Chronic Idiopathic Constipation

Not an actual patient.

Constipation is one of the most common gastroenterologic complaints in the general population.1,2

Although traditionally regarded as less than 3 bowel movements a week, constipation is much more than a number.1 It is a bowel condition characterized by infrequent bowel movements, and/or lumpy or hard stools, and/or difficulty with defecation.

Constipation illustration

Epidemiology

Constipation is seen in 6.9% of adults in the general U.S. population,3 and becomes more common with age.2,4 Constipation is more than twice as prevalent in women,4 who are more likely than men to use laxatives and seek health care.2  The prevalence is higher in older individuals, and is even more common in elderly patients receiving long-term care in hospitals or nursing homes.5

Diagnosis

For a diagnosis of chronic idiopathic constipation (CIC), symptoms should be “chronic” (persisting at least six months), and “idiopathic”, lacking another known cause.2,6 Patients should experience two or more of the following symptoms:2,6,7 

  • less than 3 bowel movements per week 
  • ≥25% of bowel movements affected by lumpy or hard stools
  • ≥25% of bowel movements affected by straining
  • ≥25% of bowel movements affected by sensation of incomplete evacuation
  • ≥25% of bowel movements affected by sensation of anorectal blockage
  • ≥25% of bowel movements affected by use of manual maneuvers to facilitate defecation

Additionally, patients with CIC rarely have loose stools without use of a laxative, and have insufficient criteria for irritable bowel syndrome.2,6,7

CIC can be further divided into 3 subtypes largely based on further physiologic testing: dyssynergic defecation (outlet obstruction), slow transit constipation (STC) and normal transit constipation (NTC).7,8,9

Pathophysiology

The pathology is multi-faceted and the 3 constipation subtypes may not be mutually exclusive, with some patients experiencing two or even three of these overlapping constipation subtypes.2,7 The symptoms of dyssynergic defecation — poor coordination between rectal and abdominal wall muscles, pelvic floor muscles and anal sphincter muscles — may co-exist with the increased rectal compliance experienced with NTC.7,10 Fewer postprandial high-amplitude propagating contractions (HAPCs) are observed in both STC, characterized primarily by reduced phasic colonic motor activity, and NTC.10

Navigating CIC

A survey of patients with chronic constipation found that the most frequent symptoms were straining (79%), hard stools (71%), abdominal discomfort (62%), bloating (57%), infrequent bowel movements (57%), and feelings of incomplete evacuation after a bowel movement (54%).6 CIC patients with abdominal symptoms also report substantial missed work, and significant financial burdens.11,12 A careful history and examination of the patient experiencing constipation is essential for taking appropriate steps to manage the condition and alleviate symptoms.2

  1. Bharucha AE, Dorn SD, Lembo A, et al. Gastroenterology. 2013;144(1):211-217.
  2. Brenner DM and Shah M. Gastroenterol Clin N Amer. 2016;45(2):205-216. 
  3. Palsson OS, Whitehead W, Törnblom H, et al. Gastroenterology. 2020;1-49. 
  4. Higgins PD and Johanson JF. Am J Gastroenterol. 2004;99(4):750-759.
  5. De Giorgio R, Ruggeri E, Stanghellini V, et al. BMC Gastroenterology. 2015;15:130.
  6. Lacy BE, Mearin F, Chang L, et al. Gastroenterology. 2016;150:1393-1407.
  7. Tack J, Müller-Lissner S, Stanghellini V, et al. Neurogastroenterol Motil. 2011;23:697-710.
  8. Locke GR, Pemberton JH, Philipps SF. Gastroenterology. 2000;119(6):1766-1778.
  9. Rao SSC and Patcharatrakul T. J Neurogastroenterol Motil. 2016;22(3):423-436.
  10. Ravi K, Bharucha AE, Camilleri M, et al. Gastroenterology. 2010;138(1):1-21.
  11. Heidelbaugh JJ, Stelwagon M, Miller SA, et al. Am J Gastroenterol. 2015;110:580-587.
  12. Herrick LM, Spalding WM, Saito YA, et al. J Med Econ. 2017; 20(3): 273-279. 

Upcoming & Past Conferences in Gastroenterology

  • Upcoming

  • Past

Digestive Disease Week (DDW), 2025

May 3 - 6, 2025 | Link to Event

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

American Society for Parenteral and Enteral Nutrition (ASPEN), 2025

March 22 - 25, 2025

Annual global conference for interdisciplinary, clinical nutrition leaders, providing the latest in clinical nutrition research, education, and products.

Annual Meeting American Academy of Allergy Asthma and Immunology (AAAAI), 2025

February 28 - March 3, 2025

Premier global educational event for allergists and immunologists, with thousands of attendees each year, discussing allergies, asthma, and immune deficiency disorders.

European Crohn's and Colitis Organisation (ECCO), 2025

February 19 - 22, 2025

Annual global congress structured around basic science, traditional medicine and clinical sessions given by some of the world's top GI specialists.

Crohn's & Colitis Congress (CCC), 2025

February 6 - 8, 2025

Annual conference for a multidisciplinary community of practitioners and researchers focusing on inflammatory bowel disease (IBD) by pairing best practices in clinical care with innovative research.

Advances in Inflammatory Bowel Diseases (AIBD), 2024

December 9 - 11, 2024

An all-encompassing event providing real-world clinical education, case studies and new evidence-based approaches in IBD management.

World Congress of Pediatric Gastroenterology, Hepatology and Nutrition (WCPGHAN), 2024

December 4 - 7, 2024

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Gattex® (teduglutide)

  • Long-Term Safety and Effectiveness of Teduglutide in Pediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: An Observational, Prospective, Multicenter Registry

Professional Society for Health Economics and Outcomes Research (ISPOR Europe), 2024

November 17 - 20, 2024

The conference program centers on the importance of scientific evidence in understanding and improving the health and well-being of people across the globe.

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN), 2024

November 6 - 9, 2024

Annual forum for participants to learn about the latest advances in pediatric gastroenterology, hepatology, and nutrition, and to discuss current topics in clinical applications.

Eohilia® (budesonide)

  • Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated analysis of adolescent safety data

American College of Gastroenterology (ACG), 2024

October 25 - 30, 2024

Premier event for clinicians and the general public about digestive disorders and the latest trends in GI technology and therapeutics.

Entyvio® (vedolizumab)

  • Investigating the Relationship Between Endoscopic Characteristics and Treatment Choice for Patients with Ulcerative Colitis Using a Real-world Data Set Linked to Endoscopic Videos Evaluated with Computer Vision
  • Comparative Efficacy of Biologics for the Induction of Clinical Remission and Response in Biologic-naïve Patients with Moderate to Severe Crohn’s Disease: Outcomes from Frequentist and Bayesian Network Meta-analyses
  • Comparative efficacy and safety of subcutaneous vedolizumab versus other targeted inflammatory bowel disease therapies in patients with moderate to severe ulcerative colitis: a network meta-analysis
  • Real-World Effectiveness and Onset of Action of Vedolizumab as a First-Line Biologic in Biologic-Naïve Patients With Ulcerative Colitis
  • Identification of Moderate Disease Severity Definitions for Crohn’s Disease and Ulcerative Colitis: A Review of Phase 3 Trials of Pharmacological Therapy

Eohilia® (budesonide)

  • Effect of budesonide oral suspension on dysphagia symptom resolution and time to first dysphagia symptom response in eosinophilic esophagitis: post hoc analysis of phase 2 and phase 3 trial placebo-controlled trials
  • Effect of budesonide oral suspension on dysphagia symptom outcomes in patients with eosinophilic esophagitis: a pooled post hoc analysis of data from a phase 2 and a phase 3 trial

American College of Allergy, Asthma & Immunology (ACAAI), 2024

October 24 - 28, 2024

Global meeting featuring thought leaders from around the world focused on advancing patient care in allergy and immunology.

Eohilia® (budesonide)

  • Effect of budesonide oral suspension on dysphagia severity outcomes in patients with eosinophilic esophagitis
  • Effect of corticosteroid use on outcomes in patients with eosinophilic esophagitis receiving budesonide oral suspension

Academy of Managed Care Pharmacy Nexus (AMCP Nexus), 2024

October 14 - 17, 2024

Annual event with more than 2,500 members and non-members of the AMCP to engage on the latest innovations and most intentional networking in managed care pharmacy.

Entyvio® (vedolizumab)

  • Development of a risk adjustment model in commercially insured patients with inflammatory bowel disease

American College of Clinical Pharmacy (ACCP), 2024

October 12 - 15, 2024

Annual event dedicated to excellence in clinical pharmacy practice, research, and education.

United European Gastroenterology Week (UEGW), 2024

October 12 - 15, 2024

Global congress for researchers from around the world to present their findings on gastroenterology and digestive health.

Gattex® (teduglutide)

  • Long-term Safety and Effectiveness of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry

Pediatric Intestinal Failure and Rehabilitation Symposium (PIFRS), 2024

September 26 - 28, 2024

Global meeting designed to bring together international and national experts in the multidisciplinary care of the intestinal failure patient.

Gattex® (teduglutide)

  • Long-term Safety & Effectiveness of Teduglutide in Pediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: A Multicenter Registry

Gastroenterology and Hematology Advanced Practice Providers (GHAAP), 2024

September 12 - 14, 2024

Conference specifically designed by advanced practice providers (APPs) for the purpose of meeting the educational needs of APPs who specialize in the management of patients with GI disorders and chronic liver disease.

Entyvio® (vedolizumab)

  • Proactive Patient Engagement to Promote Representative Patient Populations for Future Trials of Dual Targeted Therapies in Inflammatory Bowel Diseases

Eohilia® (budesonide)

  • Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated analysis of phase 2 and 3 clinical studies

American College of Clinical Pharmacology (ACCP), 2024

September 8 - 10, 2024

Annual congress to improve global health by advancing the frontiers of

clinical pharmacology

Eohilia® (budesonide)

  • Effect of food on the pharmacokinetics, safety and tolerability of budesonide oral suspension in healthy adults: a randomized phase 1 study

European Society for Clinical Nutrition & Metabolism Congress (ESPEN), 2024

September 7 - 10, 2024

Annual global congress dedicated to clinical nutrition and metabolism, including basic and clinical research, education, and organization of consensus statements about clinical care.

Gattex® (teduglutide)

  • Long-term Safety of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry
  • Long-term Effectiveness of Teduglutide in Paediatric Patients with Short Bowel Syndrome-Associated Intestinal Failure: an Observational, Prospective, Multicentre Registry

Digestive Disease Week (DDW), 2024

May 18 - 21, 2024

Global meeting for physicians, researchers, and industry in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

Gattex® (teduglutide)

  • Short bowel syndrome patient experience: a mixed-method study leveraging Inspire, an online community platform.

Entyvio® (vedolizumab)

  • Proactive patient engagement to promote representative patient populations for future trials of dual targeted therapies in inflammatory bowel diseases.
  • Machine Learning-Based Precision Medicine Approach Identifies Specific Responder Sub-Populations in the Vedolizumab treated patients by Dynamic Clustering of PRO Data: Post Hoc Analysis of VARSITY and GEMINI Dataset.
  • Biologic Therapy Sequencing in Ulcerative Colitis: A Real-World Observational Study of Second-Line Therapy After Vedolizumab [encore].
  • Real-world clinical effectiveness and safety of vedolizumab and ustekinumab in biologic-naïve patients with Crohn's disease by disease location: Results from the EVOLVE Expansion study [encore].

Eohilia® (budesonide)

  • Safety of short-term therapy with budesonide oral suspension for eosinophilic esophagitis: an integrated safety analysis of four phase 1–3 clinical studies.

Motegrity® (prucalopride)

  • Diagnostic journey of patients with chronic idiopathic constipation in the USA: analysis from a cross-sectional observational study.

Professional Society for Health Economics and Outcomes Research (ISPOR), 2024

May 5 - 8, 2024

Leading global conference discussing how to establish, incentivize, and share value sustainable for health systems, patients, and technology developers.

Academy of Managed Care Pharmacy (AMCP), 2024

April 15 - 18, 2024

Large assembly of pharmacy and healthcare professionals dedicated to the issues of managed care pharmacy, offering immersive education sessions and keynote presentations.

Campaign Urging Research for Eosinophilic Disease (CURED), 2024

April 4 - 7, 2024

International meeting concerning the field of Eosinophilic Gastrointestinal Disorders, including EoE and other eosinophilic diseases.

Eohilia® (budesonide)

  • Improved histopathologic features in patients with eosinophilic esophagitis: data from a phase 3, randomized, placebo-controlled trial of budesonide oral suspension

Medication Resources

Motegrity®

(prucalopride)

Amitiza®

(lubiprostone)