Published: 2022-11-28

The study to understand management of constipation and prescription pattern of laxative therapy

Kajal Shilpi, Amit B. Jain, Dixit Patel


Background: The objective of this study was to evaluate demographic profile and prescription pattern of laxative therapy in chronic constipation (CC) patients.

Methods: This real-world, retrospective, SMART-2 study was conducted at various centres in India between April 2021 and March 2022.

Results: Data of a total 12,080 patients diagnosed with CC were analysed. The mean age of patients was 53.84 years and majority (63.62%) were males. Most reported influencing lifestyle parameters included ‘not very active’ or ‘lightly active’ lifestyle (78%) and non-vegetarian diet (67%). Squatting (56.89%) was the common mode of defecation. As per the Bristol stool criteria, the most common stool consistency observed was type 2 (sausage-shaped but lumpy) (25.49%) followed by type 1 [separate hard lumps, like nuts (hard to pass)] (22.92%). As per the Rome IV diagnostic criteria, straining (44.62%) was the most common symptom. Faecal evacuation disorder was present in 52% of the patients. Common associated conditions were diabetes (35%) and hypothyroidism (12.9%). Antihypertensive drugs (23.7%), iron supplements (13.5%) and opiates (10.7%) were the most commonly prescribed drugs in patient’s medication history. Lactulose solution (65%) was the most prescribed drug for CC. Quality of life was adversely impacted in every one out of five patients.

Conclusions: Chronic constipation is more common among males and is influenced by lifestyle parameters. It is associated with comorbidities like diabetes and hypothyroidism. Antihypertensives, iron supplements and opiates are commonly noted in medication history for CC patients. Lactulose solution is the most common prescribed pharmacotherapy for the relief from constipation. Chronic constipation increases distress level among the patients.


Chronic constipation, Lactulose, Comorbidities, Distress

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