title: Efficacy and side-effect profiles of lactulose, docusate sodium, and sennosides compared to PEG in opioid-induced constipation: a systematic review.
abstract: Opioid-induced constipation (OIC) is a side effect of opioid therapy that can affect quality of life, adherence to treatment, and morbidity and possibly mortality.
  
  
  OBJECTIVE
  To investigate whether docusate sodium, sennosides, and lactulose have equal efficacy and side effect profiles compared to PEG in the management of OIC in adults.
  
  
  METHODS
  A systematic review was undertaken. Randomized controlled trials of adults taking opioids for cancer or non-cancer pain were considered if they met inclusion criteria.
  
  
  CONCLUSIONS
  Statistical pooling was not possible as no studies met inclusion criteria. Large, well-powered, randomized controlled trials are feasible. Standard definitions of OIC would assist with the execution of these studies and contribute to their internal and external validity. Further research is strongly encouraged.
authors.affiliation: Royal Alexandra Hospital, Alberta Thoracic Oncology Program/Chest Medicine Clinic, Room 4505 Children's Centre, Royal Alexandra Hospital, 10240 Kingsway Ave., Edmonton, AB T5H 3V9. Teresa.Ruston@albertahealthservices.ca
authors.forename: Teresa
authors.initials: T
authors.lastname: Ruston
authors.affiliation: Faculty of Medicine, Division of Geriatric Medicine, Faculty of Nursing Level 3, Edmonton Clinic Health Academy, 11405 87 Ave., University of Alberta, Edmonton, AB T6G C9.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hunter
authors.affiliation: Faculty of Medicine, Division of Geriatric Medicine, Faculty of Nursing Level 3, Edmonton Clinic Health Academy, 11405 87 Ave., University of Alberta, Edmonton, AB T6G C9.
authors.forename: Greta
authors.initials: G
authors.lastname: Cummings
authors.affiliation: Division of Gastroenterology, 2-30A Zeidler-Ledcor, 130 University Campus, University of Alberta, Edmonton, AB T6G 2X8.
authors.forename: Adriana
authors.initials: A
authors.lastname: Lazarescu
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002400:Cathartics / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy*; D004143:Dioctyl Sulfosuccinic Acid / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007792:Lactulose / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D054368:Laxatives / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D012676:Senna Extract / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D013501:Surface-Active Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D002400:Cathartics; D054368:Laxatives; D013501:Surface-Active Agents; D004143:Dioctyl Sulfosuccinic Acid; D011092:Polyethylene Glycols; D007792:Lactulose; D012676:Senna Extract