Linaclotide for constipation-predominant IBS

Irritable bowel syndrome is a chronic relapsing disorder characterised by abdominal pain or discomfort associated with defaecation, abdominal bloating and a change in bowel habit. IBS may be classified by the change in bowel function as 'diarrhoea predominant' (IBS-D), 'constipation predominant' (IBS-C) or mixed, or may be unclassified. Although it is not thought to be associated with the development of serious disease, IBS is a debilitating condition often resulting in reduced quality of life and significant use of healthcare resources. Current drug treatment strategies target the patient's predominant symptoms and typically involve the use of an antispasmodic and either a laxative or antidiarrhoeal agent. Linaclotide (Constella-Almirall) is an oral guanylate cyclase-C receptor agonist licensed for the symptomatic treatment of moderate to severe IBS-C in adults. In this article, we consider the evidence for linaclotide and how its use fits with current management strategies for IBS-C.