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Interferon research abs 1 || Hemoglobin research abs || Stem cell research abs || Nucleic acid research abs || Herpes research abs || Bronchitis research abs || Schizophrenia research abs || Tuberculosis research abs || Pneumonia research abs || Constipation research abs || Laxative research abs

Manag Care Interface. 1998 Jun;11(6):50-2.
Hemorrhoids.

Gricar JA, Goodwin SA, Cave DG.

The patients with routine, easiest-to-treat hemorrhoids average 1.25 office visits, 0.80 prescriptions, and 1.38 medical/surgical procedures during the course of a year. About 63.9% of all PTEs were treated without the use of prescription drugs. This patient group did not receive any hospital admissions or professional inpatient services. Hemorrhoid surgery was performed at an average rate of 1.37 times per PTE on an out-patient basis. Seventy-two percent of the overall medical charges for hemorrhoid treatment are direct surgical charges. Of the PTEs treated with a single drug group, only 1.5% are treated with a prescription laxative. However, the use of OTC stool softeners and laxatives were not measured in this analysis. Thus, an exact measurement of cost savings associated with appropriate use of softeners/laxatives for the prevention of recurrent hemorrhoids could not be determined. Considering the potential cost savings of using laxatives for prevention of hemorrhoids, further investigation of the prescribing patterns of this specialty may prove useful.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10181558&dopt=Abstract

Am J Gastroenterol. 2003 Apr;98(4):857-64.
Constipation, laxative use, and colon cancer in a North Carolina population.

Roberts MC, Millikan RC, Galanko JA, Martin C, Sandler RS.

Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA.

OBJECTIVE: The aim of this study was to determine whether bowel movement frequency and laxative use and type were associated with risk of colon cancer in white and black men and women. METHODS: We conducted a population-based, case-control study with equal representation by blacks. Eligible subjects between ages 40 and 80 yr residing in urban and rural communities in North Carolina were asked about bowel habits and laxatives during face-to-face interviews. There were 643 cases (349 white, 294 black) and 1048 controls (611 white, 437 black). RESULTS: Constipation, defined as fewer than three reported bowel movements per wk, was associated with a greater than two-fold risk of colon cancer (OR 2.36; 95% CI = 1.41-3.93) adjusted for age, race, sex, and relevant confounders. The association was greater for women (OR 2.69; 95% CI = 1.46-4.94) than for men (OR 1.73; 95% CI = 0.61-4.88) and stronger in blacks than whites. Black women had the highest risk (OR 3.42; 95% CI = 1.60-7.34), which remained significant (OR 3.21; 95% CI = 1.46-7.04) even after excluding subjects with late stage (distant) disease. The OR for constipation was slightly higher for distal than for proximal colon cancers. There was no association with laxative use (OR 0.88; 95% CI = 0.69-1.11). Fiber commercial laxatives appeared to exert a protective effect in a small subgroup. CONCLUSIONS: This study provides support for a positive association between constipation and increased risk for colon cancer. Women, especially black women with constipation, seem to be at the highest risk.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12738468&dopt=Abstract

Drugs. 2003;63(11):1101-20.
Tegaserod: a review of its use in the management of irritable bowel syndrome with constipation in women.

Wagstaff AJ, Frampton JE, Croom KF.

Adis International Limited, Mairangi Bay, Auckland, New Zealand. demaidis.co.nz

The treatment of irritable bowel syndrome with constipation (IBS-C) has historically been based on the severity of symptoms, with education, reassurance, dietary advice, bulking agents and laxative therapy offered as appropriate. Tegaserod (Zelnorm, Zelmac) is the first selective serotonin 5-HT(4) receptor partial agonist to be approved for the treatment of this syndrome. Tegaserod is active against multiple irritable bowel syndrome (IBS) symptoms; it stimulates gut motility and reduces visceral sensitivity and pain. The drug does not cure IBS and was not designed to treat the diarrhoea-predominant version. Its efficacy in men has not been established. Three large well designed clinical trials of tegaserod 6 mg twice daily for 12 weeks in patients (mainly women) with IBS-C have demonstrated superiority versus placebo in global relief from symptoms. Global relief response rates were 38.4-46.8% with tegaserod 6 mg twice daily and 28.3-38.8% with placebo (p < 0.05-0.0001 vs placebo). The relative increases in response rates with tegaserod 6 mg twice daily over the already high responses in the placebo groups ranged from 12-65% after 4-12 weeks of treatment. A response was seen within the first week. The proportion of patients with satisfactory relief from symptoms fell over the 4-week period following withdrawal of tegaserod and placebo, but did not reach baseline levels during this time. Diarrhoea has been associated with tegaserod in clinical trials (an incidence of about 10% versus 5% with placebo, usually occurring in the first week of treatment), but the drug is otherwise well tolerated. There were no apparent changes in the tolerability profile with extended tegaserod treatment (</=12 months). In conclusion, oral tegaserod 6 mg twice daily for 12 weeks is effective and well tolerated in the treatment of IBS-C in women. Data on long term and comparative efficacy, cost-effectiveness and quality-of-life effects would be beneficial; however, in light of the fact that very few alternatives for the treatment of IBS-C have proven efficacy, tegaserod appears to be a promising option in women not responding to increased dietary fibre or osmotic laxative therapy.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12749744&dopt=Abstract [PubMed - in process]

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