Pharmacological Management of Chronic Idiopathic Constipation

Publication Date: May 19, 2023
Last Updated: October 25, 2023

Fiber

Recommendation 1

In adults with CIC, the panel suggests the use of fiber supplementation over management without fiber supplements. (C, L)
Implementation considerations:a
  • Dietary assessment is important to determine total fiber intake from diet and supplements
  • Fiber supplements can be used as first-line therapy for CIC, particularly for individuals with low dietary fiber intake
  • Among the evaluated fiber supplements, only psyllium appears to be effective (with very limited and uncertain data on bran and inulin)
  • Adequate hydration should be encouraged with the use of fiber
  • Flatulence is a commonly observed side effect with the use of fiber
620

Osmotic laxatives

Recommendation 2

In adults with CIC, the panel recommends the use of PEG compared with management without PEG. (S, M)
Implementation considerations:a
  • A trial of fiber supplement can be considered for mild constipation before PEG use or in combination with PEG
  • Response to PEG has been shown to be durable over 6 mo
  • Side effects include abdominal distension, loose stool, flatulence, and nausea
620

Overview

Title

Pharmacological Management of Chronic Idiopathic Constipation

Authoring Organizations