Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination

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Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination

Passmore et al., 1993 | BMJ | Rct

Citation

Passmore A P, Wilson-Davies K, ... Scott M E. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. BMJ. 1993-Sep-25;307(6907):769-71

Abstract

OBJECTIVES: To compare the efficacy and cost effectiveness of a senna-fibre combination and lactulose in treating constipation in long stay elderly patients. DESIGN: Randomised, double blind, cross over study. SETTING: Four hospitals in Northern Ireland, one hospital in England, and two nursing homes in England. SUBJECTS: 77 elderly patients with a history of chronic constipation in long term hospital or nursing home care. INTERVENTION: A senna-fibre combination (10 ml daily) or lactulose (15 ml twice daily) with matching placebo for two 14 day periods, with 3-5 days before and between treatments. MAIN OUTCOME MEASURES: Stool frequency, stool consistency, and ease of evacuation; deviation from recommended dose; daily dose and cost per stool; adverse effects. RESULTS: Mean daily bowel frequency was greater with the senna-fibre combination (0.8, 95% confidence interval 0.7 to 0.9) than lactulose (0.6, 0.5 to 0.7; t = 3.51 p < or = 0.001). Scores for stool consistency and ease of evacuation were significantly higher for the senna-fibre combination than for lactulose. The recommended dose was exceeded more frequently with lactulose than the senna-fibre combination (chi 2 = 8.38, p or = 0.01). As an index of the standard daily dose, the dose per stool was 1.52 for lactulose and 0.97 for the senna-fibre combination, at a cost per stool of 39.7p for lactulose and 10.3p for senna-fibre. Adverse effects were no different for the two treatments. CONCLUSIONS: Both treatments were effective and well tolerated for chronic constipation in long stay elderly patients. The senna-fibre combination was significantly more effective than lactulose at a lower cost.

Key Findings

Mean daily bowel frequency was greater with the senna-fibre combination (0.8, 95% confidence interval 0.7 to 0.9) than lactulose (0.6, 0.5 to 0.7; t = 3.51 p < or = 0.001). Scores for stool consistency and ease of evacuation were significantly higher for the senna-fibre combination than for lactulose. The recommended dose was exceeded more frequently with lactulose than the senna-fibre combination (chi 2 = 8.38, p or = 0.01). As an index of the standard daily dose, the dose per stool was 1.52 fo

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population a history of chronic
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Constipation
  • Cost-Benefit Analysis
  • Double-Blind Method
  • Drug Combinations
  • Drug Costs
  • Female
  • Hospitalization
  • Humans
  • Lactulose
  • Long-Term Care
  • Male
  • Senna Extract

Evidence Classification

  • Level: Rct
  • Publication Types: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
  • Vertical: senna

Provenance

  • PMID: 8219947
  • DOI: (not available)
  • PMCID: PMC1696423
  • Verified: 2026-04-12 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-12