According to surveyors from both academia and the pharmaceutical industry, the general population experiences a 10% incidence rate of constipation. Such a high incidence means that there is a large market for medications and supplements targeted toward constipation, and that the number of players in the market that supply these treatment agents is correspondingly large.
New entrants into the market may feel some intimidation by the large number of companies already supplying constipation treatments. The underlying situation suggests there’s no need to worry. The reason is that constipation remains an “idiopathic” disease, meaning that there is no clear indicator of its cause. As a result, most people don’t know a priori the most effective treatment and must try a few before hitting upon one that works.
At the moment, the market for therapeutics is divisible into four categories. These include herbal supplements that are usually not regulated by the FDA unless there are exceptional circumstances, medical laxatives that can be prescribed or bought over counter, nutritional supplements available in health or fitness stores, and a new class of molecular therapies which act in novel ways unless traditional therapies.
Nutritional supplements include among them distinguished brands like Metamucil, the main ingredients of which are usually some natural product with exceptionally high fiber. For example, psyllium husks from the Plantago shrub are high in fiber and used in supplements. They are often found in powdered form so as to be mixed with water to make a drinkable source of fiber.
For constipation remedies based on herbs, one will likely find that senna is the biggest contender on the block. There actually are a number of other herbal agents which exert a propulsive effect on intestinal contents such as aloe and cascara. However, safety concerns in recent years mean that manufacturers can no longer indicate on labeling that aloe and cascara are meant for constipation. Many people adhere to FDA guidelines.
Over-the-counter laxative agents make up the largest proportion of constipation treatments. Laxative agents are diverse, operating through different physiological labels such as “stimulant”, “lubricant” or “bulk”. The stimulant laxatives actually cause greater muscle movement in the large intestine that helps push food along. The lubricant laxative reduce water uptake in the gut which helps keep the food retain fluid and eases its movement.
The newest entrants to the market for constipation treatments are the compounds with molecular specificity. This means that these medicines were designed specifically to hit chemical “signalers” or “nerve centers” in the gut. The drug Amitiza (or lubiprostone) is thought to physically interact with a ClC2 receptor that allows passage of calcium ions in and out of the intestinal space. This likely affects water balance which in turn affects how foods move through the colon.
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Nice site and good information. Thanks for covering this topic so in depth.