Is Lubiprostone safe for chronic constipation?

Question

Hi doctor,

I am a 41-year-old male. I have been experiencing constipation for many years, but it has become more severe recently. I pass stool only once every four to five days, and it is very hard. Sometimes, I notice small cracks and a little blood on the tissue paper. Additionally, I feel constant bloating and heaviness throughout the day.

My doctor prescribed Lubiprostone 8 mcg to be taken twice daily, but I am hesitant to start it because I read about potential side effects. Is it safe for long-term use? What warning signs should I look for to determine if my symptoms are not due to IBS-C but rather colon cancer or an obstruction? I have not experienced weight loss, but my appetite has slightly decreased.

Please advise me on what tests are necessary and how I should modify my lifestyle effectively.

Answer 1

Hi,

Welcome to icliniq.com.

I am deeply concerned about your worries.

Your symptoms suggest chronic constipation, likely related to irritable bowel syndrome with constipation predominance (IBS-C) or functional constipation. Common signs of this condition include passing stool only every four to five days, having hard stools, experiencing bloating, and noticing small streaks of blood from anal fissures due to straining.

The medication prescribed to you, Lubiprostone, works by activating chloride channels in the intestinal lining. This action increases bowel fluid, softens stools, and improves bowel movement frequency.

It is minimally absorbed into the bloodstream and is safe for long-term use in many patients. The most common side effects are mild nausea, headaches, or loose stools, which typically improve as your body adjusts.

Regarding your concern about serious diseases, there are warning signs that would prompt urgent investigation. These include persistent blood in the stool, unexplained weight loss, anemia, severe abdominal pain, vomiting, or a family history of colon cancer.

Small streaks of blood on tissue paper with hard stools usually indicate local irritation or fissures rather than cancer.

At 41 years old, if your constipation has been long-standing but stable, and no alarm symptoms are present, doctors often begin with conservative treatment. However, your physician may still recommend a colonoscopy for reassurance and screening, given your risk factors.

Lifestyle measures are equally important for your condition. Please follow these tips to get symptomatic relief.

Gradually increase your intake of soluble fiber (such as psyllium).
Drink two to three liters of water daily.
Engage in regular physical activity.
Maintain consistent meal and toilet schedules.
Limit excessive processed foods while increasing your intake of fruits, vegetables, and whole grains.

With a combination of medications such as Lubiprostone and lifestyle adjustments, most patients experience significant improvement in bowel regularity and comfort.

I hope this helps address your query. Kindly revert with the answers.

Thank you.