Subcutaneously Administered Methylnaltrexone May Prove Effective in Constipation Treatment

 


Constipation is a functional gastrointestinal (GI) disorder that leads to difficult, infrequent, or incomplete defecation. It is common in the community, however, 3 of 5 people in the U.S. with constipation have never discussed their symptoms with a healthcare provide, according to the study ‘Chronic Constipation in the United States: Results From a Population-Based Survey Assessing Healthcare Seeking and Use of Pharmacotherapy’, published in The American Journal of Gastroenterology, in June 2020.

Constipation treatment by definition entails the removal of the impacted stool from the body. While that is the goal of treatment, laxatives are used to aid in the removal of impacted feces. While it is not uncommon for one to be prescribed laxatives to help with constipation, laxatives are not a cure for the condition. They are commonly prescribed along with diet and lifestyle changes. Recently, a new analysis concluded that subcutaneously administered methylnaltrexone (MNTX) (Relistor), a peripherally acting µ-opioid receptor antagonist, relieves opioid-induced constipation (OID) in both chronic, noncancer-related illness and cancer-related illness.

One of the most commonly prescribed laxatives for constipation treatment is PRU adjunct, or porcine perineal urethrostomy. This procedure involves the actual removal of the upper portion of the colon (the sigmoid area) to allow a passage to be free of impacted feces. The lower end of the colon is then stapled and covered with an aseptic preparation to prevent the spread of infection. While this is not typically done as a primary procedure, it can help to alleviate chronic constipation.

Other laxatives are used to treat symptoms associated with constipation. Milk fiber has been used in capsule form for decades and has been shown to relieve constipation and other gastrointestinal symptoms. Similarly, aloe vera has also been used in capsule form to alleviate the symptoms of both chronic and acute constipation.

In addition to these dietary and lifestyle changes, laxatives can also be administered through topical means for constipation treatment. Topical laxatives work by slowing down the digestive process, thus causing the stool to pass through the digestive tract more quickly. Topical laxatives are typically used for patients that have a prolonged bout with constipation and cannot take oral laxatives due to a number of allergies or other concerns. They do however, make the bowel more comfortable and less painful.

There are other types of constipation treatment that do not involve medication or dietary change. One such method involves gently moving the bowels on a regular basis. This helps to promote regularity by ensuring that the intestines are able to empty themselves regularly. This type of treatment usually requires the assistance of a healthcare provider and should not be attempted by the average person. For some, the bowels can become weak over time and not be moved effectively by gentle movements, even with the help of a caregiver.

Enemas are another type of constipation treatment that can be performed by a healthcare provider or in the home. Enemas are inserted into the anus and allow fluid to be excreted from the body. The process of using the enema is similar to that of using a laxative and should only be performed by someone who is experienced and who knows what they are doing.

 

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