Evolución del estreñimiento en pacientes que utilizan laxantes estimulantes de manera crónica cuando se les introduce un suplemento de fibra

Abstract

Objective: To determine the progress of constipation in patients who make chronic use of stimulant laxatives when a fiber supplement is introduced in their diet. Design: Epidemiological, multicenter and prospective cohort study with a 10-week follow-up. Site: the study was conducted in 16 community pharmacies. Participants: 106 chronically constipated patients, self-medicated with stimulant laxatives, in whose diet fiber is introduced and who are kept under observation to record what happens when laxative is gradually withdrawn. Main medications: Frequency of bowel movements and consistency of stool. The laxatives required and gastrointestinal symptoms are quantified. Results: At base level, 94.2% of patients required laxatives, the average number of bowel movements/week was 4.2 (DE 2.4) and only 4.8% of patients had a normal consistency of stool (4 on the Bristol Stool Chart). From the first week of treatment with fiber, a significant reduction in the use of stimulant laxatives was reported (P<0.02). Of the patients who completed the study, less than half (41%) required a few doses of stimulant laxatives during the last week and 59% of patients managed to discontinue their use. 98.4% of patients evaluated the use of fiber as “sufficiently/very/extremely” easy. Conclusions: In patients who suffer from constipation and make chronic use of stimulant laxatives, the gradual introduction of a fiber supplement maintains the patient’s frequency of evacuations and normal consistency of stool, reducing the need for use of stimulant laxatives, whose use should be occasional as opposed to chronic.