Laxatives for the management of constipation in people receiving palliative care.

Study answer

What this study found

Overall, the laxatives studied in palliative care appeared to have broadly similar effectiveness, and no optimal agent was identified. Evidence was limited by small trials and inconsistent reporting, and there was no evaluation of polyethylene glycol or rectal interventions. In one crossover hospice study, lactulose plus senna produced significantly higher stool frequency than co-danthramer plus poloxamer in 17 participants receiving at least 80 mg/day strong opioids (P < 0.01), with rescue laxatives needed in 19/51 versus 9/51 and six diarrhoea events versus none. In Tarumi 2013, adding…

Study & population

Systematic review of randomized trials in adults with advanced illness receiving palliative care, mainly cancer, in hospice, hospital, and outpatient settings in Canada, Britain, Spain, and India.

Intervention

The review assessed short-term oral laxative regimens used in palliative care, including senna, lactulose, misrakasneham, co-danthramer plus poloxamer, magnesium hydroxide plus liquid paraffin, and docusate plus senna.

Key limitation

The evidence base was sparse, with only a small number of small randomized trials and limited power to detect clinically important differences.

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Original abstract