Treatment Algorithm for Chronic Idiopathic Constipation and Constipation-Predominant Irritable Bowel Syndrome Derived from a Canadian National Survey and Needs Assessment on Choices of Therapeutic Agents

Can J Gastroenterol Hepatol. 2017:2017:8612189. doi: 10.1155/2017/8612189. Epub 2017 Feb 8.

Abstract

Background. Chronic idiopathic constipation (CIC) and constipation-predominant irritable bowel syndrome (IBS-C) are common functional lower gastrointestinal disorders that impair patients' quality of life. In a national survey, we aimed to evaluate (1) Canadian physician practice patterns in the utilization of therapeutic agents listed in the new ACG and AGA guidelines; (2) physicians satisfaction with these agents for their CIC and IBS-C patients; and (3) the usefulness of these new guidelines in their clinical practice. Methods. A 9-item questionnaire was sent to 350 Canadian specialists to evaluate their clinical practice for the management of CIC and IBS-C. Results. The response rate to the survey was 16% (n = 55). Almost all (96%) respondents followed a standard, stepwise approach for management while they believed that only 24% of referring physicians followed the same approach. Respondents found guanylyl cyclase C (GCC) agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in prioritizing treatment choices and 69% of respondents indicated that a treatment algorithm, applicable to Canadian practice, would be valuable. Conclusion. Based on this needs assessment, a treatment algorithm was developed to provide clinical guidance in the management of IBS-C and CIC in Canada.

MeSH terms

  • Algorithms*
  • Benzofurans / therapeutic use
  • Canada
  • Chronic Disease
  • Constipation / drug therapy*
  • Dietary Fiber / therapeutic use*
  • Dietary Supplements
  • Disease Management
  • Gastroenterologists
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Irritable Bowel Syndrome / drug therapy*
  • Laxatives / therapeutic use*
  • Needs Assessment
  • Peptides / therapeutic use
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Receptors, Enterotoxin
  • Receptors, Guanylate Cyclase-Coupled / agonists
  • Receptors, Peptide / agonists
  • Serotonin 5-HT4 Receptor Agonists / therapeutic use*
  • Surveys and Questionnaires

Substances

  • Benzofurans
  • Dietary Fiber
  • Gastrointestinal Agents
  • Laxatives
  • Peptides
  • Receptors, Peptide
  • Serotonin 5-HT4 Receptor Agonists
  • prucalopride
  • Receptors, Enterotoxin
  • Receptors, Guanylate Cyclase-Coupled
  • linaclotide