bisacodyl / Generic mfg. - LARVOL DELTA

Quality of Bowel Preparation in the General Population. (PubMed, Medicina (Kaunas)) - "Enema (β = -0.20, p < 0.001), bisacodyl (β = -0.16, p < 0.001), and senna solution (β = -0.03, p = 0.012) were linked to poorer bowel preparation quality in comparison with polyethylene glycol... Age, gender, season, medications, withdrawal time, and the type of colorectal lesions influence bowel preparation quality. Personalized approaches, including patient education and targeted interventions, might contribute to improved bowel preparation, especially in older patients, and should be evaluated in future studies."

Journal • Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Oncology • Solid Tumor • Ulcerative Colitis

BOLD: Bisacodyl Oral for Lowering Dysfunction (of Tenckhoff Catheter) (clinicaltrials.gov) - P4 | N=398 | Not yet recruiting | Sponsor: Chinese University of Hong Kong

New P4 trial • Chronic Kidney Disease • Renal Disease

A PRELIMINARY REPORT ON ACCESSIBILITY, AFFORDABILITY, AND AVAILABILITY OF MEDICINES FOR PARKINSON (ADPD 2026) - "The most available medicines were for autonomic symptoms such as omeprazole (98.28%), sildenafil (89.7%), bisacodyl (84.5%), tadalafil (60.3%), and for psychiatric symptoms such as haloperidol (50%) and fluoxetine (48.3%). Among dopaminergic medicines, carbidopa/levodopa was always available in 19% of pharmacies, dopamine agonists in 13.8% (bromocriptine), 6.9% (cabergoline), and 1.7% (ropinirole), and monoamine oxidase B inhibitors in 1.72%...Affordable medicines were those always available in the reference public hospital pharmacy, such as the antipsychotics haloperidol and risperidone, the anticholinergic trihexyphenidyl, and the antidepressant fluoxetine... Similar to other low-income countries, there is poor access to PD medicines in Malawi`s pharmacies due to regulatory, supply chain, and financial barriers."

CNS Disorders • Movement Disorders • Parkinson's Disease • COMT

4-L Split-dose Polyethylene Glycol and Bisacodyl and Docusate Sodium Regimen Versus 2-L Split-dose Polyethylene Glycol Plus Oral Simethicone Regimen for Bowel Preparation Before Colonoscopy (clinicaltrials.gov) - P=N/A | N=450 | Recruiting | Sponsor: Tanta University

New trial

Noncanonical calcium-independent TRPM4 activation governs intestinal fluid homeostasis. (PubMed, Nat Commun) - "Here, we show the TRPM4 channel as a direct target of bisacodyl (BIC), a widely used clinical drug for chronic constipation management, and its active metabolite, deacetyl bisacodyl (DAB)...Additionally, we delineate a signaling axis, TRPM4 → VGCC/NCX → ANO1, that governs ion homeostasis in the epithelium. Together, these findings establish TRPM4 as a key regulator of intestinal fluid balance and reveal its noncanonical calcium-independent activation as a therapeutic strategy for constipation."

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder • Inflammation • ANO1

Effect of Linaclotide on Colonic Motility Assessed With Intraluminal Colonic High-Resolution Manometry in Healthy Subjects. An Acute, Open Label, Randomized, Crossover, Reader-Blinded Study. (PubMed, Neurogastroenterol Motil) - "In healthy controls, acute administration of linaclotide increases the total number of long-distance propagating sequences and the pre-prandial pancolonic pressurizations."

Journal • Colorectal Cancer • Constipation • Gastroenterology • Gastrointestinal Disorder

Effects of Constipation Treatment in Chronic Kidney Disease: A Pilot Feasibility Trial (clinicaltrials.gov) - P=N/A | N=14 | Completed | Sponsor: University of Tennessee | Recruiting ➔ Completed | N=40 ➔ 14

Enrollment change • Trial completion • Chronic Kidney Disease • Constipation • Gastroenterology • Gastrointestinal Disorder • Nephrology • Renal Disease

Effects of Constipation Treatment in Chronic Kidney Disease: A Pilot Feasibility Trial (clinicaltrials.gov) - P=N/A | N=40 | Recruiting | Sponsor: University of Tennessee | Trial primary completion date: Jun 2025 ➔ Nov 2025 | Trial completion date: Jul 2025 ➔ Nov 2025

Trial completion date • Trial primary completion date • Chronic Kidney Disease • Constipation • Gastroenterology • Gastrointestinal Disorder • Nephrology • Renal Disease

G Protein-Coupled Receptor 35 Holds Potential as a Beacon of Hope for Treating Chondrosarcoma. (PubMed, Balkan J Med Genet) - "G protein-coupled receptors are widely known targets for cancer treatment. Here, we showed that bisacodyl can be a potential therapeutic agent in chondrosarcoma cell lines."

Journal • Oncology • Osteosarcoma • Sarcoma • Solid Tumor • CHEK2

Myxedema Ileus: A Rarely Reported Colonic Manifestation of Myxedema Coma (ACG 2025) - "The patient was started on levothyroxine, liothyronine, and hydrocortisone. Due to concern for ileus, the patient was started on a bowel regimen including docusate-senna, bisacodyl, and polyethylene glycol without resolution of his ileus...In this case, myxedema ileus resolved with treatment of myxedema coma following administration of levothyroxine and liothyronine, as well as treatment with laxatives and gastrografin enema. Myxedema coma has a high patient mortality and early recognition of manifestations such as myxedema ileus is important to prevent further complications.Figure: Distended bowel loops throughout the abdomen noted on x-ray, suggestive of ileus."

Cardiovascular • CNS Disorders • Endocrine Disorders • Heart Failure • Hypoglycemia • Mood Disorders

Comparing Safety and Efficacy of Different Bowel Preparation Regimens in Constipated Patients Undergoing Colonoscopy: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials (ACG 2025) - "Fifteen RCTs were included in this network meta-analysis. Compared to 4L PEG (polyethylene glycol), 3L PEG + 3d-Lin (3 days-Linaclotide) (RR=1.29; 95%CI:[1.12,1.47], p=0.0002), 4L PEG + 1d-Lin (RR=1.25; 95%CI:[1.04,1.51], p=0.02), NaP (sodium phosphate) + bisacodyl (RR=1.52; 95%CI:[1.09,2.10], p=0.01) and Probiotic 14d + NaP (RR= 3.59; 95%CI:[1.83,7.04], p=0.0002) arms significantly increased the adequate bowel preparation with Probiotic 14d + NaP group ranked highest and Senna + MgSO4 (Magnesium sulphate) ranked lowest regarding this outcome. The risk of all other adverse effects, including nausea, vomiting, and bloating, was comparable between different regimens, except abdominal pain, which was significantly reduced in the 3L PEG + 3d-Lin arm (RR=0.18; 95%CI:[0.04,0.88], p=0.03) compared to 4L PEG. In constipated patients, Probiotic 14d + NaP showed the highest efficacy for adequate bowel preparation, while Senna + MgSO4 was least effective."

Retrospective data • Review • Constipation • Gastroenterology • Gastrointestinal Disorder

Preventing Inadequate Colonoscopy Bowel Preparation With the Targeted Addition of Adjuncts: A Quality Improvement Study (ACG 2025) - "This study evaluates the impact of using an alternative enhanced prep regimen consisting of combining 15 mg bisacodyl to 4L PEG-3350 on a split schedule for patients at risk for inadequate prep. This was a quality improvement project... Of 2027 outpatient colonoscopies performed during the study period, 446 high risk patients were identified (102 patients with prior inadequate prep and 344 with risk factors) and prescribed the enhanced regimen. 86.8% were males. Average age was 64."

Addiction (Opioid and Alcohol) • Constipation • Diabetes • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Metabolic Disorders • Obesity

Hypertensive Emergency: Moving Fast to Correct Slow Transit Constipation (ACG 2025) - "Despite treatment with oral antihypertensive therapy and intravenous morphine, his symptoms persisted with worsening systolic pressures greater than 200 mmHg...For his severe constipation, polyethylene glycol, senna, lactulose, and bisacodyl suppositories were administered...In cases such as this, it is important to consider this mechanism to provide timely management and attempt to reduce the morbidity and mortality associated with hypertensive emergencies.Figure: Figure 1.A. Portable Upright Abdominal X-ray B. Portable Supine Abdominal X-ray"

Cardiovascular • Colorectal Cancer • Constipation • Diabetes • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hypertension • Metabolic Disorders

Bisacodyl-Induced Ischemic Colitis Following Colonoscopy Preparation in a 58-Year-Old Female: A Case Report (ACG 2025) - "Further studies are warranted to clarify the incidence and risk factors for stimulant laxative-induced ischemic colitis. Figure: Friable mucosa in splenic flexure Figure: Friable, erythematous mucosa in the descending colon"

Case report • Clinical • Asthma • Cardiovascular • Colonic Polyps • Dermatology • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Immunology • Metabolic Disorders • Respiratory Diseases

Preparing for Success: Enhanced Bowel Preparation Protocol Significantly Reduces Inadequate Colonoscopy Preparation, a Retrospective Study of 1,850 Patients (ACG 2025) - "Variables assessed included demographic characteristics (age, gender, BMI), comorbidities (e.g., diabetes, cirrhosis, stroke, dementia, IBD, constipation), prior abdominal surgery, ASA class, functional status, incarceration status, substance use (alcohol, tobacco, marijuana), and medication use (narcotics, benzodiazepines, methadone, tricyclic antidepressants [TCAs], other antidepressants, anticholinergics, antipsychotics, laxatives). Factors independently associated with poor bowel preparation included anticholinergic use (OR 1.4, p = 0.007), baseline laxative use (OR 1.77, p = 0.008), higher ASA class (OR 1.77, p < 0.001), and marijuana use (OR 1.9, p = 0.018). TCA use demonstrated a trend toward significance (OR 1.8, p = 0.072). Following implementation of the updated protocol, "excellent" preparation rates improved from 35.51% to 42.49%, and "poor" preparation rates decreased from 3.78% to 1.62% (χ² = 11.65, p = 0.009)."

Retrospective data • Addiction (Opioid and Alcohol) • Alzheimer's Disease • Cardiovascular • CNS Disorders • Constipation • Dementia • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Metabolic Disorders

Prevalence and Prescription Patterns of IBS Treatments Across Demographic and Socioeconomic Factors (ACG 2025) - "The most commonly prescribed IBS-D medication was loperamide (4%), with prescription IBS-D drugs also used in only 2%...Black patients were more likely to be prescribed stimulant laxatives, particularly bisacodyl (10% vs. 4% in White and 2% in Asian patients)... Among 390,202 individuals in the database, 3.9% (n=14,897) were diagnosed with IBS. The majority (57%) were diagnosed between 36 and 65 years of age, were White (73%) and female (78%). The most commonly used medications for IBS-C were osmotic laxatives (18%), stimulant laxatives (9%), and fiber (6%)."

CNS Disorders • Gastrointestinal Disorder

Bowel Regimen Gone Rogue: A Rare Case of Anaphylaxis Secondary to Over-the-Counter Polyethylene Glycol 3350 (ACG 2025) - "He was given IV methylprednisolone sodium succinate 125mg, IV famotidine 20mg, IV diphenhydramine 25mg and started on an epinephrine infusion...Options without polyethylene glycols or polysorbates include sodium picosulfate, magnesium oxide, anhydrous citric acid; sodium phosphate tablets; oral sulfate solution/tablets; magnesium citrate; bisacodyl; and off label lactulose2.Citations: (1) Stone et al...April 2025. DOI: 10.1053/j.gastro.2025.02.002."

Clinical • Colorectal Cancer • Constipation • Dermatology • Diabetes • Gastroenterology • Gastrointestinal Disorder • Hypotension • Immunology • Metabolic Disorders • Pruritus • Solid Tumor

A Case of Polyethylene Glycol-Induced Ischemic Colitis (ACG 2025) - "Prior case reports have described bisacodyl and PEG with bisacodyl-associated ischemic colitis; however, no prior case reports describe ischemic colitis with PEG alone. While PEG is considered highly safe and efficacious, this case is suggestive of an infrequent episode of PEG-induced ischemic colitis.Figure: Localized erythema and shallow ulcerations of the splenic flexure.Figure: Erythema and ulceration of the sigmoid colon."

Clinical • Atherosclerosis • Colorectal Cancer • Dermatology • Gastroenterology • Gastrointestinal Disorder • Immunology • Metabolic Disorders • Osteoarthritis • Rheumatology • Solid Tumor • CRP

Defecation Patterns in Constipated Patients (clinicaltrials.gov) - P=N/A | N=130 | Recruiting | Sponsor: The California Medical Innovations Institute, Inc. | Suspended ➔ Recruiting | Trial completion date: Mar 2026 ➔ Dec 2026 | Trial primary completion date: Mar 2025 ➔ Dec 2026

Enrollment open • Trial completion date • Trial primary completion date • Constipation • Gastroenterology • Gastrointestinal Disorder

MRI ASSESSMENT OF ACUTE COLONIC VOLUME RESPONSES TO OPIOIDS AND NALOXEGOL IN HEALTHY SUBJECTS: INTERIM RESULTS FROM A RANDOMISED, DOUBLE-BLIND CROSSOVER STUDY (UEGW 2025) - "During each visit, five abdominal MRI scans (each 20 min.) are obtained at 30 min intervals, at baseline, after drug intake, after a standardized 44 g oatmeal and 100 mL Nutridrink (313 kCal) meal, after a second drug dose, and after a bisacodyl 10 mg suppository administration. Interim MRI analysis of 8 HVs suggests different colonic motility responses across groups and timepoints. Toilet visits were suppressed in both codeine groups. Different responses to drug and food intake were found in the ascending and descending colon between the naloxegol+codein and double placebo group on one hand compared to the codein+placebo group."

Clinical • Constipation • Gastroenterology • Gastrointestinal Disorder

EFFICACY AND SAFETY OF PYRIDOSTIGMINE FOR SEVERE CHRONIC CONSTIPATION REFRACTORY TO FIRST-LINE TREATMENTS (UEGW 2025) - "Aims & We carried out a retrospective observational study involving all patients diagnosed with functional constipation (constipation-predominant irritable bowel syndrome [IBS-C] or chronic idiopathic constipation) according to the Rome IV criteria, who met the criteria for severe chronic constipation (2) (defined as two or fewer spontaneous and complete bowel movements per week for a minimum of 6 months, associated with hard stools, sensation of incomplete evacuation, or straining during defecation in at least 25% of bowel movements), who were refractory to first-line treatments (dietary and lifestyle counseling, bulk-forming laxatives, osmotic laxative such as polyethylene glycol and stimulant laxative such as bisacodyl) and who were treated with pyridostigmine in our outpatient gastroenterology clinic from April 2021 to December 2024... In our cohort, pyridostigmine was an effective and safe treatment for IBS-C and chronic idiopathic constipation in patients..."

Clinical • CNS Disorders • Constipation • Dyspepsia • Fatigue • Gastroenterology • Gastrointestinal Disorder • Myasthenia Gravis

ENHANCEMENT OF SENNOSIDES AVAILABILITY IN CHRONIC CONSTIPATION VIA CO-ADMINISTRATION WITH MESALAZINE (UEGW 2025) - "Stimulant laxatives provide quick relief and are preferred by patients and pharmaceutical companies; "sennosides" and "bisacodyl," are more popular compared with bulk-forming laxatives2)... Sennosides is predicted to provoke IL-2 and IFN-γ biosynthesis that induces killer T cell aggregation and subsequent IL-1β production. As the combination group did not show any inflammation, it is assumed that mesalazine prohibits the inflammatory process. These results provide further evidence to indicate that mesalazine can alleviate sennosides-induced inflammation without adversely affecting its efficacy."

Cardiovascular • Constipation • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Immunology • Inflammation • Inflammatory Bowel Disease • Nephrology • Renal Disease • IFNG • IL1B • IL2

AGE, BMI, AND BOWEL HABITS AS PREDICTORS OF PATENCY CAPSULE FAILURE IN PATIENTS PREPARED WITH A PRO-MOTILITY PROTOCOL (UEGW 2025) - "Aims & This retrospective study aimed to evaluate factors associated with PC failure in patients undergoing a pro-motility preparation protocol, consisting of a low-residue diet, followed by a liquid diet and administration of 10 mg bisacodyl at the time of PC ingestion... In patients undergoing patency capsule testing with a pro-motility protocol, PC failure was mainly associated with higher BMI and infrequent bowel movements. A CRT model identified bowel frequency, age, and BMI as key predictors of failure, revealing distinct high- and low-risk profiles. These findings support the use of simple clinical parameters in pre-test assessment to improve patient selection and enhance test success."

Clinical • Anemia • Crohn's disease • Diabetes • Gastroenterology • Hematological Disorders • Immunology • Inflammatory Bowel Disease • Metabolic Disorders • Obesity

NON-INVASIVE BODY SURFACE COLONIC MAPPING CORRELATES WITH REAL-TIME SYMPTOMS IN PATIENTS WITH REFRACTORY SLOW-TRANSIT CONSTIPATION (UEGW 2025) - "Simultaneous HRCM and BSCM recordings were obtained during a 1-hour fasting period, 1 hour after a standardized low-fat meal, and 1 hour after luminally applied 10 mg of bisacodyl... BSCM is an easy-to-apply, painless, non-invasive tool that has the potential to elucidate underlying mechanisms driving symptoms in patients with refractory STC. Relating colonic motility to symptoms could aid in developing a more personalized approach to manage these patients' clinical treatment pathway"

Clinical • Non-invasive • Constipation • Gastroenterology • Gastrointestinal Disorder

DOUBLE-BLIND PLACEBO-CONTROLLED CROSS-OVER MRI STUDY EVALUATING THE ACUTE EFFECT OF CODEINE AND NALOXEGOL ON GASTRIC CONTENT VOLUMES AND MOTILITY IN HEALTHY VOLUNTEERS (UEGW 2025) - "in between the scans, comprising one baseline fasted MRI, one MRI after the intake of either of the three drug combinations: 25 mg naloxegol + 60 mg codeine, 60 mg codeine + placebo, or double placebo, one after a standardized meal with 44 g oatmeal and 100 mL Nutridrink (313 kCal), followed by an MRI scan after a second dose of either 30 mg codeine or placebo, and a final scan after a bisacodyl 10 mg suppository administration. Interim analysis of 10 HVs using cine-MRI revealed significant codeine-induced delays in gastric emptying compared to placebo. However, no significant differences were currently observed between codeine with and without naloxegol, and this will be reassessed on the entire study sample size. Nevertheless, gastric motility revealed only a tendency toward more contractility of the whole stomach but not of the antrum with placebo."

Clinical • Constipation • Gastroenterology • Gastrointestinal Disorder