“The management of obstructed defecation (dyschezia) remains a clinical challenge and the level of evidence is very low for pharmacological treatments, such as laxatives, or diet advice,” explains author Marc Marty.

In light of these issues, Marty and colleagues conducted a randomized, placebo-controlled trial to evaluate the safety and efficacy of a CO2-releasing suppository in patients with constipation. The trial included 323 patients (aged 18–75 years) who were randomly assigned to receive the intervention suppository or a placebo suppository once a day for 21 days. Participants were asked to report on the intensity of their discomfort related to constipation using a visual analogue scale. Notably, the patients had symptoms of constipation (according to the Rome III criteria), but had not had this confirmed with diagnostic tests or undergone biofeedback training.

The authors found that symptom relief came quickly (on day 1) in patients who received the CO2-releasing suppository, which was maintained over the study period. Compared with the placebo group, the intervention group experienced considerable improvements in their quality of life within the first few days of treatment. The differences between the treatment and placebo groups were statistically significant.

“The use of a CO2-releasing suppository could be considered in guidelines for patients with symptoms of dyschezia,” says Marty. “Further studies should be conducted to determine the best candidate patients for such treatment.”