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In this article, traditional and novel therapies for chronic con-stipation are reviewed. Traditional laxatives are effective at inducing bowel movements, but efficacy in long-term manage-ment and efficacy on constipation-associated abdominal symp-toms are less well established, with the exception of polyethylene glycol, for which long-term studies confirm sustained efficacy. Recently approved drugs include the colonic secretagogue lubi-prostone and the 5-HT4 agonist prucalopride. In controlled trials in chronic constipation, these drugs were shown to significantly improve constipation and its associated symptoms, with a favour-able safety record. Methylnaltrexone, a subcutaneously adminis-tered peripherally acting mu opioid receptor antagonist, has recently been approved for opioid-induced constipation in termi-nally ill patients. New agents under evaluation include the 5-HT4 agonists velusetrag and naronapride, the guanylate cyclase-C receptor agonist linaclotide and the peripherally acting mu opioid receptor antagonist alvimopan.

 

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