Constipation in adults.

Introduction: Although there are defined criteria for the diagnosis of constipation, in practice, diagnostic criteria are less rigid and depend in part on the perception of normal bowel habit. Constipation is highly prevalent, with approximately 12 million general practitioner prescriptions for laxatives in England in 2001.

Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of medications in people with idiopathic chronic constipation? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).

Results: At this update, searching of electronic databases retrieved 356 studies published in this time period. After deduplication, 95 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 62 studies and the further review of 33 full publications. Of the 33 full articles evaluated, three systematic reviews and one RCT were added to the overview at this update. We performed a GRADE evaluation for four PICO combinations.

Conclusions: In this systematic overview, we categorised the efficacy for three interventions, based on information relating to the effectiveness and safety of linaclotide, lubiprostone, and prucalopride.