Advancing treatment options for chronic idiopathic constipation

Expert Opinion on Pharmacotherapy

Volumn 17, Issue 4, 2016, Pages 501-511

  Quigley, Eamonn M M ^a   Neshatian, Leila ^a  

^a HOUSTON METHODIST HOSPITAL   (United States)

Author keywords

bile salt transporter inhibitor; biofeedback; botulinum toxin; Chronic constipation; colectomy; elobixibat; irritable bowel syndrome; linactolide; lubiprostone; plecanatide; prokinetic; prosecretory agent; prucalopride; velusetrag

Indexed keywords

GASTROINTESTINAL AGENT; INHIBITOR OF BILE SALT TRANSPORT; PROKINETIC AGENT; PROSECRETORY AGENT; UNCLASSIFIED DRUG;

ANORECTAL DISEASE; CHRONIC CONSTIPATION; DEFECATION DISORDER; DEFECATORY DYSFUNCTION; HUMAN; IDIOPATHIC DISEASE; MICROBIOME; NONHUMAN; OUTCOME ASSESSMENT; PELVIC FLOOR DISORDER; PHASE 2 CLINICAL TRIAL (TOPIC); PHASE 3 CLINICAL TRIAL (TOPIC); RANDOMIZED CONTROLLED TRIAL (TOPIC); RESISTANT CONSTIPATION; REVIEW; CHRONIC DISEASE; CONSTIPATION; DEFECATION; DRUG EFFECTS; MICROBIOLOGY; MICROFLORA; PATHOPHYSIOLOGY;

CHRONIC DISEASE; CONSTIPATION; DEFECATION; HUMANS; MICROBIOTA;

EID: 84959241347     PISSN: 14656566     EISSN: 17447666     Source Type: Journal    
DOI: 10.1517/14656566.2016.1127356     Document Type: Review

References (128)

1. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-Analysis. Am J Gastroenterol. 2011; 106: 1582-1591.
2. Sanchez MI, Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011; 25 (Suppl B): 11B-15B.
3. Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, et al. Chronic constipation in the elderly. Am J Gastroenterol. 2012; 107: 18-25.
4. Johanson JF, Kralstein J. Chronic constipation: a survey of the patient perspective. Aliment Pharmacol Ther. 2007; 25: 599-608.
5. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006; 130: 1480-1491.
6. Shekhar C, Monaghan PJ, Morris J, et al. Rome III functional constipation and irritable bowel syndrome with constipation are similar disorders within a spectrum of sensitization, regulated by serotonin. Gastroenterology. 2013; 145: 749-757.
7. Zhao YF, Ma XQ, Wang R, et al. Epidemiology of functional constipation and comparison with constipation-predominant irritable bowel syndrome: the systematic investigation of gastrointestinal diseases in China (SILC). Aliment Pharmacol Ther. 2011; 34: 1020-1029.
8. Wong RK, Palsson OS, Turner MJ, et al. Inability of the Rome III criteria to distinguish functional constipation from constipation-subtype irritable bowel syndrome. Am J Gastroenterol. 2010; 105: 2228-2234.
9. Hinton JM, Lennard-Jones JE. Constipation: definition and classification. Postgrad Med J. 1968; 44: 720-723.
10. Bharucha AE, Pemberton JH, Locke GR. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013; 144: 218-238.
11. Dinning PG, Jones M, Hunt L, et al. Factor analysis identifies subgroups of constipation. World J Gastroenterol. 2011; 17: 1468-1474.
12. Zarate N, Knowles CH, Newell M, et al. In patients with slow transit constipation, the pattern of colonic transit delay does not differentiate between those with and without impaired rectal evacuation. Am J Gastroenterol. 2008; 103: 427-434.
13. Andresen V, Camilleri M, Busciglio IA, et al. Effect of 5 days linaclotide on transit and bowel function in females with constipation-predominant irritable bowel syndrome. Gastroenterology. 2007; 133: 761-768.
14. Suttor VP, Prott GM, Hansen RD, et al. Evidence for pelvic floor dyssynergia in patients with irritable bowel syndrome. Dis Colon Rectum. 2010; 53: 156-160.
15. Dinning PG, Carrington EV, Scott SM. The use of colonic and anorectal high-resolution manometry and its place in clinical work and in research. Neurogastroenterol Motil. 2015;27:1693-1708.
16. Singh G, Lingala V, Wang H, et al. Use of health care resources and cost of care for adults with constipation. Clin Gastroenterol Hepatol. 2007; 5: 1053-1058.
17. Doshi JA, Cai Q, Buono JL, et al. Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population. J Manag Care Spec Pharm. 2014; 20: 382-390.
18. Sethi S, Mikami S, Leclair J, et al. Inpatient burden of constipation in the United States: an analysis of national trends in the United States from 1997 to 2010. Am J Gastroenterol. 2014; 109: 250-256.
19. Chevalier P, Lamotte M, Joseph A, et al. In-hospital costs associated with chronic constipation in Belgium: a retrospective database study. Neurogastroenterol Motil. 2014; 26: 368-376.
20. Walsh C, Murphy J, Quigley EM. Pharmacoeconomic study of chronic constipation in a secondary care centre. Ir J Med Sci. 2015; 184: 863-870.
21. Dik VK, Siersema PD, Joseph A, et al. Constipation-related direct medical costs in 16 887 patients newly diagnosed with chronic constipation. Eur J Gastroenterol Hepatol. 2014; 26: 1260-1266.
22. Wald A, Sigurdsson L. Quality of life in children and adults with constipation. Best Pract Res Clin Gastroenterol. 2011; 25: 19-27.
23. Mason HJ, Serrano-Ikkos E, Kamm MA. Psychological morbidity in women with idiopathic constipation. Am J Gastroenterol. 2000; 95: 2852-2857.
24. Neri L, Basilisco G, Corazziari E, et al. Constipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation. United European Gastroenterol J. 2014; 2: 138-147.
25. Heidelbaugh JJ, Stelwagon M, Miller SA, et al. The spectrum of constipation-predominant irritable bowel syndrome and chronic idiopathic constipation: US survey assessing symptoms, care seeking, and disease burden. Am J Gastroenterol. 2015; 110: 580-587.
26. Sommers T, Corban C, Sengupta N, et al. Emergency department burden of constipation in the United States from 2006 to 2011. Am J Gastroenterol. 2015; 110: 572-579.
27. Wald A, Scarpignato C, Mueller-Lissner S, et al. A multinational survey of prevalence and patterns of laxative use among adults with self-Defined constipation. Aliment Pharmacol Ther. 2008; 28: 917-930.
28. Wald A, Mueller-Lissner S, Kamm MA, et al. Survey of laxative use by adults with self-Defined constipation in South America and Asia: a comparison of six countries. Aliment Pharmacol Ther. 2010; 31: 274-284.
29. Brandt LJ, Prather CM, Quigley EM, et al. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol. 2005; 100 (Suppl 1): S5-S21.
30. Ford AC, Moayyedi P, Lacy BE, et al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol. 2014 Aug; 109 (Suppl 1): S2-S26.
31. Ashraf W, Park F, Lof J, et al. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Aliment Pharmacol Ther. 1995; 9: 639-647.
32. Kamm MA, Mueller-Lissner S, Wald A, et al. Oral bisacodyl is effective and well-Tolerated in patients with chronic constipation. Clin Gastroenterol Hepatol. 2011; 9: 577-583.
33. Mueller-Lissner S, Kamm MA, Wald A, et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010; 105: 897-903.
34. McRorie JW, Daggy BP, Morel JG, et al. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther. 1998; 12: 491-497.
35. Corazziari E, Badiali D, Habib FI, et al. Small volume isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in treatment of chronic nonorganic constipation. Dig Dis Sci. 1996; 41: 1636-1642.
36. Corazziari E, Badiali D, Bazzocchi G, et al. Long-Term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut. 2000; 46: 522-526.
37. DiPalma JA, DeRidder PH, Orlando RC, et al. A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. Am J Gastroenterol. 2000; 95: 446-450.
38. Attar A, Lemann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut. 1999; 44: 226-230.
39. Di Palma JA, Cleveland MV, McGowan J, et al. A randomized, multicenter comparison of polyethylene glycol laxative and tegaserod in treatment of patients with chronic constipation. Am J Gastroenterol. 2007; 102: 1964-1971.
40. Crowell MD, Shetzline MA, Moses PL, et al. Enterochromaffin cells and 5-HT signaling in the pathophysiology of disorders of gastrointestinal function. Curr Opin Investig Drugs. 2004; 5: 55-60.
41. Emmanuel AV, Tack J, Quigley EM, et al. Pharmacological management of constipation. Neurogastroenterol Motil. 2009; 21 (Suppl 2): 41-54.
42. Quigley EMM. Cisapride. What can we learn from the rise and fall of a prokinetic? J Dig Dis. 2011; 12: 147-156.
43. Tack J, Camilleri M, Chang L, et al. Systematic review: cardiovascular safety profile of 5HT 4 agonists developed for gastrointestinal disorders. Aliment Pharmacol Ther. 2012; 35: 745-767.
44. Quigley EMM. Prucalopride: safety, efficacy and potential applications. Ther Adv Gastroenterol. 2012; 5: 23-30.
45. Sanger GJ, Quigley EMM. Constipation, IBS and the 5-HT 4 receptor: what role for prucalopride? Clin Med Insights Gastroenterol. 2010; 3: 21-33.
46. Potet F, Bouyssou T, Escande D, et al. Gastrointestinal prokinetic drugs have different affinity for the human cardiac human ether-A-gogo K(+) channel. J Pharmacol Exp Ther. 2001; 299: 1007-1012.
47. Mendzelevski B, Ausma J, Chanter DO, et al. Assessment of the cardiac safety of prucalopride in healthy volunteers: a randomized, double-blind, placebo-and positive-controlled thorough QT study. Br J Clin Pharmacol. 2012; 73: 203-209.
48. Camilleri M, Kerstens R, Rykx A, et al. A placebo-controlled trial of prucalopride for severe chronic constipation. New Engl J Med. 2008; 358: 2344-2354.
49. Tack J, Van Outryve M, Beyens G, et al. Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives. Gut. 2009; 58: 357-365.
50. Quigley EM, Vandeplassche L, Kerstens R, et al. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation-A 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2009; 29: 315-328.
51. Tack J, Quigley EMM, Camilleri M, et al. Efficacy and safety of oral prucalopride in women with chronic constipation in whom laxatives have failed: an integrated analysis. Ueg J. 2013; 1: 48-49.
52. Manini ML, Camilleri M, Goldberg M, et al. Effects of Velusetrag (TD-5108) on gastrointestinal transit and bowel function in health and pharmacokinetics in health and constipation. Neurogastroenterol Motil. 2010; 22: 42-49.
53. Camilleri M, Vazquez-Roque MI, Burton D, et al. Pharmacodynamic effects of a novel prokinetic 5-HT receptor agonist, ATI-7505, in humans. Neurogastroenterol Motil. 2007; 19: 30-38.
54. Goldberg M, Li YP, Johanson JF, et al. Clinical trial: the efficacy and tolerability of velusetrag, a selective 5-HT4 agonist with high intrinsic activity, in chronic idiopathic constipation-A 4-week, randomized, double-blind, placebo-controlled, dose-response study. Aliment Pharmacol Ther. 2010; 32: 1102-1112.
55. Shin A, Camilleri M, Kolar G, et al. Systematic review with meta-Analysis: highly selective 5-HT4 agonists (prucalopride, velusetrag or naronapride) in chronic constipation. Aliment Pharmacol Ther. 2014; 39: 239-253.
56. Bang CS, Kim JH, Baik GH, et al. Mosapride treatment for functional dyspepsia: a meta-Analysis. J Gastroenterol Hepatol. 2015; 30: 28-42.
57. Liu Z, Sakakibara R, Odaka T, et al. Mosapride citrate, a novel 5-HT4 agonist and partial 5-HT3 antagonist, ameliorates constipation in parkinsonian patients. Mov Disord. 2005; 20: 680-686.
58. Choi CH, Kwon JG, Kim SK, et al. Efficacy of combination therapy with probiotics and mosapride in patients with IBS without diarrhea: a randomized, double-blind, placebo-controlled, multicenter, phase II trial. Neurogastroenterol Motil. 2015; 27: 705-716.
59. Bassil AK, Borman RA, Jarvie EM, et al. Activation of prostaglandin EP receptors by lubiprostone in rat and human stomach and colon. Br J Pharmacol. 2008; 154: 126-135.
60. Bijvelds MJ, Bot AG, Escher JC, et al. Activation of intestinal Cl-secretion by lubiprostone requires the cystic fibrosis transmembrane conductance regulator. Gastroenterology. 2009; 137: 976-985.
61. Jakab RL, Collaco AM, Ameen NA. Lubiprostone targets prostanoid signaling and promotes ion transporter trafficking, mucus exocytosis, and contractility. Dig Dis Sci. 2012; 57: 2826-2845.
62. Norimatsu Y, Moran AR, MacDonald KD. Lubiprostone activates CFTR, but not ClC-2, via the prostaglandin receptor (EP(4)). Biochem Biophys Res Commun. 2012; 426: 374-379.
63. Cuppoletti J, Malinowska DH, Chakrabarti J, et al. Effects of lubiprostone on human uterine smooth muscle cells. Prostaglandins Other Lipid Mediat. 2008; 86: 56-60.
64. Camilleri M, Bharucha AE, Ueno R, et al. Effect of a selective chloride channel activator, lubiprostone, on gastrointestinal transit, gastric sensory, and motor functions in healthy volunteers. Am J Physiol. 2006; 290: G942-G947.
65. Sweetser S, Busciglio IA, Camilleri M, et al. Effect of a chloride channel activator, lubiprostone, on colonic sensory and motor functions in healthy subjects. Am J Physiol. 2009; 296: G295-G301.
66. Cuppoletti J, Blikslager AT, Chakrabarti J, et al. Contrasting effects of linaclotide and lubiprostone on restitution of epithelial barrier properties and cellular homeostasis after exposure to cold stressors. BMC Pharmacol. 2012; 12: 3.
67. Johanson JF, Ueno R. Lubiprostone, a locally acting chloride channel activator, in adult patients with chronic constipation: a double-blind, placebo-controlled, dose-ranging study to evaluate efficacy and safety. Aliment Pharmacol Ther. 2007; 25: 1351-1361.
68. Johanson JF, Morton D, Geenen J, et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally-Acting type-2 chloride channel activator, in patients with chronic constipation. Am J Gastroenterol. 2008; 103: 170-177.
69. Barish CF, Drossman D, Johanson JF, et al. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010; 55: 1090-1097.
70. Lembo AJ, Johanson JF, Parkman HP, et al. Long-Term safety and effectiveness of lubiprostone, a chloride channel (ClC-2) activator, in patients with chronic idiopathic constipation. Dig Dis Sci. 2011; 56: 2639-2645.
71. Chey WD, Drossman DA, Johanson JF, et al. Safety and patient outcomes with lubiprostone for up to 52 weeks in patients with irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2012; 35: 587-599.
72. New drug for chronic constipation. FDA Consum. 2006; 40: 8.
73. Lang L. The Food and Drug Administration approves lubiprostone for irritable bowel syndrome with constipation. Gastroenterology. 2008; 135: 7.
74. Lin JE, Valentino M, Marszalowicz G, et al. Bacterial heat-stable enterotoxins: translation of pathogenic peptides into novel targeted diagnostics and therapeutics. Toxins. 2010; 2: 2028-2054.
75. Verkman AS, Galietta LJV. Chloride channels a drug targets. Nat Rev Drug Discovery. 2009; 8: 153-171.
76. Lin JE, Valentino M, Marszalowicz G, et al. Guanylate cyclase-C receptor activation: unexpected biology. Curr Opinion Pharmacol. 2012; 12: 632-640.
77. Hannig G, Tchernychev B, Kurtz CB, et al. Guanylate cyclase-C/cGMP: an emerging pathway in the regulation of visceral pain. Front Mol Neurosci. 2014; 7: 31.
78. Castro J, Harrington AM, Hughes PA, et al. Linaclotide inhibits colonic nociceptors and relieves abdominal pain via guanylate cyclase-C and extracellular cyclic guanosine 3, 5-monophosphate. Gastroenterology. 2013; 145: 1334-1346.
79. Eutamene H, Bradesi S, Larauche M, et al. Guanylate cyclase C-mediated antinociceptive effects of linaclotide in rodent models of visceral pain. Neurogastroenterol Motil. 2010; 22: 312-E84.
80. Johnston JM, Kurtz CB, Macdougall JE, et al. Linaclotide improves abdominal pain and bowel habits in a phase IIb study of patients with irritable bowel syndrome with constipation. Gastroenterology. 2010; 139: 1877-1886.
81. Whitehead WE, Palsson OS, Gangarosa L, et al. Lubiprostone does not influence visceral pain thresholds in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2011; 23: 944-E400.
82. Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011; 365: 527-536.
83. McWilliams V, Whiteside G, McKeage K. Linaclotide: first global approval. Drugs. 2012; 72: 2167-2175.
84. Shailubhai K, Comiskey S, Foss JA, et al. Plecanatide, an oral guanylate cyclase C agonist acting locally within the gastrointestinal tract, is safe and well-Tolerated in single doses. Dig Dis Sci. 2013; 58: 2580-2586.
85. Camilleri M, Gores GJ. Therapeutic targeting of bile acids. Am J Physiol Gastrointest Liver Physiol. 2015; 309: G209-G215.
86. Rao AS, Wong BS, Camilleri M, et al. Chenodeoxycholate in females with irritable bowel syndrome-constipation: a pharmacodynamic and pharmacogenetic analysis. Gastroenterology. 2010; 139: 1549-1558.
87. Wong BS, Camilleri M. Elobixibat for the treatment of constipation. Expert Opin Investig Drugs. 2013; 22: 277-284.
88. Simrén M, Bajor A, Gillberg PG, et al. Randomised clinical trial: the ileal bile acid transporter inhibitor A3309 vs. placebo in patients with chronic idiopathic constipation-A double-blind study. Aliment Pharmacol Ther. 2011; 34: 41-50.
89. Chey WD, Camilleri M, Chang L, et al. A randomized placebo-controlled phase IIb trial of a3309, a bile acid transporter inhibitor, for chronic idiopathic constipation. Am J Gastroenterol. 2011; 106: 1803-1812.
90. Roarty TP, Weber F, Soykan I, et al. Misoprostol in the treatment of chronic refractory constipation: results of a long-Term open label trial. Aliment Pharmacol Ther. 1997; 11: 1059-1066.
91. Bharucha AE, Low P, Camilleri M, et al. A randomised controlled study of the effect of cholinesterase inhibition on colon function in patients with diabetes mellitus and constipation. Gut. 2013; 62: 708-715.
92. Taghavi SA, Shabani S, Mehramiri A, et al. Colchicine is effective for short-Term treatment of slow transit constipation: a double-blind placebo-controlled clinical trial. Int J Colorectal Dis. 2010; 25: 389-394.
93. Norman JE, Thong KJ, Baird DT. Uterine contractility and induction of abortion in early pregnancy by misoprostol and mifepristone. Lancet. 1991; 338: 1233-1236.
94. Jaffe IA, Hyman GA. Hematologic toxicity after the use of desacetylmethylcolchicine in the treatment of gouty arthritis. N Engl J Med. 1957; 257: 157-161.
95. Caldwell RW, Lowensohn HS, Chryssanthis MA, et al. Interactions of pyridostigmine with cardiopulmonary systems and their relationships to plasma cholinesterase activity. Fundam Appl Toxicol. 1989; 12: 432-441.
96. Kenefick NJ, Nicholls RJ, Cohen RG, et al. Permanent sacral nerve stimulation for treatment of idiopathic constipation. Br J Surg. 2002; 89: 882-888.
97. Thomas GP, Dudding TC, Rahbour G, et al. Sacral nerve stimulation for constipation. Br J Surg. 2013; 100: 174-181.
98. Dinning PG, Hunt L, Patton V, et al. Treatment efficacy of sacral nerve stimulation in slow transit constipation: a two-phase, double-blind randomized controlled crossover study. Am J Gastroenterol. 2015; 110: 733-740.
99. Wexner SD, Daniel N, Jagelman DG. Colectomy for constipation: physiologic investigation is the key to success. Dis Colon Rectum. 1991; 34: 851-856.
100. Redmond JM, Smith GW, Barofsky I, et al. Physiological tests to predict long-Term outcome of total abdominal colectomy for intractable constipation. Am J Gastroenterol. 1995; 90: 748-753.
101. Hassan I, Pemberton JH, Young-Fadok TM, et al. Ileorectal anastomosis for slow transit constipation: long-Term functional and quality of life results. J Gastrointest Surg. 2006; 10: 1330-136.
102. Nyam DC, Pemberton JH, Ilstrup DM, et al. Long-Term results of surgery for chronic constipation. Dis Colon Rectum. 1997; 40: 273-279.
103. Glia A, Akerlund JE, Lindberg G. Outcome of colectomy for slow-Transit constipation in relation to presence of small-bowel dysmotility. Dis Colon Rectum. 2004; 47: 96-102.
104. Iturrino J, Camilleri M, Orrock JM. Mega-intestine after subtotal colectomy for constipation. Clin Gastroenterol Hepatol. 2011; 9: A38.
105. FitzHarris GP, Garcia-Aguilar J, Parker SC, et al. Quality of life after subtotal colectomy for slow-Transit constipation: both quality and quantity count. Dis Colon Rectum. 2003; 46: 433-440.
106. Gladman MA, Scott SM, Lunniss PJ, et al. Systematic review of surgical options for idiopathic megarectum and megacolon. Ann Surg. 2005; 241: 562-574.
107. Ding W, Jiang J, Feng X, et al. Clinical and pelvic morphologic correlation after subtotal colectomy with colorectal anastomosis for combined slow-Transit constipation and obstructive defecation. Dis Colon Rectum. 2015; 58: 91-96.
108. Li N, Jiang J, Feng X, et al. Long-Term follow-up of the Jinling procedure for combined slow-Transit constipation and obstructive defecation. Dis Colon Rectum. 2013; 56: 103-112.
109. Bassotti G, Blandizzi C. Understanding and treating refractory constipation. World J Gastrointest Pharmacol Ther. 2014; 5: 77-85.
110. Chiarioni G, Whitehead WE, Pezza V, et al. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology. 2006; 130: 657-664.
111. Heymen S, Scarlett Y, Jones K, et al. Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-Type constipation. Dis Colon Rectum. 2007; 50: 428-441.
112. Rao SS, Seaton K, Miller M, et al. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clin Gastroenterol Hepatol. 2007; 5: 331-338.
113. Rao SS, Valestin J, Brown CK, et al. Long-Term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial. Am J Gastroenterol. 2010; 105: 890-896.
114. Pourmomeny AA, Emami MH, Amooshahi M, et al. Comparing the efficacy of biofeedback and balloon-Assisted training in the treatment of dyssynergic defecation. Can J Gastroenterol. 2011; 25: 89-92.
115. Hart SL, Lee JW, Berian J, et al. A randomized controlled trial of anorectal biofeedback for constipation. Int J Colorectal Dis. 2012; 27: 459-466.
116. Simón MA, Bueno AM. Behavioural treatment of the dyssynergic defecation in chronically constipated elderly patients: a randomized controlled trial. Appl Psychophysiol Biofeedback. 2009; 34: 273-277.
117. Farid M, El Monem HA, Omar W, et al. Comparative study between biofeedback retraining and botulinum neurotoxin in the treatment of anismus patients. Int J Colorectal Dis. 2009; 24: 115-120.
118. Zhang Y, Wang ZN, He L, et al. Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training. World J Gastroenterol. 2014; 20: 12602-12607.
119. Faried M, El Nakeeb A, Youssef M, et al. Comparative study between surgical and non-surgical treatment of anismus in patients with symptoms of obstructed defecation: a prospective randomized study. J Gastrointest Surg. 2010; 14: 1235-1243.
120. Maria G, Cadeddu F, Brandara F, et al. Experience with type A botulinum toxin for treatment of outlet-Type constipation. Am J Gastroenterol. 2006; 101: 2570-257.
121. Harris MA, Ferrara A, Gallagher J, et al. Stapled transanal rectal resection vs. transvaginal rectocele repair for treatment of obstructive defecation syndrome. Dis Colon Rectum. 2009; 52: 592-597.
122. Biviano I, Badiali D, Candeloro L, et al. Comparative outcome of stapled trans-Anal rectal resection and macrogol in the treatment of defecation disorders. World J Gastroenterol. 2011; 17: 4199-4205.
123. Dodi G, Pietroletti R, Milito G, et al. Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol. 2003; 7: 148-15.
124. Schwandner O, Fürst A. Assessing the safety, effectiveness, and quality of life after the STARR procedure for obstructed defecation: results of the German STARR registry. Langenbecks Arch Surg. 2010; 395: 505-513.
125. Madbouly KM, Abbas KS, Hussein AM. Disappointing long-Term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg. 2010; 34: 2191-2196.
126. Quigley EM. The enteric microbiota in the pathogenesis and management of constipation. Best Pract Res Clin Gastroenterol. 2011; 25: 119-126.
127. Zhu L, Liu W, Alkhouri R, et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 2014; 46: 679-686.
128. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-Analysis. Am J Gastroenterol. 2014; 109: 1547-1561.