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Chapter 1: Gastrointestinal
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Irritable bowel syndrome guidance
Management of constipation in adults
Management of constipation in children
Management of diarrhoea in children
Management of dyspepsia and gastro-oesophageal reflux disease
Paediatric reflux disease guidance
Infantile colic guidance
1.1 Dyspepsia and gastro-oesophageal reflux disease
1.2 Antispasmodics and other drugs altering gut motility
1.3 Antisecretory drugs and mucosal protectants
1.4 Antimotility drugs
1.5 Chronic bowel disorders
1.6 Laxatives
1.7 Local preparations for anal and rectal disorders
1.8 Stoma care
1.9 Drugs affecting intestinal secretions
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1.6.7 Other drugs used in constipation
First Line
Second Line
Specialist
Hospital Only
Prucalopride
- Tablets 1mg, 2mg (£24.46 = 2mg daily)
Indications
- Chronic constipation in women only, when at least two laxatives (from different classes) have been tried at the highest tolerated recommended doses for at least 6 months
Dose
- 2mg once daily; elderly over 65 years, initially 1mg once daily, increased if necessary to 2mg once daily
Notes
- Review treatment if no response after 2 weeks
- For use in accordance with NICE TA211 Prucalopride for the treatment of chronic constipation in women (December 2010)
- Only to be initiated by colorectal surgeons and gastroenterologists
Linaclotide (Constella)
The routine commissioning of linaclotide (Constella) is not accepted in Devon for the treatment of irritable bowel syndrome with constipation (IBS-C) in adults (see Commissioning Policy for more details). The policy indicates that in exceptional circumstances the Trust-Managed Individual Patient Treatments process can be used for this indication.
