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Two Drugs Show Promise Against Severe Constipation
Date:5/28/2008

Help chronic cases, terminally ill patients on opiod painkillers

WEDNESDAY, May 28 (HealthDay News) -- Two new medications offer hope for the most severe forms of constipation.

Almost 15 percent of Americans are constipated at any given time, said Dr. Michael Camilleri, lead author of one of two reports in the May 29 issue of the New England Journal of Medicine. His paper reported on the efficacy of the experimental drug prucalopride on 620 people with chronic constipation.

"A minority of people have constipation because the nerves are not working well," Camilleri said. "These people, on average, had one bowel movement every two weeks."

It's not known how many Americans have such severe constipation, but "patients with this condition are seen regularly," said Camilleri, a gastroenterologist who is professor of medicine and physiology at the Mayo Clinic, in Rochester, Minn.

In the study, 47.3 percent of the people who took 2 milligrams a day of prucalopride for 12 weeks had three or more bowel movements a week, compared to 25.8 percent of those given a placebo. The success rate for people given 4 milligrams a day of prucalopride was slightly lower, at 46.6 percent.

"The results were better than with similar medications available in the past," Camilleri said.

An accompanying editorial by Dr. Arthur J. Moss, a professor of medicine and physiology at the University of Rochester in New York, raised two questions about the drug and the trial.

Two drugs that act in the same way as prucalopride were taken off the market, because they caused heart problems, Moss said. There was no indication of such problems in the newly reported trial, but that was true of the other medications at the same point in their development, he said.

"The pre-marketing studies were benign," Moss said. "But you just don't know until you get mass marketing."

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