Medical Treatments
Many treatment options
Fortunately, a number of treatment options are available for patients with constipation. This is supported by advanced medical diagnostics that are increasingly able to pin down underlying causes, necessary for accurate treatment. If the diagnosis is successful and the causes are known, then treating the underlying condition can alleviate constipation.
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If the causes are not known (idiopathic or functional constipation), patients will benefit from the wide repertory of medications with diverse modes of action to maximize treatment success. Patients who are not seeking constipation medication can turn to first line fiber therapy or biofeedback to relieve symptoms of constipation.
Amitiza as a constipation treatment
Amitiza is currently the only kind of constipation medication available for patients who suffer from chronic idiopathic constipation. Idiopathic means that the cause is unknown. Clinical studies show that Amitiza can speed up colonic transit.
Misconceptions about laxatives as constipation treatments
Patients continue to search for the best laxative. Laxatives have been blamed for nerve damage, excessive dependence, tolerance, and rebound constipation. However, many of these criticisms do not hold up against scientific studies of constipation medication.
Water-binding and bulk laxatives as constipation treatments
Although there may not be a best laxative, there are a number of choices to try. Water-binding laxatives work as constipation medication by retention of fluids. This is accomplished through competing for water absorption with the gut. The presence of such laxatives means more lubrication to ease the movement of material through the gastrointestinal tract. Bulk laxatives are another word for the same, since the intended effect to "bulk" up the stool.
Stimulating laxatives as constipation treatments
Some find the best laxative to be the stimulant laxatives. The stimulating laxatives similarly affect water retention as bulk laxatives but have an additional effect of stimulating the smooth muscles. Therefore they are like dual-action constipation medication. They are not the same as the prokinetic agents which trigger cellular receptors that flood the gut with acetylcholine.
Prokinetic agents as constipation treatments
Prokinetics were considered by some to be the best laxative, but these constipation medication were at one point successful laxative treatments ended up being taken off the market due to evidence that they had adverse effects on heart function. However, newer medications of the same class are close to being approved by the FDA. Some discussion is warranted to keep patients abreast of new developments in constipation treatments.
Linaclotide as a constipation treatment
Most of the time, new constipation medication are variants or improved versions of existing drugs. However, linaclotide is an exciting compound with a novel mode of action that has successfully passed some preliminary FDA trials. Medicines with new modes of action offer a choice especially to patients who do not respond well to existing therapies.
Prucalopride as a constipation treatment
As described above, several years ago, a class of constipation medicaton compounds known as prokinetic agents for constipation were withdrawn from the market for fears of side effects on cardiovascular function. The side effects were thought to be due to "off-target" effects of prokinetic agents. Basically, the drugs were interacting unintentionally with cellular receptors. However, prucalopride was designed to be highly specific to its designated target, the 5-HT4 receptor. Recent clinical trials hint at the possibility of access to these new constipation treatments.