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Linzess (Constella) for IBS-C and Chronic Constipation


Updated December 29, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

What Is Linzess (Constella)?:

Linzess (linaclotide) is an oral medication designed for the treatment of constipation-predominant IBS (IBS-C) and chronic idiopathic constipation (CIC). In the U.S., the medication is approved for use in adults 18 years or older who have IBS-C or CIC. In Europe, the medication is called Constella, is approved for treatment of IBS-C, and should be available in the first half of 2013.

How Linzess Works:

Linzess is characterized as a "peptide agonist of guanylate cyclase-C receptors." This means that the medication stimulates specific receptor cells within the digestive tract to increase fluid into the intestines. This action is thought to result in quicker transit time and reduced visceral hypersensitivity. The medication is believed to act locally within the small and large intestine, reducing the risk of unwanted side effects. The recommended dosage of Linzess is higher for IBS-C than that recommended for CIC.

Effectiveness of Linzess:

Clinical studies to date suggest that patients who take Linzess as opposed to a placebo are more likely to experience:

  • An increase in the number of bowel movements
  • Improved stool consistency
  • Less straining
  • Lessening of abdominal discomfort
  • Decrease in bloating

These positive effects are generally seen fairly quickly after starting the medication and remain in effect while patients continue to take the drug.

Reported side effects have been few, with mild to moderate diarrhea as the predominant complaint.

As of now, studies have only compared linaclotide to a placebo. Hopefully, future studies will compare its effectiveness to existing prescription options and other over-the-counter laxatives.

How to Take Linzess:

Linzess is available in capsule form. It is to be taken on an empty stomach no less than a half hour before your first meal of the day.


"Constella® (linaclotide) approved in Europe for the treatment of Irritable Bowel Syndrome with Constipation (IBS-C) in Adults" Ironwood Pharmaceuticals Press Release November 28, 2012.

"FDA approves Linzess to treat certain cases of irritable bowel syndrome and constipation" FDA Press Release August 30, 2012.

Gaman, A., Bucur, M. & Kuo, B. Therapeutic advances in functional gastrointestinal disease: irritable bowel syndrome Therapeutic Advances in Gastroenterology 2009 2:169-181.

"Ironwood and Forest Announce FDA Approval of Linzess (Linaclotide) for the Treatment of Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation" Ironwood Pharmaceuticals Press Release August 30, 2012.

Lee, N. & Wald, A. "Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation" Core Evidence 2012 7:39-47.

Maneerattanaporn, M., Chang, L., & Chey, W. "Emerging Pharmacological Therapies for the Irritable Bowel Syndr ome" Gastroenterology Clinics of North America 2011 40:22-243.

DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.

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