Trial reportGut2013
A randomised controlled study of the effect of cholinesterase inhibition on colon function in patients with diabetes mellitus and constipation.
Trial report in Gut, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00276406 (Pyridostigmine in Diabetics With Constipation), which is not on this map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pyridostigmine in Diabetics With Constipation: Randomized, Placebo-controlled, Double-blind Trial
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Pooled it
- Guideline
- Pooled it
- Effects of ondansetron on symptoms during a gastric emptying study and enteral lipid challenge and on daily symptoms in diabetic gastroenteropathy.Neurogastroenterology and motility · 2024Trial
- Randomised study: effects of the 5-HTAlimentary pharmacology & therapeutics · 2021Trial
- The effect of pyridostigmine on small intestinal bacterial overgrowth (SIBO) and plasma inflammatory biomarkers in HIV-associated autonomic neuropathies.Journal of neurovirology · 2019Trial
- Effect of neostigmine on gastroduodenal motility in patients with suspected gastrointestinal motility disorders.Neurogastroenterology and motility · 2015Trial
- Blunting of Colon Contractions in Diabetics with Gastroparesis Quantified by Wireless Motility Capsule Methods.PloS one · 2015Trial
- Pharmacological inhibition of hydrogen sulfide production mitigates constipation in a type 1 diabetes mouse model.Scientific reports · 2026Article
- Potential role of pyridostigmine in the management of pediatric chronic intestinal pseudo-obstruction in a girl with ACTL6B mutation: a case report and a review of literature.Frontiers in pediatrics · 2026Article
- A molecular probe for detecting cholinesterase activity in MRI.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Update on the Treatment of Autonomic Disorders.Current treatment options in neurology · 2025Article
- The impact of long-course chemoradiotherapy on the myenteric plexus, neuromuscular functions and responses to prokinetic drugs in the human rectum.United European gastroenterology journal · 2024Article
- Managing gastrointestinal manifestations in systemic sclerosis, a mechanistic approach.Expert review of clinical immunology · 2024Review
- Association of dietary inflammatory index with constipation: Evidence from the National Health and Nutrition Examination Survey.Food science & nutrition · 2024Article
- Idiopathic Slow Transit Constipation: Pathophysiology, Diagnosis, and Management.Medicina (Kaunas, Lithuania) · 2024Review
- Parkinson's Disease and Diabetes Mellitus: Synergistic Effects on Pathophysiology and GI Motility.Current gastroenterology reports · 2023Review
- Edible Seaweeds Extracts: Characterization and Functional Properties for Health Conditions.Antioxidants (Basel, Switzerland) · 2023Article
- Exploring Pharmacological Treatments for Chronic Idiopathic Constipation in Adults: A Look Back to the Future.Journal of clinical medicine · 2023Review
- Review article: diagnosis, management and patient perspectives of the spectrum of constipation disorders.Alimentary pharmacology & therapeutics · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectivesChronic constipation in diabetes mellitus is associated with colonic motor dysfunction and is managed with laxatives. Cholinesterase inhibitors increase colonic motility. This study evaluated the effects of a cholinesterase inhibitor on gastrointestinal and colonic transit and bowel function in diabetic patients with constipation.
designAfter a 9-day baseline period, 30 patients (mean ± SEM age 50 ± 2 years) with diabetes mellitus (18 type 1, 12 type 2) and chronic constipation without defaecatory disorder were randomised to oral placebo or pyridostigmine, starting with 60 mg three times a day, increasing by 60 mg every third day up to the maximum tolerated dose or 120 mg three times a day; this dose was maintained for 7 days. Gastrointestinal and colonic transit (assessed by scintigraphy) and bowel function were evaluated at baseline and the final 3 and 7 days of treatment, respectively. Treatment effects were compared using analysis of covariance, with gender, body mass index and baseline colonic transit as covariates.
results19 patients (63%) had moderate or severe autonomic dysfunction; 16 (53%) had diabetic retinopathy. 14 of 16 patients randomised to pyridostigmine tolerated 360 mg daily; two patients took 180 mg daily. Compared with placebo (mean ± SEM 1.98 ± 0.17 (baseline), 1.84 ± 0.16 (treatment)), pyridostigmine accelerated (1.96 ± 0.18 (baseline), 2.45 ± 0.2 units (treatment), p<0.01) overall colonic transit at 24 h, but not gastric emptying or small-intestinal transit. Treatment effects on stool frequency, consistency and ease of passage were significant (p ≤ 0.04). Cholinergic side effects were somewhat more common with pyridostigmine (p=0.14) than with placebo.
conclusionsCholinesterase inhibition with oral pyridostigmine accelerates colonic transit and improves bowel function in diabetic patients with chronic constipation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.