Barriers to Prescription Therapy Persist in Chronic Idiopathic Constipation Care : Gastro Hep Advances | May 2026

Introduction

Chronic idiopathic constipation (CIC) is one of the most common disorders of gut–brain interaction and is associated with substantial impairment in quality of life, healthcare utilization and economic burden. Although multiple effective prescription therapies are now available, real-world management of CIC continues to rely heavily on lifestyle modification and over-the-counter treatments.

Problem Statement

Despite evolving treatment options and updated clinical guidelines, limited real-world data exist regarding treatment decision-making, barriers to therapy access, patient perceptions and financial burden in CIC care. Understanding the disconnect between healthcare provider practices and patient experiences is essential for improving long-term disease management and treatment accessibility.

Summary

This large US real-world survey highlights important gaps between physician treatment strategies and patient experiences in chronic idiopathic constipation management. Most healthcare professionals reported following guideline-based escalation from lifestyle and dietary modification to over-the-counter agents and eventually prescription medications. However, a substantial proportion of patients who had never received prescription therapy were still considered clinically eligible for such treatment, suggesting underutilization of advanced therapies. Physicians prioritized long-term efficacy and improvement in quality of life when selecting treatment strategies, whereas patients emphasized symptom relief, affordability and treatment safety. Notably, patients frequently identified difficulty obtaining specialist appointments, limited awareness of available prescription medications and inadequate insurance coverage as major barriers to care. In contrast, physicians viewed medication cost and insurance authorization complexity as the primary prescribing obstacles. The study also demonstrated persistent reliance on lifestyle interventions despite relatively modest patient-perceived efficacy. Among prescription agents, linaclotide was generally viewed most favorably by clinicians, although overall patient satisfaction with available prescription therapies was high. Importantly, direct healthcare costs—including physician visits and medication co-payments—remained a meaningful financial burden. Overall, the study underscores that access limitations, insurance barriers and inadequate patient awareness continue to significantly influence CIC management despite the availability of effective pharmacologic therapies.