[The Tibetan formula Padma Lax in medical practice: a retrospective case series study in constipation including 174 patients]

Abstract

Background: The Tibetan Medicine Padma Lax has been approved in Switzerland for the treatment of constipation and bloating for over 40 years. In this study, data on the application in medical practice, as well as on effectiveness in various constipation-related symptoms and on safety and tolerability, were collected and assessed.

Material and methods: Physicians practicing in Switzerland documented retrospectively the course of treatment for chronic constipation, using an especially developed questionnaire. In addition to defecation frequency, data on the intensity of 12 specific symptoms of constipation were collected.

Results: 17 participating physicians provided data from a total of 174 patient cases, about 30% of which originated from gynecological practices. Among others, lifestyle factors and various underlying diseases, e.g. neurological or hormonal disturbances, were indicated as causes of the constipation. Safety and tolerability were very good; only 1 adverse event (a worsening of flatulence) was reported. The frequency of defecation increased significantly during treatment and 97% reached a frequency of >2 per week. On average, the frequency and intensity of all symptoms decreased, with the exception of the symptom soft/loose stools, which increased in as many patients as it decreased. The overall intensity of all symptoms decreased from a mean of 15.8 by 63% to 5.8. The proportion of patients with severe complaints (overall intensity score >20) decreased from 20.1% to 1.7%, and as a result, the group with hardly any complaints (overall intensity score ≤ 5) rose from 1.2% to 57%. 86% of the physicians and the patients rated the efficacy as good.

Conclusions: Padma Lax was used in constipation of different causes and in a broad spectrum of patients. Efficacy and safety were assessed as good or very good. In spite of the limitation of the retrospective study design, the data indicate that Padma Lax is an effective and well-tolerated treatment option for chronic constipation from different causes, especially also in gynecological practice, in geriatric patients, and in patients with neurogenic constipation.