CIC is a chronic, functional GI disorder characterized by infrequent bowel movements or difficult passage of stools that persists for several weeks or longer and has an unknown cause. Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Signs and symptoms of chronic constipation can include passing fewer than three stools a week, having lumpy or hard stools and excessive straining to have bowel movements. Constipation may be considered chronic if multiple symptoms are experienced for at least three months.
Although estimates vary, a 2011 retrospective analysis of 100 published studies estimated the prevalence of CIC in adults to be approximately 14%, which represents over 34 million people in the United States. Many CIC sufferers are reported to be unsatisfied with current treatment options.
The pathophysiology of CIC is not completely understood. Clinical evidence suggests that modulation of bile acids may be a useful approach to the treatment of CIC. For example, studies have shown that changes in bile acid concentrations in the colon alter bowel function, that ileal resection results in diarrhea, and that decreasing bile acid concentrations in the colon through the use of the bile acid sequestrant cholestyramine induces constipation.