Treatment
10
Table 2. Therapeutic Options for IBS-C
Symptom Therapy Dose
Constipation
Psyllium ≤30 g/d in divided doses
PEG 17–34 g/d
Chloride channel activators Lubiprostone, 8 μg bid
Guanylate Cyclase C agonists Linaclotide 290 μg qd
Abdominal pain
Smooth muscle
antispasmodics
a
Dicycylomine (10–20 mg qd-qid)
Otilonium (40–80 mg bid-tid)
Mebeverine (135 mg tid)
Peppermint oil Enteric-coated capsules,
250–750 mg, bid-tid
Tricyclic antidepressants
a
Desipramine (25–100 mg qhs)
Amitriptyline (10–50 mg qhs)
Selective serotonin reuptake
inhibitors (SSRIs)
Paroxetine (10–40 mg qd)
Sertraline (25–100 mg qd)
Citalopram (10–40 mg qd)
Lubiprostone 8 mg bid
Linaclotide 290 mg qd
a
ese drugs may cause or worsen constipation.
Table 3. Therapeutic Options for Functional Constipation
Symptom Dose
Psyllium ≤30 mg/d in divided doses
PEG
17–34 g/d
Chloride channel activators
Lubiprostone 24 μg bid
Guanylate cyclase C agonists
Linaclotide 145 μg qd
Prucalopride
a
2–4 mg/d
a
Not FDA approved in the United States.
