Current and future therapies for chronic constipation.

Author(s): Tack J

Affiliation(s): Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium. jan.tack@med.kuleuven.be

Publication date & source: 2011-02, Best Pract Res Clin Gastroenterol., 25(1):151-8.

Publication type: Review

In this article, traditional and novel therapies for chronic constipation are reviewed. Traditional laxatives are effective at inducing bowel movements, but efficacy in long-term management and efficacy on constipation-associated abdominal symptoms are less well established, with the exception of polyethylene glycol, for which long-term studies confirm sustained efficacy. Recently approved drugs include the colonic secretagogue lubiprostone and the 5-HT4 agonist prucalopride. In controlled trials in chronic constipation, these drugs were shown to significantly improve constipation and its associated symptoms, with a favourable safety record. Methylnaltrexone, a subcutaneously administered peripherally acting mu opioid receptor antagonist, has recently been approved for opioid-induced constipation in terminally ill patients. New agents under evaluation include the 5-HT4 agonists velusetrag and naronapride, the guanylate cyclase-C receptor agonist linaclotide and the peripherally acting mu opioid receptor antagonist alvimopan. Copyright (c) 2011. Published by Elsevier Ltd.