No currently available drug for treating chronic constipation appears to be superior to any other. However, all treatments that have been studied recently were better than a placebo in helping patients achieve spontaneous bowel movements.
Aware that about half of all patients are not satisfied with their treatment—specifically fiber and laxatives—researchers reviewed data from 21 randomized controlled trials involving about 9,200 patients and more than half a dozen medications for chronic constipation. The results of the study were published online in Gut in June 2016.
The researchers found that none of the drugs studied was better than any other at achieving their endpoints of at least three complete spontaneous bowel movements per week and an increase of at least one complete bowel movement per week in 9 out of 12 weeks of treatment after starting treatment.
One agent, bisacodyl, marketed under a number of trade names such as Dulcolax, seemed to have a bit of an advantage over the others in terms of improving the number of bowel movements per week over baseline.
The researchers cautioned, however, that the one trial of the agent was much shorter than trials of the other drugs—only four weeks compared with 12 to 24 weeks. They also warned that bisacodyl is associated with some unpleasant side effects such as abdominal cramping and diarrhea.
None of these drugs should be taken regularly. If you have constipation that is more than occasional, check first with your doctor about the best treatment for you.