Chronic constipation and treatment options (Review)

El‑Salhy,Magdy; Svensen,Rune; Hatlebakk,Jan  Gunnar; Gilja,Odd‑Helge; Hausken,Trygve

doi:10.3892/mmr.2013.1770

Chronic constipation and treatment options (Review)

Authors:
- Magdy El‑Salhy
- Rune Svensen
- Jan Gunnar Hatlebakk
- Odd‑Helge Gilja
- Trygve Hausken
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Affiliations: Section for Gastroenterology, Department of Medicine, Stord Hospital, Stord 5416, Norway, Section for Surgical Gastroenterology, Haukeland University Hospital, Bergen 5504, Norway, Section for Gastroenterology, Department of Clinical Medicine, University of Bergen, Bergen 5020, Norway
Published online on: November 4, 2013 https://doi.org/10.3892/mmr.2013.1770
Pages: 3-8

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Abstract

Chronic constipation (CC) is a highly prevalent heterogeneous disorder. Although CC is not known to be associated with the development of serious disease or with excess mortality, it considerably reduces the patients quality of life. In addition, it represents an economic burden to patients and society. The majority of patients with CC successfully manage the disorder by dietary management and the use of laxatives. Patients with functional CC (slow‑transit and non‑slow transit constipation) do not respond to laxatives and are a small fraction of the total population complaining of constipation. Regardless of the low number of these patients, the intractability of their symptoms causes psychological and social stress and greatly impairs their quality of life. Furthermore, these patients consume a disproportionate quantity of medical resources. It appears that these patients have a disturbance in the serotonin transmission system, which results in a cascade of alterations in a number of gut neuroendocrine hormones/transmitters. The effect of prucalopride, a serotonin receptor agonist, in this category of patients appears to be not only a pharmacological prokinetic action, but also a correction of a pre‑existing disturbance. Linaclotide, a member of the guanylin peptide family, binds to the ligand‑binding region of guanylate cyclase‑C on the luminal surface of gastrointestinal epithelia resulting in increased fluid secretion. This drug has also been found to be effective for the treatment of functional CC. In addition, biofeedback and sacral nerve stimulation are effective in the treatment of CC caused by pelvic floor disorders.

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