Relief for Chronic Constipation

Chronic constipation patients may benefit from lubiprostone and linaclotide

(RxWiki News) For individuals who experience chronic constipation, it can be a challenge to find an effective treatment out of the many options available. A recently published review points to some treatments that may work.

The review found that Resolor (prucalopride), Amitiza (lubiprostone) and Linzess (linaclotide) were all safe and effective medications for treating chronic constipation in clinical trials. 

Prucalopride is a medication that promotes bowel movements, while lubiprostone and linaclotide are medications that help to release stools.

The study authors noted that although prucalopride has not been approved for use in the US, both lubiprostone and linaclotide have been approved by the US Food and Drug Administration (FDA) and are available for use in the US.

"Speak with your doctor about treatment for chronic constipation."

This review was led by Eamonn Quigley, MD, of the Methodist Hospital, Division of Gastroenterology and Hepatology in Houston, Texas. The research team reviewed clinical trials to determine the safety and effectiveness of different treatments for chronic constipation.

Chronic constipation has been defined as meeting at least two or more of the following criteria in a three-month time period:

  1. Having to strain during at least 25 percent of bowel movements
  2. Having lumpy or hard stools in at least 25 percent of bowel movmements
  3. Sensation that you were unable to excrete the entire stool for at least 25 percent of bowel movements
  4. Sensation of obstruction/blockage in the anus or rectum for at least 25 percent of defecations
  5. Having to use manual maneuvers to facilitate or initiate at least 25 percent of bowel movements (e.g., massaging stomach)
  6. Having less than three bowel movements per week

The researchers focused on clinical trials that used treatments to stimulate and promote movement in the colon or to soften the stool making it easier to release.

For treatments that stimulate and promote movement, the researchers found the medication prucalopride to be an effective treatment.

They reviewed three large clinical trials with more than 500 participants and found that taking prucalopride significantly improved bowel function, reduced constipation-related symptoms and improved patient satisfaction and constipation-related quality of life.

The researchers noted that while prucalopride has been approved for use in Europe, it has not yet been approved for use in the US.

For treatments that help with releasing the stool, the researchers found lubiprostone and linaclotide to be effective treatments.

Lubiprostone was found to increase the frequency of bowel movements, and linaclotide was found to speed up the process of releasing the stool. Both lubiprostone and linaclotide have been approved for use for chronic constipation and are available in the US.

The study authors noted that people who experience chronic constipation are affected by more depression, anxiety, sleep problems and sexual dysfunction, which can all affect quality of life. Consequently, finding a safe and effective treatment is very important.

The authors noted that clinical trials are ongoing to determine which treatments work best to relieve chronic constipation, though currently, prucalopride, lubiprostone and linaclotide all seem to be safe and effective treatments for chronic constipation.

This review was published in the September issue of Expert Opinion on Emerging Drugs.

One of the study authors reported potential conflicts of interest with Ironwood, Forest, Almirall and Shire.

Review Date: 
September 16, 2013