Korean J Med.
2015 Jan;88(1):22-26. 10.3904/kjm.2015.88.1.22.
Guidelines for the Use of Laxatives: Which Laxatives, When?
- Affiliations
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- 1Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
- 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.
- 4Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
- 6Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
- 7Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 8Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
- 9Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 10Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea. medcsc@wmc.wonkwang.ac.kr
- KMID: 2269165
- DOI: http://doi.org/10.3904/kjm.2015.88.1.22
Abstract
- To manage chronic constipation, dietary and lifestyle modifications should be tried before pharmacological intervention. Although there is no standardized treatment guideline for medical practice, the key considerations in the choice of laxative include the treatment duration, dosing schedule, type of agent, effects and side effects of the agent, and cost. The first-line treatment is a bulking or osmotic laxative. If the patient is still symptomatic, the physician can add or switch to other laxatives. Next, prucalopride, a highly selective 5-hydroxytryptamine 4 (5-HT4) receptor agonist, could be considered. If the constipation is refractory to combination therapy with conventional laxatives and prucalopride, patients should be referred for further evaluation, including physiological testing.
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