A pilot study to explore the safety of pyridostigmine in constipated palliative care patients

Constipation is a very common and distressing problem for people receiving palliative care, affecting up to 90% of patients, and many do not get enough relief from standard laxatives. This study is testing whether a medication called pyridostigmine — which helps the gut move things along — can improve constipation in palliative care patients who are taking medications that slow the bowel. This is a safety study to see if the drug is well tolerated without making other symptoms worse. You may be eligible if: - You are 18 years of age or older - You are under the care of a specialist palliative care service - You are taking one or more medications known to cause constipation - You are dissatisfied with your current constipation management despite taking laxatives - You have a bowel function index score above 30 - Your doctor estimates you have enough time to participate in the study You may NOT be eligible if: - You have had a previous bad reaction to pyridostigmine - You have a history of bowel obstruction, irritable bowel syndrome, inflammatory bowel disease, or bowel surgery - You have faecal incontinence - You are pregnant or breastfeeding - You have severe kidney impairment, prolonged QT syndrome, asthma, epilepsy, hyperthyroidism, or myasthenia gravis - You have ischemic heart disease or a heart rhythm disorder within the past 12 months Talk to your doctor about whether this trial might be right for you.