Elobixibat Improves Stool/Gas Distribution and Fecal Bile Acids in Older Adults With Chronic Constipation

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-08-18 DOI:10.1002/jgh3.70223

Noriaki Manabe, Emiko Bukeo, Takako Konishi, Maki Ayaki, Minoru Fujita, Ken Haruma

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Abstract

Background

Bowel stool and/or gas distribution is an important indicator of bowel function. The mean colonic transverse diameter of the colon and rectum (constipation index) is a stool and/or gas distribution parameter assessed via transabdominal ultrasonography and an indirect indicator of colonic transit time. Elobixibat, an ileal bile acid transporter inhibitor, increases the number of bowel movements in chronic constipation (CC) patients.

Aims

To determine whether the constipation index changes following treatment with elobixibat and evaluate the relationship between changes in the constipation index and fecal bile acid concentration.

Methods

We conducted a prospective, randomized, double-blind, placebo-controlled trial in 17 CC patients aged ≥ 60 years who were administered elobixibat or placebo daily for 1 week. Changes in stool and/or gas distribution and stool bile acid concentrations were analyzed before and after treatment.

Results

Elobixibat, but not placebo, significantly reduced the constipation index. A significant negative correlation was found between the change in the constipation index and the change in total fecal bile acid concentration.

Conclusion

Elobixibat increases the total fecal bile acid concentration of CC patients, which results in shortened colonic transit time.

Trial Registration: JRCT ID: jRCTs061200030; https://rctportal.niph.go.jp/en/detail?trial_id=jRCTs061200030

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依洛比西他改善老年慢性便秘患者的粪便/气体分布和粪胆汁酸

肠道粪便和/或气体分布是肠道功能的重要指标。结肠和直肠的平均结肠横径（便秘指数）是经腹超声评估的粪便和/或气体分布参数，是结肠运输时间的间接指标。依洛比昔巴是一种回肠胆汁酸转运蛋白抑制剂，可增加慢性便秘（CC）患者的排便次数。目的观察依洛比昔巴治疗后便秘指数是否发生变化，并评价便秘指数变化与粪胆汁酸浓度的关系。方法：我们在17例年龄≥60岁的CC患者中进行了一项前瞻性、随机、双盲、安慰剂对照试验，这些患者每天服用埃洛比西巴特或安慰剂，持续1周。分析治疗前后大便和/或气体分布及大便胆汁酸浓度的变化。结果依洛比西巴特显著降低便秘指数，而安慰剂无明显作用。便秘指数变化与粪总胆汁酸浓度变化呈显著负相关。结论依洛比西他可提高CC患者粪总胆汁酸浓度，缩短结肠转运时间。试验注册：JRCT ID: jRCTs061200030；https://rctportal.niph.go.jp/en/detail?trial_id=jRCTs061200030

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