PSYLLIUM IS SUPERIOR TO DOCUSATE SODIUM FOR TREATMENT OF CHRONIC CONSTIPATION

Background: Stool softening is a physician's first step in the managem ent of chronic constipation. Aim: To compare stool softening (stool wa ter content) and laxative efficacy of psyllium hydrophilic mucilloid v s. docusate sodium. Methods: The multi-site, randomized, double-blind, parallel-design study of 170 subjects with chronic idiopathic constip ation involved a 2-week baseline (placebo) phase followed by 2 weeks o f treatment. The treatment phase compared psyllium (5.1 g b.d,) plus d ocusate placebo to docusate sodium (100 mg b.d.) plus psyllium placebo . Stools were collected and assessed. Results: Compared to baseline, p syllium increased stool water content vs. docusate (psyllium 2.33% vs. docusate 0.01%, P = 0.007). Psyllium also increased stool water weigh t (psyllium 84.0 g/BM; docusate 71.4 g/BM; P = 0.04), total stool outp ut (psyllium 359.9 g/week; docusate 271.9 g/week; P = 0.005), and O'Br ien rank-type score combining objective measures of constipation (psyl lium 475.1; docusate 403.9; P = 0.002). Bowel movement (BM) frequency was significantly greater for psyllium (3.5 BM/week) vs. docusate (2.9 BM/week) in treatment week 2 (P = 0.02), with no significant differen ce (P > 0.05) between treatment groups in treatment week 1 (3.3 vs, 3. 1 BM/week). Conclusion: Psyllium is superior to docusate sodium for so ftening stools by increasing stool water content, and has greater over all laxative efficacy in subjects with chronic Idiopathic constipation .