Abstract
INTRODUCTION: Pharmacological therapies for chronic idiopathic constipation (CIC) are useful, but many patients report dissatisfaction from a lack of efficacy and occurrence of adverse events. The vibrating capsule (VC) is a US Food and Drug Administration approved nonpharmacologic treatment of CIC. However, its long-term usefulness in a community setting is unknown. The goal of this study was to assess the long-term efficacy and safety of VC treatment in a real-world community setting. METHODS: We conducted a postmarketing analysis of CIC patients prescribed VC who completed at least 3 or 6 months of treatment. The clinical utility was assessed by patient reported symptoms in an electronic stool diary. Safety data were also collected. RESULTS: One thousand seven hundred twenty-two patients were prescribed VC, and 491 and 298 took the VC and kept stool diaries for 3 and 6 months, respectively. Approximately 46% of patients were older than 55 years of age and 85% were women. Compared with baseline, complete spontaneous bowel movement rates increased significantly throughout the 3 and 6-month periods (average increase of >1 complete spontaneous bowel movement per week; P < 0.0001). Mean stool consistency (Bristol Stool Form Scale) improved from 2.9 (baseline) to 4.1 during treatment ( P < 0.0001), mean straining effort (1-4) decreased from 2.9 to 1.6 ( P < 0.0001), and toileting time also significantly decreased ( P < 0.0001). Safety analysis revealed that 4.6% of patients reported feeling a sensation of vibration, 1.8% reported abdominal pain and 0.64% reported diarrhea. DISCUSSION: In a community setting, the VC seems both effective and safe for long-term treatment of chronic constipation with diarrhea being notably uncommon.