DOI QR코드

DOI QR Code

Guidelines for the Use of Laxatives - Which Laxatives, When?

변비 약물 치료의 지침 – 어떤 약제를, 언제 사용해야 하는가?

  • Shin, Jeong Eun (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Hong, Kyoung Sup (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Jung, Kee Wook (Department of Gastroenterology, University of Ulsan College of Medicine) ;
  • Lee, Tae Hee (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Bong Eun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Seon-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Hong, Sung Noh (Department of Internal Medicine, Sungkyunkwan University School of Medicine) ;
  • Kim, Seong-Eun (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Park, Kyung Sik (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Choi, Suck Chei (Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine)
  • 신정은 (단국대학교 의과대학 내과학교실) ;
  • 홍경섭 (서울대학교 의과대학 내과학교실) ;
  • 정기욱 (울산대학교 의과대학 소화기내과학교실) ;
  • 이태희 (순천향대학교 의과대학 소화기연구소) ;
  • 이봉은 (부산대학교 의과대학 내과학교실) ;
  • 박선영 (전남대학교 의과대학 내과학교실) ;
  • 홍성노 (성균관대학교 의과대학 내과학교실) ;
  • 김성은 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 박경식 (계명대학교 의과대학 내과학교실) ;
  • 최석채 (원광대학교 의과대학 내과학교실 및 소화기질환 연구소)
  • Published : 20150000

Abstract

To manage chronic constipation, dietary and lifestyle modifications should be tried before pharmacological intervention. Although there is no standardized treatment guideline for medical practice, the key considerations in the choice of laxative include the treatment duration, dosing schedule, type of agent, effects and side effects of the agent, and cost. The first-line treatment is a bulking or osmotic laxative. If the patient is still symptomatic, the physician can add or switch to other laxatives. Next, prucalopride, a highly selective 5-hydroxytryptamine 4 (5-HT4) receptor agonist, could be considered. If the constipation is refractory to combination therapy with conventional laxatives and prucalopride, patients should be referred for further evaluation, including physiological testing.

Keywords