[Laxative policy for terminal patients ineffective].
OBJECTIVE
To determine the prevalence of constipation and the use of laxatives in terminal patients.


METHODS
Retrospective.


METHODS
Hospice Rozenheuvel, Rozendaal, the Netherlands.


METHODS
Of patients who were admitted for terminal care between 1 January 1995 and 15 July 1996 the anamnestic data were recorded about presence of constipation and use of medicines, notably opioids and laxatives.


RESULTS
The study population (n = 121) consisted of 65 male and 56 female patients. 95 patients (79%) suffered from cancer. The median survival time was 18 days (spread from 1-180 days). 58 (48%) of the patients were constipated at the time of admission and 62 (51%) used opioids. The opioid users were more often constipated (68% versus 27%; p < 0.001). 35 out of 62 (56%) opioid users were given laxatives. The laxative users, however, were more often constipated (65% versus 36%; p < 0.01). Neither in users nor in non-users of opioids did laxatives have any effect on presence of constipation. Of the laxative users 37 (73%) were given lactulose in a fixed dosage.


CONCLUSIONS
Present laxative policy in terminal patients is ineffective. Monotherapy with fixed lactulose doses is not effective as a laxative in either users or non-users of opioids.
Schoorl
J
J
Rijksuniversiteit Limburg, Faculteit der Geneeskunde, Maastricht.
Zylicz
Z
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects; D002400:Cathartics / Q000008:administration & dosage / Q000627:therapeutic use*; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D017051:Hospice Care; D006801:Humans; D007792:Lactulose / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D002400:Cathartics; D007792:Lactulose