Taghavi, S.A., Shabani, S., Mehramiri, A., Eshraghian, A., Kazemi, S.M., Moeini, M., . . . Mostaghni, A.A. (2010). Colchicine is effective for short-term treatment of slow transit constipation: A double-blind placebo-controlled clinical trial. International Journal of Colorectal Disease, 25, 389–394.

To explore the effectiveness of colchicine in patients with slow-transit constipation not relieved with previous treatment.

Patients with refractory constipation were referred from gastroenterology clinics affiliated with Shiraz University of Medical Sciences in Iran. Patients initially were screened to rule out structural constipation, and transit time was measured. Patients were randomly assigned to colchicines 1 mg daily for two months (group A) or placebo starch capsule daily for two months (group B). Study assessments were done every two weeks for eight weeks.

• The study reported on a sample of 60 patients.
• Mean patient age was 38.94 years in group A and 35.47 years in group B.
• The study comprised 26 women and 4 men in group A, and 21 women and 9 men in group B.
• Patients had a diagnosis of constipation and slow-transit time; history of unsuccessful treatment with bulking agents, stimulant laxatives, and osmotic agents; and Rome II criteria validation of constipation diagnoses.

• Single site
• Outpatient
• Shiraz University of Medical Sciences in Iran

This was a double-blind, placebo-controlled, clinical trial.

Knowles Eccersley Scott Symptom (KESS) scoring system

• A significant difference (p = 0.0001) existed in two-month mean KESS scores for the colchicine group (11.67, SD = 3.91; baseline: 18.13, SD = 5.43) compared to the placebo group (18.66, SD = 3.72; baseline: 20.13, SD = 3.86).
• No significant side effects were reported in the treatment or placebo groups. 
• Open-label follow-up for one month with the placebo group showed a 90.48% significant symptom improvement (p = 0.0001) compared to original response rates.
• No relapse in symptoms were reported from the original colchicine group.

Colchicine administration showed effectiveness in select populations.

• The sample size was small (fewer than 100 patients).
• The study took place at a single site, used a selective referral source, and did not assess efficacy of colchicine in conjunction with chronic pain or chronic opioid use.

Colchicine may be effective for short-term use in the treatment of slow-transit constipation, but further studies are needed to assess its effectiveness in an oncology population with chronic opioid use.