| New Generation Laxatives |
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Sung Noh Hong1, Jeong Eun Shin2, Kyoung Sup Hong3, Kee Wook Jung4, Tae Hee Lee5, Bong Eun Lee6, Sun-Young Park7, Seong-Eun Kim8, Kyung Sik Park9, Suck Chei Choi10, Constipation Research group of the Korean Society of Neurogastroenterology and Motility |
1Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
4Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
5Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
6Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
7Department of Internal Medicine, Chonnam National University Medical School, Gwangju, 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 |
| 차세대 완하제 |
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홍성노1, 신정은2, 홍경섭3, 정기욱4, 이태희5, 이봉은6, 박선영7, 김성은8, 박경식9, 최석채10, 대한소화기기능성질환ㆍ운동학회 변비 및 항문직장기능 연구회 |
1성균관대학교 의과대학 내과학교실
2단국대학교 의과대학 내과학교실
3서울대학교 의과대학 내과학교실
4울산대학교 의과대학 소화기내과학교실
5순천향대학교 의과대학 소화기연구소
6부산대학교 의과대학 내과학교실
7전남대학교 의과대학 내과학교실
8이화여자대학교 의학전문대학원 내과학교실
9계명대학교 의과대학 내과학교실
10원광대학교 의과대학 내과학교실 및 소화기질환 연구소 |
Correspondence:
Kyung Sik Park, Tel: +82-53-250-7088, Fax: +82-53-250-7088, Email: seenae99@dsmc.or.kr
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Abstract |
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A significant proportion of chronic constipation patients are dissatisfied with their treatment. Recently, a number of new medications have been introduced for patients refractory to conventional laxatives, such as prucalopride, lubiprostone, linaclotide, and elobixibat. Prucalopride is a novel gastrointestinal prokinetic agent that acts as a 5-hydroxytryptamine type 4 (5-HT4) agonist. Compared with older nonselective 5-HT4 agonists, the higher selectivity of prucalopride for 5-HT4 receptors can reduce the risk of significant adverse cardiovascular events. Prucalopride improves stool frequency and consistency, and reduces the need for rescue medications. Lubiprostone, a chloride channel activator, increases the secretion of intestinal fluid, improves the stool frequency and consistency, and reduces straining. Linaclotide, a guanylate cyclase-C agonist, is effective in treating patients with chronic constipation and its effect on visceral sensitivity, as shown mainly in animal studies, provides an attractive pharmaceutical option for patients with irritable bowel syndrome with constipation. Elobixibat is an ileal sodium-dependent bile acid transporter inhibitor that blocks the enterohepatic circulation of bile acids, increasing the bile acid concentration in the intestine, which accelerates colonic transit and softens the stool. A phase III trial of the treatment of chronic constipation and irritable bowel syndrome with constipation is underway. The clinical application of new-generation laxatives will contribute to the management of chronic constipation refractory to conventional laxatives. |
| Key Words:
Constipation; Laxatives; Prucalopride; Lubiprostone; Linaclotide |
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