Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting
Article first published online: 21 JUL 2003
Alimentary Pharmacology & Therapeutics
Volume 18, Issue 3, pages 291–301, August 2003
How to Cite
Tytgat, G. N., Heading, R. C., Müller-Lissner, S., Kamm, M. A., Schölmerich, J., Berstad, A., Fried, M., Chaussade, S., Jewell, D. and Briggs, A. (2003), Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting. Alimentary Pharmacology & Therapeutics, 18: 291–301. doi: 10.1046/j.1365-2036.2003.01679.x
- Issue published online: 1 AUG 2003
- Article first published online: 21 JUL 2003
- Accepted for publication 11 June 2003
Background : Gastro-oesophageal reflux disease (GERD) and constipation have a major impact on public health; however, the wide variety of treatment options presents difficulties for recommending therapy. Lack of definitive guidelines in pharmacy and general practice medicine further exacerbates the decision dilemma.
Aims : To address these issues, a panel of experts discussed the principles and practice of treating GERD and constipation in the general population and in pregnancy, with the aim of developing respective treatment guidelines.
Results : The panel recommended antacids ‘on-demand’ as the first-line over-the-counter treatment in reflux, and as rescue medication for immediate relief when reflux breaks through with proton pump inhibitors. Calcium/magnesium-based antacids were recommended as the treatment of choice for pregnant women because of their good safety profile. In constipation, current data do not distinguish a hierarchy between polyethylene glycol (PEG)-based laxatives and other first-line treatments, although limitations are associated with stimulant- and bulk-forming laxatives. Where data are available, PEG is superior to lactulose in terms of efficacy. In pregnancy, PEG-based laxatives meet the criteria for the ideal treatment.
Conclusions : The experts developed algorithms that present healthcare professionals with clear treatment options and management strategies for GERD and constipation in pharmacy and general practice medicine.