Neurogastroenterology Effect of laxatives and pharmacological therapies in Gut: first published as 10.1136/gut.2010.227132 on 4 January 2011. Downloaded from chronic idiopathic constipation: systematic review and meta-analysis Alexander C Ford,1,2 Nicole C Suares1 1Leeds Gastroenterology ABSTRACT Institute, Leeds General Background There has been no definitive systematic Significance of this study Infirmary, Great George Street, review and meta-analysis to date examining the effect of Leeds, UK 2 laxatives and pharmacological therapies in chronic Leeds Institute of Molecular What is already known about this subject? idiopathic constipation (CIC). Medicine, University of Leeds, < Chronic idiopathic constipation is a common Leeds, UK Objective To assess efficacy of these therapies functional disorder of the gastrointestinal tract. systematically in CIC. < The condition is difficult to treat. Correspondence to Design Systematic review and meta-analysis of Dr Alex Ford, Leeds < Evidence for any benefit of laxatives is randomised controlled trials (RCTs). Gastroenterology Institute, conflicting, and there has been no definitive Data sources MEDLINE, EMBASE, and the Cochrane Room 230, D Floor, Clarendon summary of the evidence for efficacy of newer Wing, Leeds General Infirmary, central register of controlled trials were searched (up to pharmacological agents. Great George Street, Leeds, September 2010). LS1 3EX, UK;
[email protected] Eligibility criteria for selecting studies Placebo- What are the new findings? controlled trials of laxatives or pharmacological therapies < Polyethylene glycol, sodium picosulfate, bisa- Revised 1 October 2010 in adult CIC patients were eligible. Minimum duration of codyl, prucalopride, lubiprostone and linaclotide Accepted 26 October 2010 therapy was 1 week. Trials had to report either were all more effective than placebo for treating a dichotomous assessment of overall response to chronic idiopathic constipation, but data to therapy at last point of follow-up in the trial, or mean support efficacy of lactulose were limited.