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 ยต-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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