Therapeutic Research

Abstract

Background：Chronic constipation affects between 2 and 5％ of the Japanese population. Traditionally, stimulant laxatives were frequently used in Japan because laxatives mixed with senna were available in the pharmacy without a prescription. Linaclotide, a guanylate cyclase C receptor agonist, is approved in Japan as a new drug to treat a patient with irritable bowel syndrome with constipation in 2017. Objectives：We aimed to determine the efficacy and safety of linaclotide in patients with chronic constipation. Method：Forty –four patients with chronic constipation were treated with linaclotide once daily. Patients rated abdominal symptoms 2 weeks after treatment and judged whether linaclotide treatment was continued. Results：68％ of patients switched from lubiprostone decreased abdominal symptoms and 73％ desired the continuation of linaclotide treatment, whereas 86％ of patients without lubiprostone treatment judged the improvement of constipation. For patients treated with stimulant laxatives, 76％ determined that linaclotide was effective and 82％ continued linaclotide treatment. Conclusion：Linaclotide is an effective treatment for chronic constipation patients with a past history of treatment failures with lubiprostone as well as stimulant laxatives.