Managing Chronic Constipation From Constipating Medicines

Authors: Nicholas J. Talley, MD, PhD


Chronic constipation is remarkably common; 10 to 15% of the US population reports infrequent stools, difficult stool passage or both, and this problem increases with advancing age.1 Presumably, the age association reflects a higher prevalence of other causes of constipation, such as medication use, although this remains poorly documented. Many medications have been associated with chronic constipation. In one large general practitioner database from the United Kingdom, opioids, diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants and aluminum antacids were associated with the highest risk of medication-induced constipation.2For patients with medication-induced constipation, therapy has been empirical; clinical trials have not usually been directed at this subset and indeed, many trials have excluded patients with medication-induced constipation when testing new therapies.

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