Take a closer look at Chronic Idiopathic Constipation
Rediscover the role of colon muscle contractions

See how insufficient colon muscle contractions may be why Chronic Idiopathic Constipation (CIC) patients aren't responding to increased water intake, lifestyle changes, or medications (OTC and Rx).1‑6

CIC IS A FUNCTIONAL BOWEL DISORDER6

CIC is defined by the ROME IV criteria as a functional bowel disorder in which symptoms of difficult, infrequent or incomplete defecation predominate. There are multiple potential underlying causes of CIC and it can be divided into three broad categories: normal‑transit constipation, slow‑transit constipation, and defecatory disorder.1,4,6,20

HOW COLON MUSCLES KEEP THINGS MOVING

In a healthy colon, bowel movements may often be preceded by a type of colon muscle contraction known as high‑amplitude propagating contractions (HAPCs).7,8

These HAPCs increase upon awakening and after eating a meal, and play a critical role in transferring colonic contents.7

In addition to HAPCs, colon muscles have been shown to employ additional movement patterns to facilitate bowel movement through the colon.9,10

These movement patterns can be classified by the direction, frequency, and extent of propagation.9,12

Three possible cic risk Factors6

CIC PATIENTS MAY HAVE FEWER HAPCs5,11

Chronic Idiopathic Constipation is most often caused by the disordered function of the colon, rectum, or pelvic floor.1,6 Colonic motor disturbances have been observed across all subgroups of CIC.1,5

In manometric studies, CIC patients have been shown to have fewer and lower amplitude HAPCs in the colon when compared to healthy controls.5,11

This reduction in HAPCs can have an impact on having bowel movements and may be the reason why a patient is constipated.1-5,7

Sizing up an average HAPC12*

*Data based on a high‑resolution colonic manometry study in 10 healthy subjects. This study was designed to investigate the full complement of motor patterns in the normal human colon.12

WHAT'S BEHIND HAPCs?

Because HAPCs are triggered by awakening, it has been suggested that clock genes may be involved.7

Neurotransmitters, such as serotonin, are also involved. Interestingly, about 95% of the body's serotonin is found in the gut, where stimuli can trigger its release from gastrointestinal mucosal cells. Once released, serotonin is involved in the initiation of HAPCs, mediating colonic motility and other basic gut functions.10,13-18

About 95% of the body's SEROTONIN is found in the gut16

MANY PATIENTS STILL CAN'T FIND RELIEF3

If your patients can't find relief, they aren't alone. In a 2004 web‑based survey of 557 adult U.S. patients who experienced at least two symptoms of constipation, and had sought doctor care for their symptoms in the past year, more than half said their chronic constipation symptoms are extremely, very or somewhat bothersome.3

And when patients do have bowel movements, they may not feel it was complete. A study of 94 patients with scintigraphically confirmed slow‑transit constipation found that patients who saw an increase in bowel movements while taking laxatives reported never or rarely having a feeling of complete evacuation.19

In a survey of adult chronic constipation patients3

96%
had tried treatments
FOR THEIR SYMPTOMS
(OTC AND/OR Rx)
47%
weren't completely
satisfied with
their current
treatment

Data from a U.S. web‑based survey in 2004 of 557 adults who experienced at least two symptoms of constipation and sought doctor care for their symptoms in the year before the survey. Treatments used included medications (OTC and Rx).3

If your CIC PATIENTS
can’t find relief,
consider their colon
muscles