Study of Effect of Tegaserod on Small and Large Bowel Transit by Scintigraphic Method
Status:
Unknown status
Trial end date:
2006-10-01
Target enrollment:
Participant gender:
Summary
Functional constipation is a common problem in Hong Kong. In a recent telephone survey, the
prevalence of constipation as defined by Rome II criteria was 14%. Apart from organic,
metabolic, neurological and drug induced causes, constipation most often arises from 2
disorders of colorectal motility: slow transit constipation or pelvic floor dysfunction or
both. In the position statement from the American Gastroenterological Association , colon
transit study was recommended to differentiate slow transit constipation from pelvic floor
dysfunction. The management algorithm for normal transit and slow transit constipation was
different and surgery should be considered for patients with slow transit constipation. In a
recent paper by Bonapace , scintigraphy could be used to study both gastric, small bowel and
large bowel transit time. The clinical diagnosis was changed in 51% of cases of constipation
after scintigraphy and patient management such as adding a prokinetic agent, referral to
biofeedback center, decision on surgery was affected in 64% of cases.
Tegaserod is a recently approved prokinetic agent to be marketed in Hong Kong for the
management of patients with constipation predominant irritable bowel syndrome (C-IBS). In a
paper from Mayo clinic based on scintigraphic examination, tegaserod 2mg bd accelerates
orocaecal transit in C-IBS patients. However studies in functional constipation basing on
tegaserod 6 mg twice daily has not been published yet. Therefore, the Gastroenterology team
and nuclear medicine teams of Princess Margaret Hospital, Gastroenterology teams of Caritas
Medical Center and Yan Chai Hospital decide to study small and large bowel transit in
functional constipation patients by scintigraphy. The efficacy of tegaserod in improving
bowel transit is also examined in this randomized double blind placebo controlled study.