Does Colace (docusate) Work For Constipation? No!

This study was highlighted in theGeriPal Top 25 articles in HPM.- Ed.)Randomized, Double-Blind, Placebo-Controlled Trial of Oral Docusate in the Management of Constipation in Hospice Patients. Tarumi et al. Journal of Pain and Symptom Management, 2013: 45(1), 2-13.Palliative care fellows may wonder about their attendings fixation on bowel movements. It may be because we do not ask medical students to disimpact patients any more or because, given the lack of ambulatory care many residents do, they do not see it as a big deal (Constipation a GREAT topic for those of us who like puns and dad jokes).For patients, however, constipation is a topic they think about many times a day. It is very common (39-70% prevalence) in patients with cancer or other serious illness, particularly in elderly patients. The prevalence goes up to 80% in patients on opiates and for many of my patients, the bloating, nausea and discomfort associated with opiates are worse than the pain we are treating.At the hospital where I work, Colace (docusate) is often used as the first treatment of constipation and/or as the drug of choice to prevent constipation. This has been despite alack of evidence (JPSM 2000:19:130-6). I was thrilled to see this RCT of docusate and sennosides vs placebo and sennosides looking at whether docusate improved stool frequency, volume, and consistency. They found no difference in any of these variables.Let ' s take a closer look using theJAMA Users ' Guides to the Medical...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: arnold constipation docusate geripal top 25 pallimed writing group senna Source Type: blogs