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Polyethylene glycol (PEG) and sennosides (senna) are established laxative agents used in the management of opioid-induced constipation (OIC). Polyethylene glycol is an osmotic laxative that works by drawing water into the intestinal lumen, thereby softening the stool and facilitating its passage. Sennosides are stimulant laxatives derived from the senna plant; they are hydrolyzed by gut bacteria into active metabolites that stimulate the myenteric plexus and increase colonic motility. The British Columbia Cancer Agency (BCCA) evaluated these two treatments in a randomized, double-blind, crossover clinical trial involving cancer outpatients. The study aimed to compare the efficacy and tolerability of a stepped bowel protocol using these agents, providing evidence for their use as first-line treatments for OIC in palliative care settings.
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