Linzess Constella for IBS Constipation

Constipation can be easy to joke about, but of course not being able to comfortably pass a bowel movement is no laughing matter. And while there are lots of potential causes of constipation (eating too little fiber, taking certain medications, having recent surgery), in most cases the condition is temporary and is easy to deal with by changing the diet, getting more exercise, or taking over-the-counter laxatives or stool softeners.

But for some folks, constipation can be a bigger problem—one that requires more aggressive treatment. That's where the prescription medication Linzess (linoclotide) comes in. (In Europe, linoclotide is sold under the brand name Costella.) It's used to treat people with a subtype of irritable bowel syndrome (IBS) who have constipation along with stomach pain, cramps, and bloating. It's often referred to as constipation-predominant irritable bowel syndrome (IBS-C).

Linzess also is used to treat chronic idiopathic constipation (CIC), which the National Institutes of Health defines as "difficult or infrequent passage of stools that lasts for three months or longer with no apparent medical reason for the condition."

If you're dealing with either IBS-C or CIC and your doctor prescribes Linzess for you, here's what you need to know about how the drug helps relieve constipation and more.

How Linzess Works

Linzess is characterized as a "peptide agonist of guanylate cyclase-C receptors." This means the medication stimulates specific receptor cells within the digestive tract to increase the flow of fluid into the intestines.

This action is thought to speed up the rate at which the colon contracts and to reduce the amount of pain a person feels within the abdomen and digestive tract, what's known as "visceral hypersensitivity." Because Linzess is believed to work "locally," within the small and large intestine, there's little risk it will cause unwanted side effects, such as mild to moderate diarrhea.

Is It Effective?

Research shows Linzess works really well. For example, in clinical studies, compared to people taking a placebo, those taking Linzess were more likely to experience:

An increase in the number of bowel movements
Improved stool consistency
Less straining
Less abdominal pain and discomfort
Decrease in bloating

What's more, the drug works quickly once a person starts taking, and is effective for as long as she's on it.

How to Take Linzess

Linzess comes as a capsule. It's easy to take: Swallow the capsule whole (don't crush it up, for example, because this will affect the rate at which your body absorbs it) and, unless your doctor tells you otherwise, take it at the same time every day, on an empty stomach, no less than a half hour before your first meal of the day. So for instance, if you normally have breakfast around 8 a.m., take your Linzess capsule before 7:30.

One more precaution: Even though Linzess is a safe and effective medication for most people, it may not be a good idea for women who are pregnant or nursing a baby to take it. Make sure your doctor knows if you're expecting or breastfeeding if he says he wants to prescribe Linzess for you. Otherwise, know that once you start taking the drug, you may start feeling better within a week or so.

Sources:

_{Ford, A., et.al. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.}

_{Gaman, A., Bucur, M. & Kuo, B. Therapeutic advances in functional gastrointestinal disease: irritable bowel syndrome Therapeutic Advances in Gastroenterology 2009 2:169-181.}

_{Lee, N. & Wald, A. "Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation" Core Evidence 2012 7:39-47.}

_{Maneerattanaporn, M., Chang, L., & Chey, W. "Emerging Pharmacological Therapies for the Irritable Bowel Syndrome" Gastroenterology Clinics of North America 2011 40:22-243.}