Chronic Idiopathic Constipation in Adults: A Review on Current Guidelines and Emerging Treatment Options.
chronic idiopathic constipation
guidelines
osmotic laxatives
pelvic floor rehabilitation
prokinetics
secretagogues
Journal
Clinical and experimental gastroenterology
ISSN: 1178-7023
Titre abrégé: Clin Exp Gastroenterol
Pays: New Zealand
ID NLM: 101532800
Informations de publication
Date de publication:
2021
2021
Historique:
received:
11
05
2021
accepted:
28
09
2021
entrez:
29
10
2021
pubmed:
30
10
2021
medline:
30
10
2021
Statut:
epublish
Résumé
Chronic idiopathic constipation (CIC) is a common functional bowel disorder characterized by difficult, infrequent, and/or incomplete defecation. It has a great impact on the quality of life and on health care system and represents a heavy economic burden. The diagnosis is based on symptoms, classified by the Rome IV criteria. The aim of this review was to evaluate the current therapeutic guidelines for adult CIC and highlight new emerging treatments. In detail, European, French, Spanish and Korean guidelines have been identified and compared. Osmotic laxatives, and in particular polyethylene glycol, represent the first-line therapeutic approach. Stimulant laxatives are recommended as a second-line therapy. Pelvic floor rehabilitation is recommended in patients with ano-rectal dyssynergia. In patients who fail to improve with pharmacological therapies sacral nerve stimulation is considered as last chance before surgery. Surgical approach has however limited indications in selected cases. Inertia coli refractory to any approach and obstructed defecation are two subtypes which can benefit from surgery. Among emerging agents, prucalopride, a prokinetic agent, is recommended as a second-line treatment in refractory CIC patients. In addition, the secretagogues linaclotide and plecanatide and the bile acid transported inhibitor elobixibat can be effective in patients not responsive to a second-line therapeutic regimen, although they are not worldwide commercially available.
Identifiants
pubmed: 34712055
doi: 10.2147/CEG.S256364
pii: 256364
pmc: PMC8547593
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
413-428Informations de copyright
© 2021 Bassotti et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
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