John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Chronic idiopathic constipation in adults: what's new? Volume 24, issue 7, Septembre 2017


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1 Hôpital Charles Nicolle, service d’hépato-gastroentérolopie - UMR 1073, 1 rue de Germont, 76031 Rouen Cedex, France
2 Hôpital Charles Nicolle, service de physiologie digestive et urinaire - UMR 1073, 1 rue de Germont, 76031 Rouen Cedex, France
* Tirés à part

Chronic constipation is a frequent intestinal functional dysfunction. Its symptoms are different in groups of people, characterized by a sensation of incomplete evacuation, infrequent defecations (less than 3 per week), or difficulty to defecate, for at least 6 months. New ROME IV criteria have been defined. They make a distinction between the Irritable Bowel Syndrome with constipation and functional constipation. The aims of this paper are to highlight the novelties about the pathophysiology and the treatment of the constipation. Concerning pathophysiological mechanisms, the role of the microbiota in constipation and the laxative action of biliary acids has been recently demonstrated. New treatments include secretagogues which increase the secretion of chlorine, Elobixat which reduces the reabsorption of biliary acids and probiotics which change the composition of microbiota. The neurostimulation of sacral nerves is in development. Some treatments have been proposed for constipation induced by opioids. They act on peripherical antagonists of opioid receptor.