New treatments for chronic constipation: what is the evidence?

Chronic constipation is a health condition that significantly limits the well-being of affected patients, being disabling in its more severe forms and exerting a substantial impact on individual well-being and psychosocial functioning, with high direct and indirect healthcare costs. For this reason, advances in the understanding of its pathophysiology and in the development of new therapeutic options are essential for physicians responsible for the care of patients with defecatory disorders. A strong physician–patient relationship is crucial, as well as overcoming fear – both among physicians and patients – regarding the use of laxatives, which can be effective when treatment is individualized, taking into account the underlying pathophysiological mechanisms of constipation, indications, adverse effects, and therapeutic response. In addition, the use of combination therapies with favorable safety profiles should be considered, and clinicians should remain aware of overlapping syndromes, such as irritable bowel syndrome with constipation, since their identification is associated with a significant improvement in patient- reported outcomes.