Chronic constipation affects roughly 16% of adults and 33% of those over 60, with significant impact on quality of life. Modern guidelines recommend stepwise treatment starting with lifestyle and dietary measures (fluid, fibre, exercise), then bulk-forming laxatives, then osmotic and stimulant laxatives, with newer secretagogues for refractory cases. The MedsBase Constipation Medicine catalogue stocks the full pharmacological range, supplied by WHO-GMP πιστοποιημένους κατασκευαστές.
Osmotic laxatives — first-line pharmacotherapy. Lactulose (a non-absorbed disaccharide that draws water into the colon and is metabolised by bacteria producing osmotically-active short-chain fatty acids — also lowers ammonia in hepatic encephalopathy) is stocked as Duphalac Syrup. Onset 24–48 hours; titrate dose (start 15 ml daily, increase to 15 ml twice daily) based on stool output. Macrogol / polyethylene glycol (PEG) 3350 — better tolerated than lactulose, less bloating — is stocked as Movicol Sachets. Mix one sachet in water, can take 1–3 sachets daily.
Stimulant laxatives — for short-term use or as add-on. Bisacodyl 5 mg (stimulates colonic peristalsis directly) is stocked as Dulcoflex. Take in evening for morning bowel action (6–12 hour onset). Useful for bowel preparation before procedures, post-operative constipation, opioid-induced constipation. Cremalax (combination herbal-laxative) as Cremalax. Long-term daily stimulant laxative use (months/years) was once thought to cause “lazy bowel” — modern evidence does not support this, but bulk and osmotic laxatives remain preferred for chronic use.
Lubiprostone — for refractory IBS-C and chronic idiopathic constipation. Lubiprostone (a chloride-channel-2 activator that stimulates intestinal fluid secretion) is FDA-approved for chronic idiopathic constipation, IBS-C (in women), and opioid-induced constipation. Take 24 mcg twice daily with food (lower 8 mcg dose for IBS-C in women). Stocked as Lubowel 24. Side-effect: nausea (mitigated by taking with food).
Prucalopride — selective 5-HT4 agonist for chronic constipation. Prucalopride 2 mg daily is a selective 5-HT4 receptor agonist that stimulates colonic motility — useful for chronic constipation refractory to laxatives. Stocked as Pruvict. Cleaner cardiac safety profile than older 5-HT4 agonists (cisapride, tegaserod). Particularly useful in opioid-induced and elderly constipation.
Herbal adjuncts. The Himalaya Herbolax formulation (containing trivanga bhasma, kasani, sat isabgol — psyllium husk equivalent, and other herbal ingredients) provides bulk + mild stimulant effect. Stocked as Herbolax.
Πώς να επιλέξετε. Mild constipation, no risk factors → lifestyle first (fibre 25–30 g/day, fluid 1.5–2 L/day, regular activity), then bulk-forming agent (psyllium / methylcellulose). Inadequate response → osmotic laxative (lactulose or PEG/macrogol). Add-on for breakthrough → stimulant (bisacodyl). Chronic refractory → lubiprostone or prucalopride. Opioid-induced → osmotic + stimulant first; specific opioid antagonists (naloxegol, methylnaltrexone) where available. Elderly with multiple medications → review polypharmacy (anticholinergics, opioids, calcium-channel blockers, iron) for constipation contributors.
Σημαντικό. New-onset constipation in adults over 50 (particularly with weight loss, rectal bleeding, family history of bowel cancer, or alternating bowel habit) warrants assessment for colorectal cancer rather than empirical laxative use — see your GP for FIT testing or colonoscopy referral. Severe abdominal pain, vomiting, or absolute constipation (no flatus or stool) suggests bowel obstruction and is an emergency. Pregnancy: bulk-forming laxatives, lactulose, and macrogol are first-line; stimulants reserved for short-term use. Children: PEG with electrolytes (PEG 4000 / Macrogol with electrolytes) is the first-line modern treatment.
All MedsBase Constipation Medicine products ship from WHO-GMP πιστοποιημένους κατασκευαστές με διακριτική συσκευασία και καλύπτονται από την Πολιτική Εγγύησης Επαναποστολής.