Lubiprostone for the treatment of adults with constipation and irritable bowel syndrome

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Chronic constipation and IBS-C are two of the most common functional bowel disorders encountered by primary care providers and gastroenterologists, affecting up to 27% of the population in Western countries [1-4]. The treatment of these disorders is often empiric and most current therapies are indicated for episodic constipation. Over time, most patients become refractory to one or more laxatives. Lubiprostone (Amitiza) has been approved by the US Food and Drug Administration (FDA) for the treatment of chronic-idiopathic constipation [6]. It is an oral bicyclic fatty acid that selectively activates type 2 chloride channels in the apical membrane of the intestinal epithelial cells, hence stimulating chloride secretion, along with passive secretion of sodium and water, inducing peristalsis and laxation, without stimulating gastrointestinal smooth muscle. Several trials have shown it to be effective in the treatment of chronic idiopathic constipation, and recently also IBS-C. It has little systemic absorption and almost free of any serious adverse effects, however, occasionally can cause nausea. Based on the available evidence, it is reasonable to conclude that lubiprostone should be added to the short list of evidence-based pharmacotherapies for chronic constipation and IBS-C. Given the overlap between chronic constipation and IBS-C, clinicians can consider two strategies when deciding on the initial dose of lubiprostone. Based on current product labeling, it is recommended that 8 μg bid be started in patients with IBS-C whereas 24 μg bid be used in those with chronic constipation. Thus far, lubiprostone offers a novel approach to our therapeutic armamentarium, however, there is a need for more drugs with different mechanisms of action, in order to treat constipation that is often multifunctional.

Original languageEnglish (US)
Pages (from-to)1619-1625
Number of pages7
JournalDigestive Diseases and Sciences
Volume56
Issue number6
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

Fingerprint

Irritable Bowel Syndrome
Constipation
Therapeutics
Product Labeling
Peristalsis
Laxatives
Chloride Channels
Lubiprostone
United States Food and Drug Administration
Nausea
Smooth Muscle
Chlorides
Primary Health Care
Fatty Acids
Epithelial Cells
Sodium
Drug Therapy
Membranes
Water
Pharmaceutical Preparations

Keywords

  • Chloride channels (ClCs)
  • Chronic idiopathic constipation
  • Clinical efficacy
  • IBS-C
  • Lubiprostone
  • Safety and tolerability
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Lubiprostone for the treatment of adults with constipation and irritable bowel syndrome. / Schey, Ron; Rao, Satish Sanku Chander.

In: Digestive Diseases and Sciences, Vol. 56, No. 6, 01.06.2011, p. 1619-1625.

Research output: Contribution to journalReview article

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