Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
Palliative Medicine
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Sykes, N.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Sykes, N.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

A clinical comparison of laxatives in a hospice

NP Sykes

Department of Public Health Medicine, University of Leeds and St Gemma's Hospice, Leeds

Codanthramer standard strength was compared by means of a randomized crossover clinical trial with a mixture of equal proportions of lactulose and senna. Subjects were hospice inpatients who had cancer but had had no bowel diversion or evidence of intestinal obstruction. Lactulose/senna produced a significantly greater stool frequency than codanthramer in patients receiving strong opioid analgesia and reduced the usage of rectal measures. Patients' subjective assessment of bowel function indicated that lactulose/senna was more likely than codanthramer to relieve constipation or to restore normality. The incidence of diarrhoea was greater with lactulose/senna, but not significantly so when measured by patients' perceptions. Despite the difference in efficacy, patient preference was evenly divided between the agents, although there was some criticism of codanthramer's taste. It is concluded that standard strength codanthramer is less effective than the same volume of lactulose and senna in equal proportions and is more expensive. Strong codanthramer may redress the cost imbalance, but this remains to be tested. It is also suggested that a laxative dose protocol related to dose of opioid analgesia may improve the effectiveness of oral laxative therapy.

Key Words: cathartics • constipation • lactulose • opioids • palliative treatment • senna

Palliative Medicine, Vol. 5, No. 4, 307-314 (1991)
DOI: 10.1177/026921639100500406
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Palliat MedHome page
P. Larkin, N. Sykes, C Centeno, J. Ellershaw, F Elsner, B Eugene, J. Gootjes, M Nabal, A Noguera, C Ripamonti, et al.
The management of constipation in palliative care: clinical practice recommendations
Palliative Medicine, October 1, 2008; 22(7): 796 - 807.
[Abstract] [PDF]

Home page
 AM J HOSP PALLIAT CAREHome page
P. Esper, J. N. Hampton, J. Finn, D. C. Smith, S. Regiani, and K. J. Pienta
A new concept in cancer care: The supportive care program
American Journal of Hospice and Palliative Medicine, November 1, 1999; 16(6): 713 - 722.
[Abstract] [PDF]

Home page
 Palliat MedHome page
N P Sykes
The relationship between opioid use and laxative use in terminally ill cancer patients
Palliative Medicine, July 1, 1998; 12(5): 375 - 382.
[Abstract] [PDF]

Home page
 Palliat MedHome page
N. Sykes
An investigation of the ability of oral naloxone to correct opioid-related constipation in patients with advanced cancer
Palliative Medicine, April 1, 1996; 10(2): 135 - 144.
[Abstract] [PDF]