Marian Bátovský
Chronic constipation without an organic cause is either the main symptom of irritable bowel syndrome with constipation (IBS-C) or of chronic idiopathic constipation (CIC). The systematic review of the therapy for IBS-C with assessment of the efficacy of available drugs showed the best results for prosecretory agents: linaclotide and lubiprostone. For the CIC therapy there were recommend four preparations which are available also in Slovakia: selective 5-HT4 receptors agonist prucalopride, stimulant laxatives sodium picosulphate and bisacodyl and osmotic laxative polyethylene glycol. The prosecretory agent linaclotide and lubiprostone and serotonergic agent velusetrag are not registered in Slovakia. The bile acid transporter inhibitor A3309 has been proposed as a potential treatment for CIC. Prucalopride, a selective 5-HT4 agonist, demonstrates positive efficacy findings in three placebo-controlled studies involving 1 974 patients with chronic constipation. Based largely on the data from these pivotal studies, prucalopride was approved within EU in 2009 for the symptomatic treatment of chronic constipation in women in whom laxatives fail to provide adequate relief.