Chronic Idiopathic Constipation

Not an actual patient.

Constipation is one of the most common gastroenterologic complaints in the general population.1,2

Although traditionally regarded as less than 3 bowel movements a week, constipation is much more than a number.1 It is a bowel condition characterized by infrequent bowel movements, and/or lumpy or hard stools, and/or difficulty with defecation.

Constipation illustration

Epidemiology

Constipation is seen in 6.9% of adults in the general U.S. population,3 and becomes more common with age.2,4 Constipation is more than twice as prevalent in women,4 who are more likely than men to use laxatives and seek health care.2  The prevalence is higher in older individuals, and is even more common in elderly patients receiving long-term care in hospitals or nursing homes.5

Diagnosis

For a diagnosis of chronic idiopathic constipation (CIC), symptoms should be “chronic” (persisting at least six months), and “idiopathic”, lacking another known cause.2,6 Patients should experience two or more of the following symptoms:2,6,7 

  • less than 3 bowel movements per week 
  • ≥25% of bowel movements affected by lumpy or hard stools
  • ≥25% of bowel movements affected by straining
  • ≥25% of bowel movements affected by sensation of incomplete evacuation
  • ≥25% of bowel movements affected by sensation of anorectal blockage
  • ≥25% of bowel movements affected by use of manual maneuvers to facilitate defecation

Additionally, patients with CIC rarely have loose stools without use of a laxative, and have insufficient criteria for irritable bowel syndrome.2,6,7

CIC can be further divided into 3 subtypes largely based on further physiologic testing: dyssynergic defecation (outlet obstruction), slow transit constipation (STC) and normal transit constipation (NTC).7,8,9

Pathophysiology

The pathology is multi-faceted and the 3 constipation subtypes may not be mutually exclusive, with some patients experiencing two or even three of these overlapping constipation subtypes.2,7 The symptoms of dyssynergic defecation — poor coordination between rectal and abdominal wall muscles, pelvic floor muscles and anal sphincter muscles — may co-exist with the increased rectal compliance experienced with NTC.7,10 Fewer postprandial high-amplitude propagating contractions (HAPCs) are observed in both STC, characterized primarily by reduced phasic colonic motor activity, and NTC.10

Navigating CIC

A survey of patients with chronic constipation found that the most frequent symptoms were straining (79%), hard stools (71%), abdominal discomfort (62%), bloating (57%), infrequent bowel movements (57%), and feelings of incomplete evacuation after a bowel movement (54%).6 CIC patients with abdominal symptoms also report substantial missed work, and significant financial burdens.11,12 A careful history and examination of the patient experiencing constipation is essential for taking appropriate steps to manage the condition and alleviate symptoms.2

  1. Bharucha AE, Dorn SD, Lembo A, et al. Gastroenterology. 2013;144(1):211-217.
  2. Brenner DM and Shah M. Gastroenterol Clin N Amer. 2016;45(2):205-216. 
  3. Palsson OS, Whitehead W, Törnblom H, et al. Gastroenterology. 2020;1-49. 
  4. Higgins PD and Johanson JF. Am J Gastroenterol. 2004;99(4):750-759.
  5. De Giorgio R, Ruggeri E, Stanghellini V, et al. BMC Gastroenterology. 2015;15:130.
  6. Lacy BE, Mearin F, Chang L, et al. Gastroenterology. 2016;150:1393-1407.
  7. Tack J, Müller-Lissner S, Stanghellini V, et al. Neurogastroenterol Motil. 2011;23:697-710.
  8. Locke GR, Pemberton JH, Philipps SF. Gastroenterology. 2000;119(6):1766-1778.
  9. Rao SSC and Patcharatrakul T. J Neurogastroenterol Motil. 2016;22(3):423-436.
  10. Ravi K, Bharucha AE, Camilleri M, et al. Gastroenterology. 2010;138(1):1-21.
  11. Heidelbaugh JJ, Stelwagon M, Miller SA, et al. Am J Gastroenterol. 2015;110:580-587.
  12. Herrick LM, Spalding WM, Saito YA, et al. J Med Econ. 2017; 20(3): 273-279. 

Upcoming & Past Conferences in Gastroenterology

  • Upcoming

  • Past

Professional Society for Health Economics and Outcomes Research (ISPOR), 2024

May 5 - 8, 2024 | Link to Event

Leading global conference discussing how to establish, incentivize, and share value sustainable for health systems, patients, and technology developers.

Digestive Disease Week (DDW), 2024

May 18 - 21, 2024 | Link to Event

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2024

November 6 - 9, 2024 | Link to Event

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Academy of Managed Care Pharmacy (AMCP), 2024

April 15 - 18, 2024

Large assembly of pharmacy and healthcare professionals dedicated to the issues of managed care pharmacy, offering immersive education sessions and keynote presentations.

American Society for Parenteral and Enteral Nutrition (ASPEN), 2024

March 2 - 5, 2024

Annual global conference for interdisciplinary, clinical nutrition leaders, providing the latest in clinical nutrition research, education, and products.

Crohn's & Colitis Congress (CCC), 2024

January 25 - 25, 2024

Annual conference for a multidisciplinary community of practitioners and researchers focusing on inflammatory bowel disease (IBD) by pairing best practices in clinical care with innovative research.

Advances in Inflammatory Bowel Diseases (AIBD), 2023

December 14 - 16, 2023

An all-encompassing event providing real-world clinical education, case studies and new evidence-based approaches in IBD management.

Entyvio® (vedolizumab)

  • Biologic Therapy Sequencing in Ulcerative Colitis: A Real-World Observational Study of Second-Line Therapy After Vedolizumab

American College of Gastroenterology (ACG), 2023

October 20 - 25, 2023

Premier event for clinicians and the general public about digestive disorders and the latest trends in GI technology and therapeutics.

Entyvio® (vedolizumab)

  • Response Trajectory by the Clinical Decision Support Tool Probability Groups in Vedolizumab-Treated Patients With Crohn’s Disease: A Pooled Analysis of GEMINI 2, VISIBLE 2, and VERSIFY
  • Number Needed to Treat to Maintain Clinical Remission with Advanced Therapies in Patients with Moderate to Severe Ulcerative Colitis
  • Vedolizumab Long-Term Treatment Persistence and Safety – Results From a Multinational Extended Access Program Study
  • Corticosteroid-Free Remission in Anti-TNF-Failed Crohn’s Disease Patients Treated With Vedolizumab as Second-Line Biologic Therapy: A Real-World Data Review
  • Real-World Clinical Effectiveness and Safety of Vedolizumab and Ustekinumab in Bio-Naïve Patients With Late Crohn’s Disease: Results From the EVOLVE Expansion Study
  • Healthcare Resource Utilization and Costs Across Different Sequences of Advanced Therapies in Patients with Crohn’s Disease or Ulcerative Colitis

Motegrity® (prucalopride)

  • Efficacy and safety of prucalopride in patients with chronic idiopathic constipation from different racial and ethnic groups: a post hoc analysis of phase 3 and 4 clinical study data

Academy of Managed Care Pharmacy Nexus (AMCP Nexus), 2023

October 16 - 19, 2023

Annual event with more than 2,500 members and non-members of the AMCP to engage on the latest innovations and most intentional networking in managed care pharmacy.

  • Costs and Patient Characteristics Associated With High Versus Low Healthcare Resource Utilization in Patients With Inflammatory Bowel Disease: a Real-World Study in the USA

United European Gastroenterology Week (UEGW), 2023

October 14 - 17, 2023

Global congress for researchers from around the world to present their findings on gastroenterology and digestive health.

Entyvio® (vedolizumab)

  • Machine Learning-Based Precision Medicine Approach Identifies Specific Responder Sub-Populations by Dynamic Clustering of PRO Data: Post Hoc Analysis of VARSITY Dataset
  • High-dimensional single-cell analysis identifies cellular signature associated with response to vedolizumab therapy in ulcerative colitis
  • Corticosteroid-Free Remission in Anti-TNF-Failed Crohn’s Disease Patients Treated With Vedolizumab as Second-Line Biologic Therapy: A Real-World Data Review
  • Vedolizumab Long-Term Treatment Persistence And Safety – Results From A Multinational Extended Access Programme Study

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2023

October 4 - 7, 2023

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition and to discuss current topics in clinical applications.

Gattex® (teduglutide)

  • Teduglutide Long-Term Safety and Effectiveness for a Pediatric Cohort Enrolled in an Observational, Prospective, Multi-Center Short Bowel Syndrome and Intestinal Failure Registry

European Society for Clinical Nutrition & Metabolism Congress (ESPEN), 2023

September 11 - 14, 2023

Annual global congress dedicated to clinical nutrition and metabolism, including basic and clinical research, education, and organization of consensus statements about clinical care.

American Neurogastro­enterology and Motility Society (ANMS), 2023

August 11 - 13, 2023

Annual meeting uncovering cutting-edge research ranging from basic neurogastroenterology, translational and clinical aspects of gastrointestinal motility, and functional disorders.

Motegrity® (prucalopride)

  • Prescription medication use in chronic idiopathic constipation in the USA from the healthcare professional perspective: a retrospective observational study
  • Management of chronic idiopathic constipation in US patients from the healthcare professional perspective: a retrospective observational study

Congress of the Intestinal Rehabilitation and Transplant Association (CIRTA), 2023

June 30 - July 3, 2023

Bi-annual congress promoting intestinal rehabilitation and transplantation as a safe, innovative science involving nutritional, medical, surgical and transplant therapies through education, policy development and research.

Gattex® (teduglutide)

  • Long-term safety analysis of teduglutide treatment in adult patients with short bowel syndrome and intestinal failure (SBS-IF): analysis from a prospective, multinational registry

European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), 2023

May 17 - 20, 2023

Annual congress discussing innovative treatments and research discoveries to enhance the standards of care for patients and help pediatric gastroenterology, hepatology, and nutrition professionals improve their practice.

Gattex® (teduglutide)

  • Pooled analysis of open-label, long-term pediatric extension studies: Safety, efficacy, and predictors of teduglutide response in patients with short bowel syndrome-associated intestinal failure

Professional Society for Health Economics and Outcomes Research (ISPOR), 2023

May 7 - 10, 2023

Leading global conference discussing how to establish, incentivize, and share value sustainable for health systems, patients, and technology developers.

Entyvio® (vedolizumab)

  • [Supplemental Material] Systematic Literature Review to Evaluate Randomized Clinical Trials of Advanced Therapies for Moderate to Severe Crohn’s Disease
  • Systematic Literature Review to Evaluate Randomized Clinical Trials of Advanced Therapies for Moderate to Severe Crohn’s Disease

Digestive Disease Week (DDW), 2023

May 6 - 9, 2023

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

  • Deployment of an Artificial Intelligence Tool for Precision Medicine in Ulcerative Colitis: Preliminary Data From 8 Globally Distributed Clinical Sites

Entyvio® (vedolizumab)

  • Real-World Clinical Effectiveness and Safety of Vedolizumab and Ustekinumab in Biologic-Naïve Patients With Crohn’s Disease: Results From the EVOLVE Expansion Study
  • Mucosal Healing With Vedolizumab in Inflammatory Bowel Disease Patients With Chronic Pouchitis: Evidence From EARNEST, a Randomized, Double-Blind, Placebo-Controlled Trial
  • Interim results from the randomized VERDICT trial to determine the optimal treatment target in patients with ulcerative colitis
  • Change in Fatigue in Patients With Ulcerative Colitis or Crohn’s Disease Initiating Vedolizumab or Other Biologic Therapy: Data From Belgian Registry Patients
  • Disease Trajectories in Ulcerative Colitis: Early Identification of Patients With Endoscopic Remission at Week 52
  • Efficacy and Safety Outcomes in Patients With Moderate to Severe Ulcerative Colitis Stratified by Ethnicity and Race: a Pooled Analysis of Data From GEMINI 1, VARSITY, and VISIBLE 1

American Society for Parenteral and Enteral Nutrition (ASPEN), 2023

April 20 - 23, 2023

Annual global conference for interdisciplinary, clinical nutrition leaders, providing the latest in clinical nutrition research, education, and products.

Medication Resources

Motegrity®

(prucalopride)

Amitiza®

(lubiprostone)