Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review.

"CONFLICTS OF INTEREST Guarantor of the article: Darren M. Brenner, MD. Specific author contributions: S.S.C.R. and D.M.B. conceived the project and developed the search criteria and parameters for the systematic review, reviewed the literature independently, and provided independent recommendations regarding the quality of studies, strength of evidence, and recommendation grading. Both authors equally contributed to the writing of the manuscript and provided extensive revisions. Financial support: Medical writing support and literature search was provided by BioCentric, Inc. The development of this manuscript was supported by funding from the Bayer US LLC. Potential competing interests: SSCR has served as an advisory board member and consultant for Bayer Pharmaceuticals and previously received unrestricted research grant support from Sun Sweets corporation and California dried plums grower's association.DMB has received consulting fees from Bayer Pharmaceuticals and is supported in research by an unrestricted gift from the Irene D. Pritzker Foundation.Study HighlightsWHAT IS KNOWN✓ Chronic constipation is a common condition that significantly affects quality of life.✓ Approximately 40% of individuals with constipation self-treat with over-the-counter (OTC) laxatives.✓ Multiple classes of OTC therapies are available for treating chronic constipation.✓ Polyethylene glycol was the only OTC therapy to receive a strong recommendation based on high levels of evidence in a previous systematic review published in 2005.WHAT IS NEW HERE✓ The spectrum of OTC products that have been tested has increased and the quality of evidence has improved.✓ There is now good evidence based on high-quality trials supporting the use of polyethylene glycol and senna for constipation.✓ Moderate evidence supports the use of psyllium, fruits, magnesium-containing compounds, bisacodyl, and sodium picosulfate for the treatment of constipation.✓ There is a clear need for more rigorous, high-quality studies using standardized endpoints."

"Financial support: Medical writing support and literature search was provided by BioCentric, Inc. The development of this manuscript was supported by funding from the Bayer US LLC."