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Koga J, Ojiro K, Yanagida A, Suto T, Hiki H, Inoue Y, Sakai C, Nakamoto K, Fujisawa Y, Orihara A, Murakami H, Hirasawa S, Nakajima K, Sakazawa T, Yamane H. Ingestion of Indigestible Cacao Proteins Promotes Defecation and Alters the Intestinal Microbiota in Mice. Curr Dev Nutr 2022; 6:nzac129. [PMID: 36204331 PMCID: PMC9529219 DOI: 10.1093/cdn/nzac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/26/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background In animals, the health effects of ingested cacao proteins are unknown because the proteins are difficult to extract and purify from cacao beans. Objectives This study aimed to develop an extraction and purification method for cacao proteins and reveal the effect of ingestion of cacao proteins on defecation and intestinal microbiota in mice. Methods Three groups of mice were fed a control diet (AIN-93 G), a cacao lignin diet (AIN-93 G containing 1.22% cacao lignin), or a cacao protein and lignin diet (AIN-93 G containing 1.97% cacao proteins and 1.22% cacao lignin) by pair-feeding for 8 d. Feces were collected as 2 bulked samples from days 1 to 4 and days 5 to 8 on each diet. The collected feces were weighed and the intestinal microbiota was analyzed by next-generation sequencing-based 16S rRNA. Results A new extraction and purification method for cacao proteins has been developed, then found that the proteins are resistant to digestive enzymes. However, the cacao protein powder made by this method contained 34.9% of lignin in addition to 56.4% of proteins. Therefore, to reveal the effect by cacao proteins alone, the fecal weight and intestinal microbiota of mice fed the cacao protein and lignin diet were compared with those of mice fed the cacao lignin diet. The fecal weight of mice fed the cacao protein and lignin diet was significantly greater than of mice fed the cacao lignin diet. The relative abundance of Lactococcus and Mucispirillum species in mice fed the cacao protein and lignin diet was significantly higher than in mice fed the cacao lignin diet, but the relative abundance of Anaerotruncus, Oscillospira, and Roseburia species in mice fed the cacao protein and lignin diet was significantly lower than in mice fed the cacao lignin diet. Conclusions Ingestion of indigestible cacao proteins promoted defecation and altered the intestinal microbiota such as Lactococcus, Mucispirillum, Anaerotruncus, Oscillospira, and Roseburia species in mice.
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Affiliation(s)
- Jinichiro Koga
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Kota Ojiro
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Ayumi Yanagida
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Takahisa Suto
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Hideaki Hiki
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Yuki Inoue
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Chihiro Sakai
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Kohei Nakamoto
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Yuta Fujisawa
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Ayaka Orihara
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Haruka Murakami
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Shintaro Hirasawa
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Kengo Nakajima
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Tomoko Sakazawa
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
| | - Hisakazu Yamane
- Department of Biosciences, School of Science and Engineering, Teikyo University, Utsunomiya, Tochigi, Japan
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Association between Dietary Factors and Constipation in Adults Living in Luxembourg and Taking Part in the ORISCAV-LUX 2 Survey. Nutrients 2021; 14:nu14010122. [PMID: 35010999 PMCID: PMC8746799 DOI: 10.3390/nu14010122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022] Open
Abstract
Constipation, a disorder of bowel movements, is among the most frequent gastrointestinal complaints in Western countries. Dietary constituents such as inadequate fiber intake have been related to constipation, but discrepancies exist in the findings regarding dietary factors. This study investigated the association between dietary patterns and bowel movements in adults living in Luxembourg. Data from 1431 participants from ORISCAV-LUX 2 (a cross-sectional survey) who completed a 174-item food frequency questionnaire (FFQ) were analyzed. A questionnaire-based constipation score was assessed by a validated scoring system. Confounders such as physical activity and serum/urine indicators were assessed. Women had higher constipation scores than men (p < 0.001). In food group-based regression models, a negative association was found between higher constipation score and intake of grains (Beta = −0.62, 95%CI: −1.18, −0.05) and lipid-rich foods (Beta = −0.84, 95%CI: −1.55, −0.13), while a positive association was found for sugary products (Beta = 0.54, 95%CI: 0.11, 0.97) (p < 0.05). In a nutrient-based regression model, a positive association was found between constipation score and total energy (Beta = 5.24, 95%CI: 0.37, 10.11) as well as sodium intake (Beta = 2.04, 95%CI: 0.21, 3.87), and a negative one was found for total fats (Beta = −4.17, 95%CI: −7.46, −0.89) and starch (Beta = −2.91, 95%CI: −4.47, −1.36) (p < 0.05). Interestingly, neither fruits and vegetables or dietary fiber were significantly associated with constipation. Thus, grains, lipid-rich foods, total fats and starch were associated with a lower constipation score, while sugary products, sodium, and higher energy intake were correlated with higher constipation.
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Wang L, Hu L, Xu Q, Yin B, Fang D, Wang G, Zhao J, Zhang H, Chen W. Bifidobacterium adolescentis Exerts Strain-Specific Effects on Constipation Induced by Loperamide in BALB/c Mice. Int J Mol Sci 2017; 18:ijms18020318. [PMID: 28230723 PMCID: PMC5343854 DOI: 10.3390/ijms18020318] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 12/12/2022] Open
Abstract
Constipation is one of the most common gastrointestinal complaints worldwide. This study was performed to determine whether Bifidobacterium adolescentis exerts inter-strain differences in alleviating constipation induced by loperamide in BALB/c mice and to analyze the main reasons for these differences. BALB/c mice underwent gavage with B. adolescentis (CCFM 626, 667, and 669) once per day for 17 days. The primary outcome measures included related constipation indicators, and the secondary outcome measures were the basic biological characteristics of the strains, the concentration changes of short-chain fatty acids in feces, and the changes in the fecal flora. B. adolescentis CCFM 669 and 667 relieved constipation symptoms by adhering to intestinal epithelial cells, growing quickly in vitro and increasing the concentrations of propionic and butyric acids. The effect of B. adolescentis on the gut microbiota in mice with constipation was investigated via 16S rRNA metagenomic analysis. The results revealed that the relative abundance of Lactobacillus increased and the amount of Clostridium decreased in the B. adolescentis CCFM 669 and 667 treatment groups. In conclusion, B. adolescentis exhibits strain-specific effects in the alleviation of constipation, mostly due to the strains’ growth rates, adhesive capacity and effects on the gut microbiome and microenvironment.
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Affiliation(s)
- Linlin Wang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Lujun Hu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Qi Xu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Boxing Yin
- Kangyuan Dairy Co., Ltd., Yangzhou University, Yangzhou 225004, China.
| | - Dongsheng Fang
- Kangyuan Dairy Co., Ltd., Yangzhou University, Yangzhou 225004, China.
| | - Gang Wang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China.
- International Joint Research Laboratory for Probiotics, Jiangnan University, Wuxi 214122, China.
- Beijing Innovation Centre of Food Nutrition and Human Health, Beijing Technology and Business University (BTBU), Beijing 100048, China.
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Cudmore S, Doolan A, Lacey S, Shanahan F. A randomised, double-blind, placebo-controlled clinical study: the effects of a synbiotic, Lepicol, in adults with chronic, functional constipation. Int J Food Sci Nutr 2016; 68:366-377. [PMID: 27776217 DOI: 10.1080/09637486.2016.1244661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The study objective was to evaluate the safety and effects of Lepicol® (pysllium fibre, inulin and 5 probiotic strains) in adults with chronic, functional constipation during a 4 week intervention. 69 subjects with functional constipation according to Rome III criteria were randomised to receive Lepicol (n = 35) or placebo (n = 34) daily. Both groups had improved frequency of bowel movements, with an increase of 1.082 bowel movements in the Lepicol group over placebo after one week, and 1.079 more than placebo after week 2, but with no significant difference at week 4. Both groups showed significant improvements in quality of life scores at 4 weeks, with the average score being 12.033% better in the Lepicol group, which also had 15.2% improvement in intensity of symptoms and 28.5% increase in satisfaction with quality of life compared to the placebo. Symptoms of constipation improved to a greater degree and there was a significant reduction in laxative use in the Lepicol group.
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Affiliation(s)
- Sally Cudmore
- a Atlantia Food Clinical Trials, Cork , Ireland.,b APC Microbiome Institute, University College Cork , Cork , Ireland
| | | | - Seán Lacey
- c Department of Mathematics , Cork Institute of Technology , Cork , Ireland
| | - Fergus Shanahan
- a Atlantia Food Clinical Trials, Cork , Ireland.,b APC Microbiome Institute, University College Cork , Cork , Ireland.,d Cork University Hospital, School of Medicine, University College Cork , Cork , Ireland
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Drewes AM, Munkholm P, Simrén M, Breivik H, Kongsgaard UE, Hatlebakk JG, Agreus L, Friedrichsen M, Christrup LL. Definition, diagnosis and treatment strategies for opioid-induced bowel dysfunction–Recommendations of the Nordic Working Group. Scand J Pain 2016; 11:111-122. [DOI: 10.1016/j.sjpain.2015.12.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/12/2015] [Indexed: 02/07/2023]
Abstract
Abstract
Background and aims
Opioid-induced bowel dysfunction (OIBD) is an increasing problem due to the common use of opioids for pain worldwide. It manifests with different symptoms, such as dry mouth, gastro-oesophageal reflux, vomiting, bloating, abdominal pain, anorexia, hard stools, constipation and incomplete evacuation. Opioid-induced constipation (OIC) is one of its many symptoms and probably the most prevalent. The current review describes the pathophysiology, clinical implications and treatment of OIBD.
Methods
The Nordic Working Group was formed to provide input for Scandinavian specialists in multiple, relevant areas. Seven main topics with associated statements were defined. The working plan provided a structured format for systematic reviews and included instructions on how to evaluate the level of evidence according to the GRADE guidelines. The quality of evidence supporting the different statements was rated as high, moderate or low. At a second meeting, the group discussed and voted on each section with recommendations (weak and strong) for the statements.
Results
The literature review supported the fact that opioid receptors are expressed throughout the gastrointestinal tract. When blocked by exogenous opioids, there are changes in motility, secretion and absorption of fluids, and sphincter function that are reflected in clinical symptoms. The group supported a recent consensus statement for OIC, which takes into account the change in bowel habits for at least one week rather than focusing on the frequency of bowel movements. Many patients with pain receive opioid therapy and concomitant constipation is associated with increased morbidity and utilization of healthcare resources. Opioid treatment for acute postoperative pain will prolong the postoperative ileus and should also be considered in this context. There are no available tools to assess OIBD, but many rating scales have been developed to assess constipation, and a few specifically address OIC. A clinical treatment strategy for OIBD/OIC was proposed and presented in a flowchart. First-line treatment of OIC is conventional laxatives, lifestyle changes, tapering the opioid dosage and alternative analgesics. Whilst opioid rotation may also improve symptoms, these remain unalleviated in a substantial proportion of patients. Should conventional treatment fail, mechanism-based treatment with opioid antagonists should be considered, and they show advantages over laxatives. It should not be overlooked that many reasons for constipation other than OIBD exist, which should be taken into consideration in the individual patient.
Conclusion and implications
It is the belief of this Nordic Working Group that increased awareness of adverse effects and OIBD, particularly OIC, will lead to better pain treatment in patients on opioid therapy. Subsequently, optimised therapy will improve quality of life and, from a socio-economic perspective, may also reduce costs associated with hospitalisation, sick leave and early retirement in these patients.
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Affiliation(s)
- Asbjørn M. Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology , Aalborg University Hospital , Hobrovej Denmark
| | - Pia Munkholm
- NOH (Nordsjællands Hospital) Gastroenterology , Hillerød Denmark
| | - Magnus Simrén
- Department of Internal Medicine & Clinical Nutrition , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Göteborg Sweden
| | - Harald Breivik
- Department of Pain Management and Research , Oslo University Hospital and University of Oslo , Rikshospitalet Norway
| | - Ulf E. Kongsgaard
- Department of Anaesthesiology, Division of Emergencies and Critical Care , Oslo University Hospital, Norway and Medical Faculty, University of Oslo , Rikshospitalet Norway
| | - Jan G. Hatlebakk
- Department of Clinical Medicine , Haukeland University Hospital , Bergen , Norway
| | - Lars Agreus
- Division of Family Medicine , Karolinska Institute , Stockholm , Sweden
| | - Maria Friedrichsen
- Department of Social and Welfare Studies , Faculty of Medicine and Health Sciences , Norrköping , Sweden
| | - Lona L. Christrup
- Department of Drug Design and Pharmacology , Faculty of Health Sciences, University of Copenhagen , københavn Denmark
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Abstract
Chronic constipation is a very common disease in children. Successful treatment of constipation can be achieved not only with medication but also with lifestyle changes, including a proper diet. Diets including fruits, fluids, and probiotics are good for constipation. Some dietary components are helpful for constipation, and some are harmful. In this study, we present diets related to constipation from the literature, and propose some perspectives regarding diets related to constipation.
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Affiliation(s)
- Sun Hwan Bae
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
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The future of probiotics for disorders of the brain-gut axis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 817:417-32. [PMID: 24997045 DOI: 10.1007/978-1-4939-0897-4_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Probiotics, or at the very least products that might have probiotic properties, have been with us for decades, if not centuries, but it has only been in recent years that they have been subjected to serious scientific study. This surge in interest in probiotics has coincided with the era of the microbiome; as more and more is understood about the gut microbiota in health and disease, the therapeutic option of modulating the microbiota through the administration of probiotics has gained a more secure foundation. Regrettably, while a vast literature attests to the beneficial impact of probiotics in a variety of animal models and the mechanisms underlying such positive effects have been dissected in great detail, the data base on probiotics in man remains pretty slender.To make progress, a number of basic issues need to be addressed: strain characterization and other aspects of quality control need to be rigorously applied and additional steps such as dose optimization, definition of desired site of effect and tailoring of formulation accordingly accomplished before large scale trials, based on appropriately selected study endpoints and employing a clinically meaningful study duration, are embarked upon. Meantime, it is to be hoped that the regulatory climate will have been clarified and appropriate guidelines for the evaluation of probiotics, whether as food or drug, developed. Ultimately, the current terminology may have to be abandoned as evidence for biological and clinical activity for dead bacteria, bacterial components and bacterial products accumulates.
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Lee YY. What's New in the Toolbox for Constipation and Fecal Incontinence? Front Med (Lausanne) 2014; 1:5. [PMID: 25705618 PMCID: PMC4335388 DOI: 10.3389/fmed.2014.00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 03/13/2014] [Indexed: 12/11/2022] Open
Abstract
Constipation and fecal incontinence (FI) are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multi-factorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut-brain-microbiota axis. Initial approach to management should always be the exclusion of secondary causes. Mild symptoms can be approached with conservative measures that may include dietary modifications, exercise, and medications. New prokinetics (e.g., prucalopride) and secretagogues (e.g., lubiprostone and linaclotide) are effective and safe in constipation. Biofeedback is the treatment of choice for dyssynergic defecation. Refractory constipation may respond to neuromodulation therapy with colectomy as the last resort especially for slow-transit constipation of neuropathic origin. Likewise, in refractory FI, less invasive approach can be tried first before progressing to more invasive surgical approach. Injectable bulking agents, sacral nerve stimulation, and SECCA procedure have modest efficacy but safe and less invasive. Surgery has equivocal efficacy but there are promising new techniques including dynamic graciloplasty, artificial bowel sphincter, and magnetic anal sphincter. Despite being challenging, there are no short of alternatives in our toolbox for the management of constipation and FI.
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Affiliation(s)
- Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia , Kota Bharu , Malaysia ; Section of Gastroenterology and Hepatology, Department of Medicine, Medical College of Georgia, Georgia Regents University , Augusta, GA , USA
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Layer P. Management of irritable bowel syndrome with constipation: a flexible approach to treating a complex condition with multiple symptoms. Expert Rev Gastroenterol Hepatol 2013; 7:9-14. [PMID: 23859755 DOI: 10.1586/17474124.2013.820049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Irritable bowel syndrome is a heterogeneous disease with a complex underlying pathophysiology and multiple symptoms - that is, clinical manifestation patterns. As such, management of irritable bowel syndrome requires a flexible approach tailored to the individual patient. This article reviews rational, evidence-based management strategy and treatment options for this variable condition.
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Affiliation(s)
- Peter Layer
- Medizinische Klinik, Israelitisches Krankenhaus in Hamburg, Orchideenstieg 14, 22297 Hamburg, Germany.
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Johnston JM, Shiff SJ, Quigley EMM. A review of the clinical efficacy of linaclotide in irritable bowel syndrome with constipation. Curr Med Res Opin 2013. [PMID: 23198977 DOI: 10.1185/03007995.2012.754743] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aims were: firstly, to review the definition and diagnosis of irritable bowel syndrome with constipation (IBS-C, a subtype of IBS); secondly, to critically assess current therapies for IBS-C with a focus on effectiveness for abdominal pain; and thirdly, to review clinical studies evaluating the efficacy of linaclotide, a therapy recently approved by the US Food and Drug Administration for the treatment of adults with IBS-C and chronic idiopathic constipation and the European Medicines Agency for the symptomatic treatment of moderate to severe IBS-C in adults, and in development for treatment of IBS-C worldwide. METHODS A comprehensive literature review was performed to summarize IBS-C and current treatments. MEDLINE and gastrointestinal society congress proceedings were searched to identify data from linaclotide clinical studies in adults with IBS-C published between January 2010 and August 2012. RESULTS IBS-C patients have chronic, relapsing symptoms. Rome III diagnostic criteria define the presence of chronic abdominal pain that improves with defecation and has onset associated with changes in stool frequency or form as a key element of IBS-C and other IBS subtypes. IBS-C patients generally are not completely satisfied with existing therapies. A therapy that treats bowel and abdominal symptoms effectively and can be taken safely on a chronic basis is a current unmet need for IBS-C patients. The guanylate cyclase-C agonist linaclotide has been shown to reduce visceral hypersensitivity in preclinical studies and to improve abdominal pain and constipation symptoms in phase 2 and 3 clinical trials of IBS-C patients. CONCLUSIONS IBS-C is a functional gastrointestinal disorder with chronic, relapsing abdominal and constipation symptoms. By virtue of its effects in relieving abdominal pain by reducing visceral hypersensitivity and improving constipation symptoms by increasing intestinal secretion and accelerating transit, linaclotide may be uniquely positioned for a role in the management of IBS-C patients.
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