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Step on the accelerator: modern treatment of constipation – Lumbar Fusion

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This article discusses the effective management of constipation, the challenges in making a positive diagnosis, and the importance of a positive patient-provider relationship. It highlights recent findings such as the high percentage of patients with severe constipation and upper gastrointestinal symptoms, the effectiveness of gold kiwifruits in treating constipation, and the high rate of opioid use after lumbar fusion surgery. The article also mentions the dissatisfaction of patients with over-the-counter treatments and explores pharmacologic and nonpharmacologic treatments for constipation. Overall, constipation significantly impacts patients’ quality of life, and both pharmacologic and nonpharmacologic treatments show promise in improving symptoms and quality of life

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine clinic in UK

Published article

PURPOSE OF REVIEW: This review aims to explore effective management of constipation, examine challenges in making a positive diagnosis, and highlights the significance of a positive patient-provider relationship and emerging treatments.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Curr Opin Gastroenterol. 2023 Sep 4. doi: 10.1097/MOG.0000000000000982. Online ahead of print.ABSTRACTPURPOSE OF REVIEW: This review aims to explore effective management of constipation, examine challenges in making a positive diagnosis, and highlights the significance of a positive patient-provider relationship and emerging treatments.RECENT FINDINGS: Less than one-fifth of patients feel satisfied with treatment of their constipation.,

Curr Opin Gastroenterol. 2023 Sep 4. doi: 10.1097/MOG.0000000000000982. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: This review aims to explore effective management of constipation, examine challenges in making a positive diagnosis, and highlights the significance of a positive patient-provider relationship and emerging treatments.

RECENT FINDINGS: Less than one-fifth of patients feel satisfied with treatment of their constipation. Sixty percent of patients with functional dyspepsia and gastroparesis have severe to very severe constipation that correlates with their upper gastrointestinal symptom severity. Two gold kiwifruits are noninferior to 10 g of psyllium in the treatment of constipation. More than 40% of patients undergoing lumbar fusion continue to fill opioid prescriptions 90 days after surgery, contributing to 80 000 chronic opioid users annually. Most patients are using over-the-counter (OTC) treatments for constipation with greater than 60% dissatisfied. Pharmacologic management involves the use of GCC agonists and emerging drug classes such as bile acid transport inhibitors and sodium hydrogen exchanger isoform 3 (NHE3) inhibitors. Nonpharmacologic treatments, including neuromodulation and FDA-approved vibrating capsule, show promise in improving symptoms and quality of life.

SUMMARY: Constipation significantly impacts patients’ quality of life and well being and the majority of patients are refractory to conservative measures and OTC treatments. Both pharmacologic and nonpharmacologic treatments hold promise for improving constipation and quality of life.

PMID:37678175 | DOI:10.1097/MOG.0000000000000982

The London Spine Unit : innovative spine clinic in UK

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Step on the accelerator: modern treatment of constipation

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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Curr Opin Gastroenterol. 2023 Sep 4. doi: 10.1097/MOG.0000000000000982. Online ahead of print.ABSTRACTPURPOSE OF REVIEW: This review aims to explore effective management of constipation, examine challenges in making a positive diagnosis, and highlights the significance of a positive patient-provider relationship and emerging treatments.RECENT FINDINGS: Less than one-fifth of patients feel satisfied with treatment of their constipation.

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