Emerging treatments for chronic constipation

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Chronic constipation (CC) is a prevalent global health issue causing significant morbidity.
• Evolving definitions of CC now encompass a wider range of symptoms beyond stool frequency, including straining and bloating.
• Therapeutic strategies are shifting to address these diverse symptoms alongside bowel regularity.

Purpose of the Study:

• To review conventional laxative treatments for constipation.
• To assess novel pharmacological approaches for managing CC.
• To evaluate the efficacy and safety of selective prokinetics and prosecretory agents.

Main Methods:

• Review of existing literature on conventional laxative therapies.
• Assessment of clinical studies on selective prokinetic and prosecretory agents for chronic idiopathic constipation.
• Evaluation of efficacy and safety data from randomized controlled trials.

Main Results:

• High-quality evidence supporting traditional laxatives is limited due to a historical lack of rigorous clinical trials.
• Selective prokinetic (prucalopride) and prosecretory agents (lubiprostone, linaclotide) demonstrate efficacy in large clinical studies.
• These novel agents have favorable safety profiles.

Conclusions:

• Prucalopride, lubiprostone, and linaclotide are effective and safe options for managing chronic constipation.
• Emerging therapies, including ileal bile acid absorption inhibition, show potential for future CC treatment.
• Further research and high-quality trials are crucial for validating constipation treatments.