In surveys conducted by academic researchers and pharmaceutical companies, it has been revealed that constipation is a condition that’s estimated to afflict anywhere from 5 to 15% of the general population. The high incidence suggests not only that there exists a very large market for people interested in constipation treatments, but also that in response to the demand a plethora of agents have been developed to combat constipation.
Many entrepreneurs interested in entering the market for supplying constipation treatments may be discouraged by what may seem to be a mature, stable and saturated market. The real situation however, is both more hopeful and bleak simultaneously. The reason is that there are few if any constipation remedies that are effective for everyone all the time. The market is split into various treatments of varying efficacy, with little diagnostics to distinguish which patients benefit from which treatments.
Currently, the treatment market can be divided into 4 types. There are supplemental agents, which don’t require FDA approval. There are herbal agents, which usually fall outside FDA jurisdiction but has occasionally experienced periods of regulation. There are general laxative agents that are either over-the-counter or by prescription. There are the new “targeted therapies” that attempt to address molecular and hormonal causes of constipation.
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.
Herbal agents have come to mean senna, which is a shrubby, bushy plant of Middle Eastern origins. In the past, cascara and aloe have also been used as natural laxative herbs, but the FDA banned such substances for safety reasons. Now, senna is the primary herb for treating constipation. Senna can be purchased in capsule form or tea form. The herb has been used for thousands of years and is thought to be mostly safe, but as with any medication agents consultation with a physician is recommended before dosing.
The largest class of laxatives in the market of constipation treatments is the one that includes OTC agents found in pharmacies and apothecaries. Such laxatives come in various brand names, have various active ingredients and act in different ways. Patients might consider trying two or three classes before settling on any one. For example, lubricant laxatives help reduce water uptake by coating food in an oily cover. If a patient doesn’t respond to it, he or she might try a stimulant laxative that causes the gastrointestinal tract to contract more often for speeding up movement of contents.
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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