Exploring Pharmacological Treatments for Chronic Idiopathic Constipation in Adults: A Look Back to the Future

Despite great progress in pharmaceutical research, the medical treatment of chronic idiopathic constipation is far from ideal. The aim of the present article was to review literature data, focusing on poorly studied or commercially unavailable/unapproved drugs potentially useful for the treatment of chronic idiopathic constipation in adults. An extensive online literature search was conducted using the keywords chronic constipation, colon, constipation, drugs, laxatives, and treatment, in various combinations between January 1960 and December 2022. The literature search showed the presence of some drugs whose efficacy has only recently been demonstrated by modern investigations, and which are likely to be incorporated into future guidelines, of others that are proven effective and potentially effective on constipated patients but limited by small or relatively old studies, or by side effects which could be used in experienced hands, and of others that might be useful but lack a solid scientific background. Looking into the future for patients with chronic constipation might add some more tools to the therapeutic portfolio, especially for certain subgroups of these patients.

Automated summary

Despite progress in pharmaceutical research, medical treatment for chronic idiopathic constipation still has room for improvement. This article reviews literature data on drugs that are poorly studied, commercially unavailable, or unapproved, but potentially useful for treating chronic idiopathic constipation in adults. The literature search reveals drugs with recently proven efficacy, likely to be included in future guidelines, as well as drugs with limited evidence from small or outdated studies or associated side effects that could be used with caution by experienced practitioners. Some drugs also lack a solid scientific background but may have potential in the future. Looking ahead, additional therapeutic options may be available for certain subgroups of patients with chronic constipation.