Effect of flaxssed and olive oils compared to mineral oil in the treatment of constipation in patients with chronic kidney disease on hemodialysis

Abstract

Introduction: Constipation is a gastrointestinal symptom of significant morbidity. The primary treatment is based on the adoption of a high fiber diet, liquids and physical activity. However, when this is not efficient, the use of laxatives is needed. The prevalence of constipation in patients with chronic kidney disease (CKD), especially those on hemodialysis (HD), is greater than in the general population, since they have a large number of risk factors such as fluid and potassium restriction (which leads to reduced fiber intake), frequent use of phosphate binders, as well as sedentary lifestyle, aging and comorbidities. Mineral oil usually used to tract constipation, but it is a petroleum derivative and it is not absorbed. Edible oils such as flaxseed and olive oils, have functional properties and add calories, so they can be a healthier alternative for the treatment of constipation of this patients, but they have not yet been tested. Objective: To investigate the effect of flaxseed and olive oils compared to mineral oil in the treatment of constipation in patients with CKD on HD. Methodology: a double-blind, randomized, controlled trial will be conducted for 4 weeks. A total of 50 patients on chronic HD program, older than 18 years and constipation diagnosis confirmed by Rome III criteria will be evaluated. Patients will be randomized into 3 groups: mineral oil group (control), flaxseed oil group and olive oil group. The initial daily dose of each oil will be 4 ml and it can be adjusted according to the patient response, evaluated by an adapted Bristol scale. After the intervention, the Rome III criteria will be reapplied.