How Does Linzess Work for IBS (Irritable Bowel Syndrome)?

What is Linzess?

Linzess is a medication used to relieve symptoms of irritable bowel syndrome with constipation (IBS‑C) and for the treatment of chronic idiopathic constipation (CIC) or chronic constipation of unknown cause. This medication works in the intestines to help reduce pain and increase bowel movements. It increases the production of cyclic guanosine monophosphate, a chemical that reduces pain-sensing nerve sensitivity and increases the secretion of fluid into the intestine. In August 2012, the FDA approved Linzess (linaclotide), which is manufactured by Ironwood Pharmaceuticals.

Irritable Bowel Syndrome with Constipation (IBS-C)

One of the symptoms often associated with IBS is constipation. The main symptom of IBS is abdominal pain, which is associated with changes in the frequency of bowel movements. Changes in bowel movements may be recurrent or chronic constipation, or diarrhea. At different times, people may have both diarrhea and constipation along with abdominal bloating or distention. 

People and doctors may differently define constipation. Doctors often define constipation as dry hardened stools while most people regard constipation as difficulty passing stools, straining, having infrequent stools, being unable to completely empty the bowels, or the feeling of wanting to pass stools but unable to do so. Around 10-15 percent of people in the United States are affected by IBS, and around 9-23 percent worldwide. 

Linzess showed a marked improvement in patients who have IBS. It was found that after taking Linzess, normal bowel movements returned in 1 in every 5 patients. More bowel movements were also seen in people who took Linzess and had chronic constipation. The discomforts experienced, such as straining and bloating, were also reduced. 

The causes of IBS‑C are unknown. However, according to researchers, several factors may be involved. Factors include:

• Nerve Sensitivity: People with IBS‑C are more prone to experiencing abdominal pain than those without IBS‑C because of extra sensitive nerves in their intestines. 

• Absorption of Fluid: Stools can become hard, dry, and difficult to pass if the colon tends to absorb excess fluid from the stool. Another reason would be the slow movement of muscles in the colon. 

• Brain-Gut Connection: The brain and the gut could have a miscommunication, causing abdominal discomfort, abdominal pain, a change in bowel habits. 

Inform your doctor about your symptoms to help find relief. 

IBS-C and CIC

Both symptoms of IBS-C and CIC are long-lasting, and they include difficult and infrequent bowel movements, as well as passing lumpy or hard stools. However, abdominal pain is common in patients with IBS‑C. 

Mechanism of Action

Linzess is different from laxatives. It is metabolized into naturally occurring amino acids and smaller peptides. It is also related to the human GI peptides called uroguanylin and guanylin. 

• Uroguanylin - is expressed in the duodenum and proximal small intestine (lower pH environment).

• Guanylin - mainly expressed in the higher pH environment of the colon, wherein visceral hypersensitivity is regulated. 

Linzess works in two ways. First is to increase motility in the gastrointestinal tract, and second is to reduce visceral hypersensitivity. Linzess is metabolized within the gastrointestinal tract. It has a low systemic availability and is minimally  

Linaclotide brings about a locally pharmacological effect in the gastrointestinal tract along with a minimal systemic absorption after oral intake. It also tends to be unaffected by stomach acid degradation, as well as aminopeptidase, chymotrypsin, trypsin, and pepsin. However, when it is exposed to carboxypeptidase, it produces a single 13-amino acid degradation product. 

Who could use Linzess?

Linzess could be for people who are:

• Frustrated by their persistent symptoms
• Dissatisfied with the results of over-the-counter medications
• Unable to find relief from various over-the-counter options
• Seeking for an effective treatment that is FDA-approved

Although getting sufferers to open up about their condition can be quite a challenge, it is still important to talk to them about their symptoms. There are many people with chronic idiopathic constipation (CIC) or IBS-C who find their condition embarrassing to talk about, so they end up being unable to bring up their other symptoms. Since both CIC and IBS‑C have multiple symptoms, more encouragement may be required during patient assessment. 

Who should not take Linzess?

Children and individuals who are younger than 17 years old should not use Linzess because the medication may harm them. Patients who have an intestinal obstruction should not also use Linzess. It is still unknown whether this medication is safe to take by breastfeeding and pregnant women. For this reason, women who are breastfeeding, pregnant, or planning for a pregnancy should speak with their doctor before taking Linzess.

Side Effects

Taking Linzess may cause side effects, which include bloating, gas, diarrhea, and abdominal pain or discomfort. Seek immediate medical attention if any of these side effects persist or worsen. However, there are many people who use Linzess and do not experience serious side effects. 

If you experience serious side effects, such as severe diarrhea, stop taking this medication and inform your doctor at once. Very serious allergic reactions to Linzess are rare. However, seek emergency medical help if you experience any of the following allergic reactions:

• Itching
• Rash
• Swelling of the face, lips, tongue, or throat
• Difficulty breathing
• Dizziness

There are also reports of weight changes in people who are taking Linzess. Some have reported gaining weight while others reported losing weight with this medication. You can monitor your weight and inform your doctor if you have significantly gained or lost weight while on medication.

Important Information

Before taking Linzess, inform your healthcare provider or pharmacist if you are allergic to the medication, or if you have other types of allergies. This medication may cause certain allergic reactions or other problems since it contains inactive ingredients. You can ask your doctor or pharmacist for more details about the medication.  

You also need to inform your doctor or pharmacist if you have a medical history of intestinal obstruction or blockage. If you need to undergo surgery, inform your dentist or doctor of all the medications you are currently taking, which includes prescription and nonprescription drugs, herbal medicine, and supplements. 

This product should only be used when clearly required during pregnancy. Women can discuss the benefits and risks of taking this medication with their healthcare provider. It is still unknown whether this medication can pass into the breast milk or not. Tell your doctor if you are currently breastfeeding your child.