• J Schoorl and Z Zylicz.
• Rijksuniversiteit Limburg, Faculteit der Geneeskunde, Maastricht.
• Ned Tijdschr Geneeskd. 1997 Apr 26; 141 (17): 823-6.

ObjectiveTo determine the prevalence of constipation and the use of laxatives in terminal patients.DesignRetrospective.SettingHospice Rozenheuvel, Rozendaal, the Netherlands.MethodOf patients who were admitted for terminal care between 1 January 1995 and 15 July 1996 the anamnestic data were recorded about presence of constipation and use of medicines, notably opioids and laxatives.ResultsThe study population (n = 121) consisted of 65 male and 56 female patients. 95 patients (79%) suffered from cancer. The median survival time was 18 days (spread from 1-180 days). 58 (48%) of the patients were constipated at the time of admission and 62 (51%) used opioids. The opioid users were more often constipated (68% versus 27%; p < 0.001). 35 out of 62 (56%) opioid users were given laxatives. The laxative users, however, were more often constipated (65% versus 36%; p < 0.01). Neither in users nor in non-users of opioids did laxatives have any effect on presence of constipation. Of the laxative users 37 (73%) were given lactulose in a fixed dosage.ConclusionPresent laxative policy in terminal patients is ineffective. Monotherapy with fixed lactulose doses is not effective as a laxative in either users or non-users of opioids.

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