Slow Constipation To Prucalopride Case Study Answers

Response of Slow Constipation to Prucalopride: a case study.
A seventy-two year old gentleman presented with a history of constipation for the past 6-7 years. Since his retirement from last 2 years, his constipation had increased. Medical history revealed that he was a known case of Diabetes and on oral hypoglycemic medications with diabetes under control. There were no alarming features like weight loss, fever, blood in stool or anorexia. Post retirement, his physical activity was reduced. Furthermore, he gave no history of abdominal pain, but reported straining at the time of defecation which had increased since last 6-8 months.
General examination did not reveal any significant positive finding. There was no pallor, no pedal edema and
Considering the increased constipation and straining, the patient underwent colonoscopy that showed normal study. Based on straining and normal colonoscopy, the patient underwent rectal manometery which also furnished normal study. Post this; the patient underwent marker study which yielded results suggestive of slow constipation.
Taking into consideration that there was no abdominal pain, normal blood reports, normal colonoscopy, normal rectal manometery and marker study of slow constipation, the patient was confirmed with a diagnosis of slow constipation. The patient was taking isabgol husk and lactulose syrup for the last few years. He was advised to increase their dose along with an increase in physical exercise and fiber-rich diet.
During the follow-up visit after 2 weeks, the patient reported no significant improvements. He was started on Prucalopride 2 mg twice a day. The patient started the same and revisited after two weeks. He felt improvements in constipation and straining after starting the medication. The patient was asked to continue the medication and to revisit after one
STC patients have reduced numbers and function of colonic enterochromografine cells with decreased serotonin activity. Reduced serotonin activity may be associated with the motor and secretory abnormalities resulting in slow colonic transit. In such patients, serotonin 5-HT4 receptors are attractive mechanistic targets for the agents (agonists) that may be useful in constipation treatment. 3 Prucalopride is one such highly selective serotonin 5-HT4 receptor agonist that has a stimulatory effect on gut motility and colonic transit. It is approved in several Western European countries for the management of chronic constipation and in cases where laxatives fail to provide adequate relief. A daily dose of 2 mg has been shown to provide clinical benefits with a tolerable safety profile.