Therapy often permanent |
 |  | Translated by Marta Campbell |
 |
28.11.2024 16:00 Uhr |
If the general measures do not work, laxatives are used. The guidelines state: »Conventional laxatives should be given for the treatment of chronic constipation in patients for whom the previous basic measures were not sufficiently effective or poorly tolerated«. The word »should« in guideline language means the strongest of the possible recommendations, Madisch explained. So there is no doubt about it.
According to the guidelines, the drugs of first choice are macrogols, sodium picosulphate and bisacodyl. Very important for counselling: »Limiting the period of use is unjustified«. In addition, the agents mentioned can also be used during pregnancy and in geriatric patients. They have shown in conclusive studies and meta-analyses that stool consistency improves and symptoms decrease during treatment. Patients' quality of life improves again. »Sometimes the main symptoms of chronic constipation are flatulence. In this case, however, the constipation must be treated first«, Madisch explained.
A review has also refuted the greatest fear of patients and GPs: osmotic and stimulant laxatives could damage the intestinal wall and potentially cause cancer. The literature search covered the period from 1968 to 2023. 43 studies in total met the criteria, which aimed to determine damage to the intestinal wall or the intestinal nervous system as well as any genetic changes and carcinogenicity.
The medic summarised: »There is no evidence at all with regard to intestinal safety that we get any problems even with long-term use of laxatives«. Hence the clear statement in the guideline in favour of consistent long-term treatment of constipation. This is also so important because a person with chronic constipation generally cannot get rid of it. Although attempts can be made to discontinue the medication, experience has shown that the constipation then returns. And it can also worsen with increasing age or the onset of diseases such as Parkinson's, for example. It is therefore not a question of whether laxatives should be taken long-term for chronic constipation – a clear yes for the expert – but also in what dose.
| Deutsch/German | Englisch/English |
|---|---|
| Ballaststoffe | fibres |
| Bauch | abdomen, belly |
| Blähungen | flatulence |
| Darm | intestines |
| Darmspiegelung | colonoscopy |
| Darmwand | intestinal wall |
| Flohsamen | psyllium seeds |
| Flüssigkeit | fluid, liquid |
| Genmutation | gene mutation |
| Krampf | cramp |
| krebserregend | carcinogenic |
| Laxanzien | laxatives |
| Nervenzellen | nerve cells |
| osmotisch | osmotic |
| stimulierend | stimulating |
| Stuhlgang | bowel movement, defecation |
| Toilettentraining | toilet training |
| Verstopfung | constipation |
