Exploring Pharmacological Treatments for Chronic Idiopathic Constipation in Adults: A Look Back to the Future

Abstract

Despite great progress in pharmaceutical research, the medical treatment of chronic idiopathic constipation is far from ideal. The aim of the present article was to review literature data, focusing on poorly studied or commercially unavailable/unapproved drugs potentially useful for the treatment of chronic idiopathic constipation in adults. An extensive online literature search was conducted using the keywords “chronic constipation”, “colon”, “constipation”, “drugs”, “laxatives”, and “treatment”, in various combinations between January 1960 and December 2022. The literature search showed the presence of some drugs whose efficacy has only recently been demonstrated by modern investigations, and which are likely to be incorporated into future guidelines, of others that are proven effective and potentially effective on constipated patients but limited by small or relatively old studies, or by side effects which could be used in experienced hands, and of others that might be useful but lack a solid scientific background. Looking into the future for patients with chronic constipation might add some more tools to the therapeutic portfolio, especially for certain subgroups of these patients.

Integrated metabolic profiles and microbial communities to reveal the beneficial effect of red pitaya on early constipation

“…It is considered to be related to the intestinal nervous system, gastrointestinal Kakhar interstitial cells, abnormal levels of gastrointestinal hormones, changes of gastrointestinal neurotransmitters, intestinal flora, psychological factors, gastrointestinal smooth muscle, and other factors. 31 Fecal excretion relies on the coordinated movement of the colon, and colonic dysmotility is one of the important mechanisms underlying constipation. Weakening of the pelvic floor muscle can lead to shorter contraction time, resulting in difficulty with defecation, thus pelvic floor muscle dysfunction is also one of the mechanisms of constipation.…”

Broccoli-Derived Exosome-like Nanoparticles Alleviate Loperamide-Induced Constipation, in Correlation with Regulation on Gut Microbiota and Tryptophan Metabolism

“…It is often accompanied by many bothersome and uncomfortable symptoms including difficult or infrequent passage of stool, lumpy or hard stools, and sensation of incomplete evacuation or blockage, which considerably damage patients’ quality of life, psychological status, and stability of pre-existing diseases (e.g., cardiovascular disease) . Current medications available for treating constipation mainly include laxatives, secretagogues, serotonergic agonists, and suppositories . However, they usually cannot eradicate constipation and may cause drug dependence and side effects, such as flatulence, bloating, abdominal pain, and kidney and cardiovascular damage .…”

“…Current medications available for treating constipation mainly include laxatives, secretagogues, serotonergic agonists, and suppositories . However, they usually cannot eradicate constipation and may cause drug dependence and side effects, such as flatulence, bloating, abdominal pain, and kidney and cardiovascular damage . Besides, dietary fiber, an emerging therapy against constipation, is not widely promoted due to gas and abdominal discomfort .…”