Volume 89 - 2026 - Fasc.1 - Reviews
Linaclotide for irritable bowel syndrome with constipation: integrating realworld evidence into the therapeutic puzzle
Irritable bowel syndrome with constipation (IBS-C) is
a common subtype of functional bowel disorder associated
with substantial symptom burden and reduced quality of
life. Management typically begins with dietary and lifestyle
modification, laxatives, and antispasmodics; however, many
patients experience inadequate relief, underscoring the need for
more effective therapies.
Linaclotide, a synthetic guanylin analog, is an established
treatment for IBS-C. By activating guanylate cyclase-C (GCC)
receptors on intestinal epithelial cells, it promotes intestinal
fluid secretion, accelerates transit, and alleviates visceral
hypersensitivity. Randomized controlled trials have demonstrated
its efficacy and favorable safety profile, with mild-to-moderate
diarrhea and abdominal pain being the most common adverse
events. Because clinical trial populations may not fully reflect
real-world patient diversity, real-world evidence (RWE) provides
valuable complementary data. This review summarizes current
RWE on linaclotide in IBS-C, integrating findings from multiple
studies to present a comprehensive view of its effectiveness and
safety in routine clinical practice