Marciniak CM, Toledo S, Lee J, Jesselson M, Bateman J, Grover B, Tierny J. Lubiprostone vs Senna in postoperative orthopedic surgery patients with opioid-induced constipation: A double-blind, active-comparator trial. World J Gastroenterol 2014; 20(43): 16323-16333 [PMID: 25473191 DOI: 10.3748/wjg.v20.i43.16323]
Corresponding Author of This Article
Christina M Marciniak, MD, Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Northwestern University, 345 E Superior, Chicago, IL 60611, United States. cmarciniak@ric.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Clinical Trial
Open-Access Policy of This Article
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World J Gastroenterol. Nov 21, 2014; 20(43): 16323-16333 Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16323
Lubiprostone vs Senna in postoperative orthopedic surgery patients with opioid-induced constipation: A double-blind, active-comparator trial
Christina M Marciniak, Santiago Toledo, Jungwha Lee, Michael Jesselson, Jillian Bateman, Benjamin Grover, Joy Tierny
Christina M Marciniak, Santiago Toledo, Department of Physical Medicine and Rehabilitation, School of Medicine, Northwestern University, Chicago, IL 60611, United States
Jungwha Lee, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
Michael Jesselson, University of Chicago Medical Center, Chicago, IL 60637, United States
Jillian Bateman, Joy Tierny, The Rehabilitation Institute of Chicago, Chicago, IL 60611, United States
Benjamin Grover, Chicago College of Osteopathic Medicine, Chicago, IL 60515, United States
Author contributions: Marciniak CM, Toledo S, Jesselson M, Bateman J and Lee J designed the research project; Marciniak CM, Toledo S, Jesselson M, Bateman J, Grover B and Tierny J performed the research; Marciniak CM and Lee J analyzed the data; Marciniak CM and Lee J wrote the manuscript.
Supported by A grant from Takeda Pharmaceuticals North America, Inc
Correspondence to: Christina M Marciniak, MD, Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Northwestern University, 345 E Superior, Chicago, IL 60611, United States. cmarciniak@ric.org
Telephone: +1-312-2381000 Fax: +1-312-2382512
Received: March 3, 2014 Revised: June 5, 2014 Accepted: July 24, 2014 Published online: November 21, 2014
Core Tip
Core tip: Constipation is frequent in postoperative orthopedic patients treated with opioids. Opioid side effects are associated with poorer pain control, and thus may limit the ability to mobilize patients immediately following orthopedic surgery. There is very limited information comparing the efficacy and safety of pharmacologic interventions for opioid-induced constipation. In this study we found that two medications, lubiprostone and Senna, were associated with improvement in bowel-related symptoms in opioid-induced constipation in post-operative orthopedic patients, with no differences found between the two medications. Rescue bowel medications were frequently required by participants in both groups, indicating that multiple laxative medications may be required for constipation symptom control in this setting.
