Ultrasound predicts constipation treatment response

  • Manabe N & al.
  • JGH Open
  • 01.08.2019

  • von Craig Hicks
  • Clinical Essentials
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Takeaway

  • Ultrasound results can predict how patients with chronic constipation will respond to various medical therapies.

Why this matters

  • Choosing the best individualized medical treatment for constipation typically involves trial and error, sometimes resulting in adverse effects such as abdominal pain, severe diarrhea, and ischemic colitis.

Study design

  • Researchers studied patients with chronic constipation (n=223; 148 women; mean age, 62.9±3.4 years), using ultrasound to measure transverse diameters of 4 colon segments and the rectum, and evaluating stool and gas distribution based on the constipation index (CI) and left/right distribution (L/R) ratio.
  • They then treated patients with fiber- or osmosis-based laxatives for 2 weeks, adding stimulant-based laxatives if the first treatment was ineffective.
  • Funding: Kawasaki Medical School General Medical Center.

Key results

  • Patients who did not respond to fiber- or osmosis-based laxatives had significantly higher CI than those who did (P<.05 ci cutoff for predicting favorable outcomes>
  • Patients who did not respond to stimulant-based laxatives had significantly lower L/R ratio than those who did (P<.05 l cutoff for predicting responders>

Limitations

  • The study was not double-blinded, patients did not maintain symptom diaries, and the treatment period was only 4 weeks.