This article is first seen at Medscape.
Citation: New Chronic Constipation Guideline Weighs Treatment Options – Medscape – Jun 02, 2023.
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A new set of guidelines has been published in the American Journal of Gastroenterology with the aim of assisting clinicians in dealing with the increasing number of treatment options available for chronic idiopathic constipation in generally healthy individuals. Developed collaboratively by the American Gastroenterological Association and American College of Gastroenterology, this marks the first update on chronic idiopathic constipation (CIC) in a decade.
In an interview, Dr. Lin Chang, the lead author of the guideline from the University of California, Los Angeles, mentioned that CIC is a common condition, affecting 8% to 12% of all adults in the United States. It is defined as constipation lasting at least three months without any underlying malignancy, obstruction, medication side effect, or inflammatory bowel disease. Primary care physicians are the ones who will mostly treat these patients rather than specialists, and many of these patients would have already attempted various over-the-counter treatments before consulting their physicians.
The new guideline, which incorporates evidence from 28 studies, provides recommendations for various treatment options. It covers different types of fiber, osmotic laxatives such as polyethylene glycol, magnesium oxide, and lactulose, as well as stimulant laxatives like bisacodyl, sodium picosulfate, and senna. Additionally, the guideline assesses secretagogues such as lubiprostone, linaclotide, plecanatide, and the serotonin type 4 agonist prucalopride.
Notably, the commonly used agent docusate sodium, a stool softener, was not included in the guideline due to insufficient data for evaluation. Fruit-based laxatives were also excluded as they had recently undergone a separate evidence review. Furthermore, lifestyle modifications like exercise, surgical interventions, and probiotics were not assessed in this particular guideline.
The guideline’s strongest recommendations are for polyethylene glycol, sodium picosulfate, linaclotide, plecanatide, and prucalopride. Meanwhile, fiber, lactulose, senna, magnesium oxide, and lubiprostone received conditional recommendations.
Link to the full Article (Medscape):
New Chronic Constipation Guideline Weighs Treatment Options (medscape.com)
Link to the full Chronic Idiopathic Constipation Guideline:
