This randomized controlled trial investigated the effectiveness of linaclotide compared to placebo in reducing abdominal symptoms (bloating, discomfort, pain) in IBS-C patients using a patient-reported outcome tool (DIBSS-C). The study involved 614 patients across 78 U.S. centers, demonstrating that linaclotide significantly improved abdominal symptoms compared to placebo, with greater reductions in overall abdominal scores (-1.9 vs -1.2) and higher responder rates (40.5% vs 23.4%). Diarrhea-related discontinuation rates were low (1.6%), and symptom improvement persisted unless the medication was withdrawn.

The study supports linaclotide as a superior treatment option for IBS-C, particularly in addressing challenging abdominal symptoms not effectively relieved by osmotic laxatives. The authors emphasize realistic expectations—patients may require up to 12 weeks to see maximal benefit, and complete symptom resolution is uncommon. They recommend using linaclotide as part of a multimodal approach, combining it with dietary modifications, complementary therapies, or neuromodulators for optimal patient outcomes.

Reference: Deutsch J, Schoenfeld P. Treating All the Symptoms of IBS-C: Linaclotide Significantly Decreases Abdominal Pain, Bloating, and Discomfort. American College of Gastroenterology. Published January 13, 2022. Accessed April 14, 2025. https://gi.org/journals-publications/ebgi/treating-all-the-symptoms-of-ibs-c/