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New joint guideline on chronic idiopathic constipation is first to recommend magnesium oxide and senna

Ten recommendations to guide pharmacological management of CIC.

New guidelines for the pharmacological treatment of chronic idiopathic constipation (CIC) in adults are the first to recommend magnesium oxide and senna as evidence-based treatments. The first joint clinical practice guideline developed by AGA and ACG published today in both societies’ scientific journals, ACG’s The American Journal of Gastroenterology and AGA’s Gastroenterology. An accompanying Clinical Support Decision Tool is available in Gastroenterology.

Under the leadership of Lin Chang, MD, AGAF, FACG, and William D. Chey, MD, AGAF, FACG, a multidisciplinary guideline panel conducted systematic reviews of various over-the-counter and prescription pharmacological agents available for the treatment of CIC: fiber, osmotic laxatives (polyethylene glycol, magnesium oxide, lactulose), stimulant laxatives (bisacodyl, sodium picosulfate, senna), secretagogues (lubiprostone, linaclotide, plecanatide), and serotonin type 4 agonist (prucalopride).

Among their 10 recommendations for the pharmacological management of CIC in adults, based on available evidence, the panel made strong recommendations for the use of polyethylene glycol, sodium picosulfate, linaclotide, plecanatide, and prucalopride for CIC in adults. Conditional recommendations were made for the use of fiber, lactulose, senna, magnesium oxide, and lubiprostone.

Read AGA-ACG Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation in June’s issue of Gastroenterology