An endocrine marker for pancreatic cancer.

Possibly the tendency was to replace one liquid laxative with another in the belief that liquid preparations are more effective than tablets or fibre products. Thus although the use of senna tablets increased, the rise in the use of senna syrup was much greater, partly because it was given by nursing staff. Increased prescribing of lactulose may have been due to extensive promotion, the wish to use a liquid preparation, and the perception that the potential lack of griping was an important benefit. Recommendations made to prescribers were not followed, and we conclude that the educational bulletins issued to promote fibre as a first line laxative were not enough to influence prescribing without some form of reinforcement.