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Research ArticleOriginal Article

Use of Colchicine to Treat Severe Constipation in Developmentally Disabled Patients

Paul S. Frame, Peter Dolan, Rakhi Kohli and Shirley W. Eberly
The Journal of the American Board of Family Practice September 1998, 11 (5) 341-346; DOI: https://doi.org/10.3122/15572625-11-5-341
Paul S. Frame
From Tri-County Family Medicine (PSF), Cohocton, the Department of Family Medicine (PSF), and the Department of Biostatistics (SWE), University of Rochester School of Medicine and Dentistry, the Finger Lakes Developmental Disabilities Services Organization (PD), and the University of Rochester School of Medicine and Dentistry (RK), Rochester, NY.
MD
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Peter Dolan
From Tri-County Family Medicine (PSF), Cohocton, the Department of Family Medicine (PSF), and the Department of Biostatistics (SWE), University of Rochester School of Medicine and Dentistry, the Finger Lakes Developmental Disabilities Services Organization (PD), and the University of Rochester School of Medicine and Dentistry (RK), Rochester, NY.
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Rakhi Kohli
From Tri-County Family Medicine (PSF), Cohocton, the Department of Family Medicine (PSF), and the Department of Biostatistics (SWE), University of Rochester School of Medicine and Dentistry, the Finger Lakes Developmental Disabilities Services Organization (PD), and the University of Rochester School of Medicine and Dentistry (RK), Rochester, NY.
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Shirley W. Eberly
From Tri-County Family Medicine (PSF), Cohocton, the Department of Family Medicine (PSF), and the Department of Biostatistics (SWE), University of Rochester School of Medicine and Dentistry, the Finger Lakes Developmental Disabilities Services Organization (PD), and the University of Rochester School of Medicine and Dentistry (RK), Rochester, NY.
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Abstract

Background: Patients with severe developmental disabilities often have concurrent decreased neuromuscular tone of the gastrointestinal tract, which can lead to a weak gag reflex, esophageal reflux, aspiration, and severe intractable constipation. High doses of multiple laxatives are frequently needed to maintain bowel motility in these patients. Colchicine, a natural alkaloid that is primarily used for the treatment of acute attacks of gout, causes an increase in gastrointestinal motility by neurogenic stimulation. The purpose of this study was to determine whether daily colchicine administration can improve bowel function and reduce laxative use in profoundly disabled patients with severe, intractable constipation who currently require large doses of multiple laxatives.

Methods: Twelve developmentally disabled patients who required three or more different laxatives to manage their chronic constipation were selected to participate in a double-blind, crossover study. Eleven patients who completed the study received placebo treatment for 8 weeks and colchicine treatment for 8 weeks. The total number of bowel movements and the total number of laxatives used during each of the two 8-week periods were compared.

Results: Eight of 11 patients experienced an improved bowel pattern while on colchicine compared with placebo, as defined by an increase in total number of bowel movements or a decrease in total number of rectal laxatives used. No clinically important complications were related to use of colchicine.

Conclusions: Colchicine appears to be a valuable adjunct in the management of severe intractable constipation. Larger, long-term studies are needed to confirm these preliminary results.

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The Journal of the American Board of Family     Practice: 11 (5)
The Journal of the American Board of Family Practice
Vol. 11, Issue 5
1 Sep 1998
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Use of Colchicine to Treat Severe Constipation in Developmentally Disabled Patients
Paul S. Frame, Peter Dolan, Rakhi Kohli, Shirley W. Eberly
The Journal of the American Board of Family Practice Sep 1998, 11 (5) 341-346; DOI: 10.3122/15572625-11-5-341

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Use of Colchicine to Treat Severe Constipation in Developmentally Disabled Patients
Paul S. Frame, Peter Dolan, Rakhi Kohli, Shirley W. Eberly
The Journal of the American Board of Family Practice Sep 1998, 11 (5) 341-346; DOI: 10.3122/15572625-11-5-341
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