Condition
Constipation-Predominant Irritable Bowel Syndrome (IBS-C)
IBS-C is a long-term gut disorder in which recurring abdominal pain comes with hard, infrequent stools, shaped by close signaling between gut and brain. Psyllium fiber and peppermint oil have strong evidence behind them, while in large trials linaclotide and plecanatide helped about 30 to 34 percent of people reach pain and bowel goals, versus 14 to 21 percent on placebo. Those results come from drugs, so they don't show what supplements do.
Sources: PMID 29380823; PMID 29545635
- Supplements studied
- 0
- Medicines and peptides
- 2
- Graded outcomes
- 4
Prescription medicines and peptides studied, for context
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| FDA Responder Rate IBS-C Phase 3: 33.6-33.7% FDA responders vs 13.9-21.0% placebo (P<0.0001). Dual endpoint: ≥30% pain improvement + ≥1 CSBM increase for ≥50% of weeks. Effect maintained over 26 weeks. | Improves (the measure goes up) | Large effect | 20 studies | |||
Studies that measured fda responder rate ibs-c
| ||||||
| Abdominal Pain Relief Significant improvement in worst abdominal pain scores vs placebo. Pain relief observed within first week. cGMP-mediated visceral analgesia independent of bowel effects. No rebound worsening on discontinuation. | Improves (the measure goes down) | Large effect | 15 studies | |||
Studies that measured abdominal pain relief
| ||||||
Key findings
- FDA Responder Rate IBS-CImproves (the measure goes up)
- Abdominal Pain ReliefImproves (the measure goes down)
- Overall Response IBS-CImproves (the measure goes up)
The Constipation-Predominant Irritable Bowel Syndrome (IBS-C) Supportive Care protocol
2 primary supplements · 6 supporting supplements
- Psyllium Fiber5–10 g daily in divided doses, gradually increased; with plenty of water
- Probiotics10–50 billion CFU daily (Bifidobacterium infantis 35,624, B. lactis DN-173 010)
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Studies cited
27 studies from PubMed
- Linaclotide combined with polyethylene glycol for bowel preparation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials.
- Combined linaclotide and polyethylene glycol electrolyte for colonoscopy preparation: a network meta-analysis of 14 randomized controlled trials.
- Management of Chronic Constipation: A Comprehensive Review.
- Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation: a systematic literature review with meta-analysis and number needed to treat/harm.
- Effects of linaclotide in the treatment of chronic constipation and irritable bowel syndrome with constipation: a meta-analysis.
- The Effect of Acid Suppression Therapy on the Safety and Efficacy of Plecanatide: Analysis of Randomized Phase III Trials
- Efficacy and safety of linaclotide in patients with irritable bowel syndrome with constipation: Chinese sub-cohort analysis of a phase III, randomized, double-blind, placebo-controlled trial
- Systematic review and network meta-analysis: efficacy of licensed drugs for abdominal bloating in irritable bowel syndrome with constipation.
- Bisacodyl: A review of pharmacology and clinical evidence to guide use in clinical practice in patients with constipation.
- Efficacy of Linaclotide in Reducing Abdominal Symptoms of Bloating, Discomfort, and Pain: A Phase 3B Trial Using a Novel Abdominal Scoring System
- Evaluation of Plecanatide for the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation in Patients 65 Years or Older
- Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis.
- Safety and tolerability of linaclotide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: pooled Phase 3 analysis
- Efficacy of Secretagogues in Patients With Irritable Bowel Syndrome With Constipation: Systematic Review and Network Meta-analysis.
- Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials
- Efficacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis
- Formulary Drug Reviews: Plecanatide.
- Review article: Linaclotide for the management of irritable bowel syndrome with constipation.
- Effect of linaclotide in irritable bowel syndrome with constipation (IBS-C): a systematic review and meta-analysis.
- Linaclotide: a review of its use in the treatment of irritable bowel syndrome with constipation.
- Linaclotide: a novel therapy for chronic constipation and constipation-predominant irritable bowel syndrome
- Effects of linaclotide in patients with irritable bowel syndrome with constipation or chronic constipation: a meta-analysis.
- A review of the clinical efficacy of linaclotide in irritable bowel syndrome with constipation.
- Linaclotide, novel therapy for the treatment of chronic idiopathic constipation and constipation-predominant irritable bowel syndrome
- Randomised clinical trials: linaclotide phase 3 studies in IBS-C - a prespecified further analysis based on European Medicines Agency-specified endpoints
- A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation
- Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety