Condition
Constipation-Predominant Irritable Bowel Syndrome (IBS-C)
IBS-C is a long-term gut disorder in which recurring abdominal pain comes with hard, infrequent stools, shaped by close signaling between gut and brain. Psyllium fiber and peppermint oil have strong evidence behind them, while in large trials linaclotide and plecanatide helped about 30 to 34 percent of people reach pain and bowel goals, versus 14 to 21 percent on placebo. Those results come from drugs, so they don't show what supplements do.
Sources: PMID 29380823; PMID 29545635
- Supplements studied
- 0
- Medicines and peptides
- 2
- Graded outcomes
- 4
No supplement studies yetWe haven’t found supplement studies for Constipation-Predominant Irritable Bowel Syndrome (IBS-C). The medicines and peptides studied for it are listed below.
Prescription medicines and peptides studied, for context
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| FDA Responder Rate IBS-C Phase 3: 33.6-33.7% FDA responders vs 13.9-21.0% placebo (P<0.0001). Dual endpoint: ≥30% pain improvement + ≥1 CSBM increase for ≥50% of weeks. Effect maintained over 26 weeks. | Improves (the measure goes up) | Large effect | 20 studies | |||
Studies that measured fda responder rate ibs-c
| ||||||
| Abdominal Pain Relief Significant improvement in worst abdominal pain scores vs placebo. Pain relief observed within first week. cGMP-mediated visceral analgesia independent of bowel effects. No rebound worsening on discontinuation. | Improves (the measure goes down) | Large effect | 15 studies | |||
Studies that measured abdominal pain relief
| ||||||
Key findings
- FDA Responder Rate IBS-CImproves (the measure goes up)
- Abdominal Pain ReliefImproves (the measure goes down)
- Overall Response IBS-CImproves (the measure goes up)
The Constipation-Predominant Irritable Bowel Syndrome (IBS-C) Supportive Care protocol
2 primary supplements · 6 supporting supplements
- Psyllium Fiber5–10 g daily in divided doses, gradually increased; with plenty of water
- Probiotics10–50 billion CFU daily (Bifidobacterium infantis 35,624, B. lactis DN-173 010)
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Studies cited
77 studies from PubMed
- Linaclotide combined with polyethylene glycol for bowel preparation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials.
- Efficacy and tolerability of plecanatide for irritable bowel syndrome with constipation and chronic idiopathic constipation: a systematic review and meta-analysis.
- Efficacy and Safety of Linaclotide as an Adjunct to Polyethylene Glycol in Bowel Preparation: A Meta-Analysis.
- Efficacy and safety of pharmacological therapies for functional constipation in children: a systematic review and meta-analysis.
- Safety and efficacy of linaclotide as an adjuvant for bowel preparation: A systematic review and meta-analysis.
- ESPGHAN/NASPGHAN guidelines for treatment of irritable bowel syndrome and functional abdominal pain-not otherwise specified in children aged 4-18 years.
- Management of Chronic Constipation: A Comprehensive Review.
- Combined linaclotide and polyethylene glycol electrolyte for colonoscopy preparation: a network meta-analysis of 14 randomized controlled trials.
- Post-marketing safety assessment of constipation drugs: a real-world pharmacovigilance study based on FAERS database.
- The Safety of Pharmacotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.
- Constipation-predominant irritable bowel syndrome treatment options Linaclotide, Lubiprostone, Plecanatide, and Tenapanor: analysis of the FDA Adverse Event Reporting System (FAERS) database.
- Efficacy and Safety of Plecanatide in Chinese Patients with Functional Constipation: A Phase III Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.
- Plecanatide Is Efficacious in Women Aged 18 to 40 Years With IBS-C and Bloating: A Pooled Analysis of Two Phase 3, Randomized, Placebo-Controlled Trials.
- Efficacy and safety of linaclotide in treating functional constipation in paediatric patients: a randomised, double-blind, placebo-controlled, multicentre, phase 3 trial
- Efficacy and safety of linaclotide in treatment-resistant chronic constipation: A multicenter, open-label study
- Safety and efficacy of linaclotide in children aged 7-17 years with irritable bowel syndrome with constipation.
- Safety and efficacy of linaclotide in children aged 2-5 years with functional constipation: Phase 2, randomized study.
- Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation: a systematic literature review with meta-analysis and number needed to treat/harm.
- Plecanatide Improves Abdominal Bloating and Bowel Symptoms of Irritable Bowel Syndrome with Constipation
- Assessing real-world safety of plecanatide: a pharmacovigilance study based on the FDA adverse event reporting system.
- Efficacy and Safety of Plecanatide in Treatment of Irritable Bowel Syndrome With Constipation and Chronic Idiopathic Constipation.
- Bowel preparation efficacy and safety of compound polyethylene glycol electrolyte powder combined with linaclotide for colonoscopy: A randomized controlled trial.
- Intestinal neuropod cell GUCY2C regulates visceral pain.
- Enteroendocrine cell regulation of the gut-brain axis.
- Editorial: repurposed linaclotide and the quest for abdominal pain management in irritable bowel syndrome.
- Plecanatide Improves Symptoms of Irritable Bowel Syndrome with Constipation: Results of an Integrated Efficacy and Safety Analysis of Two Phase 3 Trials
- Plecanatide Improves Symptoms of Irritable Bowel Syndrome with Constipation: Results of an Integrated Efficacy and Safety Analysis of Two Phase 3 Trials.
- Efficacy and safety of linaclotide in patients with irritable bowel syndrome with constipation: Chinese sub-cohort analysis of a phase III, randomized, double-blind, placebo-controlled trial
- Chronic Constipation: Gastroenterohepatologist's Approach.
- Effects of linaclotide in the treatment of chronic constipation and irritable bowel syndrome with constipation: a meta-analysis.
- The Effect of Acid Suppression Therapy on the Safety and Efficacy of Plecanatide: Analysis of Randomized Phase III Trials
- Guanylyl cyclase C as a diagnostic and therapeutic target in colorectal cancer.
- Efficacy of Linaclotide in Reducing Abdominal Symptoms of Bloating, Discomfort, and Pain: A Phase 3B Trial Using a Novel Abdominal Scoring System
- [Efficacy and Safety of Linaclotide in Elderly Patients].
- Improving the Gastrointestinal Stability of Linaclotide.
- Bisacodyl: A review of pharmacology and clinical evidence to guide use in clinical practice in patients with constipation.
- Systematic review and network meta-analysis: efficacy of licensed drugs for abdominal bloating in irritable bowel syndrome with constipation.
- Guanylyl cyclase 2C (GUCY2C) in gastrointestinal cancers: recent innovations and therapeutic potential.
- Randomised clinical trial: linaclotide vs placebo-a study of bi-directional gut and brain axis.
- Tadalafil versus linaclotide in gastrointestinal dysfunction and depressive behavior in constipation-predominant irritable bowel syndrome.
- Evaluation of Plecanatide for the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation in Patients 65 Years or Older
- Safety and tolerability of linaclotide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: pooled Phase 3 analysis
- Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis.
- Efficacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis
- Linaclotide improves gastrointestinal transit in cystic fibrosis mice by inhibiting sodium/hydrogen exchanger 3.
- Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials
- Plecanatide: a new guanylate cyclase agonist for the treatment of chronic idiopathic constipation
- Plecanatide (Trulance) for Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation
- Guanylate cyclase-C as a therapeutic target in gastrointestinal disorders.
- Safety and tolerability of plecanatide in patients with chronic idiopathic constipation: long-term evidence from an open-label study.
- Efficacy and safety of plecanatide in treating constipation predominant irritable bowel syndrome.
- Efficacy of Secretagogues in Patients With Irritable Bowel Syndrome With Constipation: Systematic Review and Network Meta-analysis.
- Gastrointestinal Pharmacology.
- Linaclotide activates guanylate cyclase-C/cGMP/protein kinase-II-dependent trafficking of CFTR in the intestine.
- A Randomized Phase III Clinical Trial of Plecanatide, a Uroguanylin Analog, in Patients With Chronic Idiopathic Constipation
- Randomized clinical trial: efficacy and safety of plecanatide in the treatment of chronic idiopathic constipation
- Plecanatide-mediated activation of guanylate cyclase-C suppresses inflammation-induced colorectal carcinogenesis in Apc(+/Min-FCCC) mice.
- Formulary Drug Reviews: Plecanatide.
- GUCY2C ligand replacement to prevent colorectal cancer.
- Guanylyl cyclase C signaling axis and colon cancer prevention.
- Linaclotide in Chronic Idiopathic Constipation Patients with Moderate to Severe Abdominal Bloating: A Randomized, Controlled Trial
- Plecanatide and dolcanatide, novel guanylate cyclase-C agonists, ameliorate gastrointestinal inflammation in experimental models of murine colitis.
- Linaclotide: a novel therapy for chronic constipation and constipation-predominant irritable bowel syndrome
- Linaclotide: a review of its use in the treatment of irritable bowel syndrome with constipation.
- Effect of linaclotide in irritable bowel syndrome with constipation (IBS-C): a systematic review and meta-analysis.
- Review article: Linaclotide for the management of irritable bowel syndrome with constipation.
- Randomised clinical trials: linaclotide phase 3 studies in IBS-C - a prespecified further analysis based on European Medicines Agency-specified endpoints
- Linaclotide, novel therapy for the treatment of chronic idiopathic constipation and constipation-predominant irritable bowel syndrome
- Translating colorectal cancer prevention through the guanylyl cyclase C signaling axis.
- A review of the clinical efficacy of linaclotide in irritable bowel syndrome with constipation.
- Effects of linaclotide in patients with irritable bowel syndrome with constipation or chronic constipation: a meta-analysis.
- Plecanatide, an oral guanylate cyclase C agonist acting locally in the gastrointestinal tract, is safe and well-tolerated in single doses.
- Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety
- A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation
- Linaclotide in the management of gastrointestinal tract disorders.
- The pharmacokinetics, pharmacodynamics, clinical efficacy, safety and tolerability of linaclotide.
- Linaclotide, a synthetic guanylate cyclase C agonist, for the treatment of functional gastrointestinal disorders associated with constipation.