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Pharmacological Management of Chronic Idiopathic Constipation

Publication Date: May 18, 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

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Overview

Title

Pharmacological Management of Chronic Idiopathic Constipation

Authoring Organizations