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Guideline

Pharmacological management of chronic idiopathic constipation

In this joint guideline from AGA and ACG, experts provide 10 recommendations for managing chronic idiopathic constipation (CIC) in adults.

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Recommendations

1. In adults with CIC, the panel suggests the use of fiber supplementation over management without fiber supplements.

2. In adults with CIC, the panel recommends the use of polyethylene glycol (PEG) compared with management without PEG.

3. In adults with CIC, the panel suggests the use of magnesium oxide over management without magnesium oxide.

4. In adults with CIC who fail or are intolerant to over-the-counter (OTC) therapies, the panel suggests the use of lactulose over management without lactulose.

5. In adults with CIC, the panel recommends the use of bisacodyl or sodium picosulphate short term or as rescue therapy over management without bisacodyl or sodium picosulphate.

6. In adults with CIC, the panel suggests the use of senna over management without senna.

7. In adults with CIC who do not respond to OTC agents, the panel suggests the use of lubiprostone over management without lubiprostone.

8. In adults with CIC who do not respond to OTC agents, the panel recommends the use of linaclotide over management without linaclotide.

9. In adults with CIC who do not respond to OTC agents, the panel recommends the use of plecanatide over management without plecanatide.

10. In adults with CIC who do not respond to OTC agents, the panel recommends the use of prucalopride over management without prucalopride.

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