Effect of an oral bulking agent and a rectal laxative administered alone or in a combination for the treatment of constipation

Objectives - The aim of the present study was to search for a synergetic action between psyllium and a defecation-inducing drug, Eductyl(R), for symptom relief in patients suffering from chronic constipation. Methods - Twenty healthy volunteers and 20 patients complaining of chronic constipation were included in a randomized crossover study. The study was divided into four 2-weeks periods: pre-inclusion and three periods of treatment with psyllium, Eductyl(R), and Eductyl(R) + psyllium respectively. Colonic transit time was determined at the end of each period of treatment. During each of the four periods, a self-administered questionnaire was used to assess symptoms of constipation. Results - For constipated patients, treatment with Eductyl(R) and Eductyl(R)-psyllium improved clinical symptoms of constipation: increased stool frequency, resulted in fewer hard stools and less sensation of incomplete evacuation and less straining to defecate. The improvement was associated with a decrease in total and segmental colonic transit time. The Eductyl(R)-psyllium combination did not exhibit any synergetic effect. Conclusion - Treatment with Eductyl(R) alone is more efficient than with psyllium alone in providing symptom relief. Combination with psyllium is not synergetic.