Medicines associated with the development of drug-induced constipation


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Abstract

According to foreign studies, a decrease in the number of bowel movements per week, a feeling of incomplete bowel emptying, the need for additional straining, changing the consistency of feces to hard or lumpy, and bloating are symptoms of constipation. According to statistics, constipation is more common among people over 60 years old (with a frequency of 36%), both in women and in men. Constipation often appears to be an adverse drug reaction as a result of the use of both prescription and over-the-counter medicines. In this case, it is called drug-induced constipation (DIC). It was estimated that 40% of drugs affect the gastrointestinal tract, causing many unpleasant symptoms, including DIC. These nonspecific symptoms may disappear soon after stopping the drug or replacing it with another drug that does not have such side effects. Identification of DIC is a rather difficult task due to lack of awareness in this matter of both doctors and patients. However, this is a very important problem, because severe constipation can lead to small bowel obstruction, gastrointestinal perforation, and death. Among the most common classes of drugs that cause constipation, opioids and anticancer drugs are distinguished. In addition to these drugs, there is evidence that drugs with anticholinergic properties, including antidepressants and antipsychotics, can also cause DIC. Medications with a lower incidence of constipation include anticonvulsants, calcium preparations and aluminum-containing antacids, antihistamines, diuretics, and non-dihydropyridine calcium antagonists. Some plant-based medicines, such as chondroitin sulfate, glucosamine sulfate, echinacea, and palmetto, can also cause constipation. The treatment of constipation is associated with certain difficulties and significant material costs, because according to some studies, for example, in the United States annually about 1.6 billion dollars are spent on providing help for constipation and about 800 million dollars are spent on over-the-counter drugs for its treatment. Therefore, it is so important to know about drugs that can cause DIC.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology Moscow, Russia

E. Yu Shakhova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Moscow, Russia

A. I Kochetkov

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

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