title: New Options in Constipation Management.
abstract: Constipation is common in the general population and for those on opioids and/or who are suffering from advanced cancer. Self-management consists of dietary changes, exercise, and laxatives. However, responses to self-management efforts are often inadequate to relieve the subjective and objective experience of constipation. Multiple new anti-constipating medications have recently been tested in randomized trials and the following are available commercially: probiotics, prucalopride, lubiprostone, linaclotide, elobixibat, antidepressants, methylnaltrexone, alvimopan, and naloxegol. This review will discuss the evidence-based benefits of these medications and outline an approach to managing constipation.
authors.affiliation: Cleveland Clinic Lerner School of Medicine Case, Western Reserve University, 9500 Euclid Avenue, T34, Cleveland, OH, 44195, USA. davism6@ccf.org.|Clinical Fellowship Program, Cleveland, OH, USA. davism6@ccf.org.|Palliative Medicine and Supportive Oncology Services, Taussig Cancer Institute, Cleveland, OH, USA. davism6@ccf.org.
authors.forename: Mellar
authors.initials: M
authors.lastname: Davis
authors.affiliation: Cleveland Clinic Lerner School of Medicine Case, Western Reserve University, 9500 Euclid Avenue, T34, Cleveland, OH, 44195, USA.|Clinical Fellowship Program, Cleveland, OH, USA.|Palliative Medicine and Supportive Oncology Services, Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gamier
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects; D002352:Carrier Proteins / Q000037:antagonists & inhibitors; D065101:Chloride Channel Agonists / Q000627:therapeutic use; D003248:Constipation / Q000188:drug therapy* / Q000209:etiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use*; D008562:Membrane Glycoproteins / Q000037:antagonists & inhibitors; D009369:Neoplasms / Q000150:complications; D019936:Probiotics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
chemical_list: D000701:Analgesics, Opioid; D002352:Carrier Proteins; D065101:Chloride Channel Agonists; D005765:Gastrointestinal Agents; D054368:Laxatives; D008562:Membrane Glycoproteins; C037643:bile acid binding proteins
keywords: Antagonist; Constipation; Linaclotide; Lubiprostone; Mu receptor; Probiotics; Prokinetics; Transporter