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2015 ; 15
(ä): 139
Nephropedia Template TP
gab.com Text
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English Wikipedia
Trans-anal irrigation therapy to treat adult chronic functional constipation:
systematic review and meta-analysis
#MMPMID26474758
Emmett CD
; Close HJ
; Yiannakou Y
; Mason JM
BMC Gastroenterol
2015[Oct]; 15
(ä): 139
PMID26474758
show ga
BACKGROUND: Trans-anal irrigation (TAI) is used widely to treat bowel
dysfunction, although evidence for its use in adult chronic functional
constipation remains unclear. Long-term outcome data are lacking, and the
effectiveness of therapy in this patient group is not definitively known.
METHODS: Evidence for effectiveness and safety was reviewed and the quality of
studies was assessed. Primary research articles of patients with chronic
functional constipation, treated with TAI as outpatients and published in English
in indexed journals were eligible. Searching included major bibliographical
databases and search terms: bowel dysfunction, defecation, constipation and
irrigation. Fixed- and random-effect meta-analyses were performed. RESULTS: Seven
eligible uncontrolled studies, including 254 patients, of retrospective or
prospective design were identified. The definition of treatment response varied
and was investigator-determined. The fixed-effect pooled response rate (the
proportion of patients with a positive outcome based on investigator-reported
response for each study) was 50.4 % (95 % CI: 44.3-56.5 %) but featured
substantial heterogeneity (I(2)?=?67.1 %). A random-effects estimate was similar:
50.9 % (95 % CI: 39.4-62.3 %). Adverse events were inconsistently reported but
were commonplace and minor. CONCLUSIONS: The reported success rate of irrigation
for functional constipation is about 50 %, comparable to or better than the
response seen in trials of pharmacological therapies. TAI is a safe treatment
benefitting some patients with functional constipation, which is a chronic
refractory condition. However findings for TAI vary, possibly due to varying
methodology and context. Well-designed prospective trials are required to improve
the current weak evidence base.
|*Anal Canal
[MESH]
|Adult
[MESH]
|Chronic Disease
[MESH]
|Constipation/*therapy
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Prospective Studies
[MESH]
|Retrospective Studies
[MESH]
|Therapeutic Irrigation/methods/*statistics & numerical data
[MESH]
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