Intestinal Sodium Blockade being developed for hypertension may also have potentially large applications in the treatment of constipation-related disorders. Constipation-related disorders, defined as less than 3 bowel movements per week, affect approximately 30 to 50 million people in North America. Among these patients, up to 6 million have Irritable Bowel Syndrome with predominant constipation (IBS-C), a condition which couples constipation to pain, bloating and discomfort. Only about 500,000 of these IBS-C patients are medically diagnosed. Additionally, up to 7 million people in North America have opioid induced constipation, a condition common in cancer patients receiving morphine-related medications for pain. The burden of IBS-C and constipation-related disorders is high in terms of cost and quality of life, generating nearly $30 billion of direct and indirect costs to the healthcare system and negatively affecting quality of life more than diabetes, particularly with regard to pain, social functioning, and fatigue.
By modulating sodium absorption in the upper and lower portions of the GI tract, Ardelyx’s NHE3 inhibitors help normalize or augment the intestinal fluid content, an effect that is expected to result in the hydration of the intestinal contents. This normalization of GI fluid may lead to normalization of stool form, thereby alleviating constipation and accelerating stool transit, while providing relief of discomfort and bloating. For individuals with constipation — a group of conditions that includes constipation-predominant irritable bowel syndrome (IBS-C), chronic idiopathic constipation (CIC), and opioid bowel dysfunction (OBD)- these benefits may help to increase the number of complete spontaneous bowel movements (CSBMs) per week, an indicator of improved bowel function.
