencing. ResultsThe constipation group had a significantly increased alpha diversity in Observed species, Chao 1, and ACE as compared to the non-constipation group. At the phylum levels, the relative abundances of Bacteroidetes and Fusobacteria decreased significantly, while those of Firmicutes, Verrucomicrobia, and Synergistetes increased significantly in the constipation group. At the genus level, the relative abundances of Christensenella and Desulfovibrio were higher in the constipation group. The α-diversity indices of gut microbiota were correlated positively with the levels of serum total bile acid and correlated negatively with BSS scores. The BSS scores were positively correlated with the relative abundance of Bacteroidetes but negatively correlated with the relative abundance of Firmicutes. PICRUSt analysis revealed the potential metabolic pathways of lipopolysaccharide, vitamin B6, riboflavin, pyruvate, and propionate functions. ConclusionsThe alternation of the gut microbiota in schizophrenia patients with antipsychotic-induced constipation indicates antipsychotic agents might affect gastrointestinal motility via varying microbiome-related metabolites, and the specific bacteria, such as Synergistetes which might act as an anti-inflammatory factor in the healthy human gut, related to colonic transit motility seem inconsistent to the findings from previous literature in gastroenterology. However, the causal effects are still unknown. Our study provides a new possibility to understand the mechanisms of antipsychotic-induced constipation.

Hirschsprung's Disease in Adults, A Case Report

Hirschsprung's disease (HD) is a rare congenital disease characterized by the absence of ganglion cells in the distal rectum and which is usually diagnosed in early childhood. We speak of Hirschsprung’s disease of adults in patients where the diagnosis was made after the age of 10 years, it is a rare but not exceptional condition. This should be borne in mind in young adults with a history of chronic constipation. Due to the rarity of Hirschsprung’s disease in adults, patients are rarely referred for evaluation, including rectal biopsy, further delaying diagnosis. The elements of the diagnosis are primarily clinical. The basic treatment for Hirschsprung's disease recognized in adulthood is surgical resection of the lymph node segment of the intestine with the intention of creating an anastomosis with healthy and properly innervated tissue. In this regard, we present the case of a 22-year-old young man, followed in the gastro-entero-hepatology department at the Arrazi hospital of the Mohammed VI University Hospital in Marrakech for aetiological assessment of a chronic constipation of terminal appearance, complicated by 2 episodes of sigmoid volvulus resolved by rectal probe detorsion, the rectal biopsy of which revealed aganglion in favor of Hirschsprung’s disease.

Establishing Minimal Clinically Important Differences in Quality of Life Measures in Opioid-Induced Constipation

Opioids have a role in chronic pain management. However, opioid-induced constipation may cause patients to skip or reduce opioid doses, leading to inadequate pain relief and negatively impacting quality of life. We sought to establish a minimal clinically important difference to understand whether changes in quality of life scores are of value to patients. Integrated data from the double-blind, controlled, phase 3 COMPOSE-1 and COMPOSE-2 trials of naldemedine in chronic noncancer pain and opioid-induced constipation were used to determine minimal clinically important differences using Patient Assessment of Constipation Symptoms (PAC-SYM) and Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaires. Patients completed the questionnaires (5-point Likert scale; predose, Weeks 2, 4, and 12), kept a daily log of Bowel Movement and Constipation Assessment, and rated satisfaction at end of study. Minimal clinically important differences were computed using an anchor-based method with 6 anchors: 5 from the Bowel Movement and Constipation Assessment and 1 from patient satisfaction. Threshold values for each anchor were set to define responders versus nonresponders based on score definitions. Clinically meaningful cutoff values for changes in PAC-SYM and PAC-QOL scores were determined using receiver operating characteristic curves. Data from 1095 patients (549, naldemedine; 546, placebo) were analyzed. The area under the curve for the receiver operating characteristic curves (ranges, 0.719 to 0.798 for PAC-SYM and 0.734 to 0.833 for PAC-QOL) indicated that both instruments can discriminate responders and nonresponders for each anchor. PAC-SYM cutoff values ranged from-1.04 to-0.83; PAC-QOL cutoff values ranged from-0.93 to-0.82. Based on data derived from the anchor method, reductions in PAC-SYM and PAC-QOL scores of >1.0 in patients with chronic noncancer pain and opioid-induced constipation are clinically meaningful. gov Registration: NCT01965158; NCT01993940.

Transcutaneous Acupoint Electrical Stimulation on Chemotherapy-Induced Constipation for Non-Small Cell Lung Cancer Patients: A Randomized Controlled Trial

Objective:Chemotherapy-induced constipation (CIC) adversely affects the quality of life of non-small cell lung cancer (NSCLC) patients. This study aimed to investigate the clinical effects of transcutaneous acupoint electrical stimulation (TAES) on CIC.Methods:Sixty NSCLC patients who received chemotherapy at Hunan Cancer Hospital, Changsha, China, were assigned to the TAES (n = 30) or control (n = 30) group using Research Randomizer. In the TAES group, four acupoints, namely Tianshu, Quchi, Zusanli, and Shangjuxu, were stimulated six times a week, lasting for 4 weeks, while the control group received the usual care. The Bristol Stool Form Scale (BSFS) and the Constipation Assessment Scale (CAS) were used.Results:Both the BSFS and CAS scores for the experimental group were significantly higher than that for the control group (P = 0.004 and P < 0.001 separately).Conclusions:TAES was effective for alleviating constipation in NSCLC patients receiving chemotherapy and was a safe and practical nursing intervention.

Constipation and diabetic kidney disease: The Fukuoka Diabetes Registry.

Constipation was shown to be associated with higher risk of end-stage kidney disease or incident chronic kidney disease, although evidence in diabetic patients is lacking. The objective of the present study was to examine the association between constipation and diabetic kidney disease (DKD). In total, 4826 Japanese outpatients with type 2 diabetes were classified according to presence or absence of constipation (defecation frequency < 3 times/week and/or taking laxative medication). DKD was defined as presence of decreased estimated glomerular filtration rate (eGFR < 60ml/min/1.73m2), and/or albuminuria (urinary albumin-to-creatinine ratio ≥ 30mg/g). Odds ratios for the presence of DKD were computed by a logistic regression model. Compared with participants without constipation, the age- and sex-adjusted odds ratio for presence of DKD was 1.58 (95% confidence interval 1.38-1.82) for those with constipation. This association persisted following adjustment for potential confounding factors. Decreased defecation frequency and laxative use were also significantly associated with higher prevalence of DKD. Overall, these findings were identical even when decreased eGFR and albuminuria were separately analyzed. Constipation was associated with higher likelihood of DKD in patients with diabetes, suggesting the importance of clinical assessment of constipation to identify patients at high risk of progression of kidney disease.