• GLP-1 receptor agonists slow gastric emptying and intestinal motility.¹
• Constipation generally occurs at frequencies in the range of 4–12%, which are lower than those documented for other gastrointestinal adverse events; however, some clinical trials have reported prevalences of up to 25–35% in people with obesity.²

• Constipation shows a bidirectional association with depression.^3-5
• Anxiety is associated with an increased risk of constipation.^3-4
• Several commonly used medications, including antidepressants and antipsychotics, are associated with constipation.¹⁰

• Parkinson's disease: affects more than 80% of patients⁷
• Constipation is the major cause of pain after Spinal cord injury (approximately 80%)⁸
• Multiple sclerosis: up to 70% report constipation or faecal incontinence⁹

1. Jalleh RJ, Plummer MP, Marathe CS, et al. Clinical consequences of delayed gastric emptying with GLP-1 receptor agonists and tirzepatide. J Clin Endocrinol Metab. 2024;110(1):1-15. doi:10.1210/clinem/dgae719
2. Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, et al. Clinical recommendations to manage gastrointestinal adverse events in patients treated with GLP-1 receptor agonists: a multidisciplinary expert consensus. J Clin Med. 2023;12(1):145. doi:10.3390/jcm12010145
3. Li X, Bian C, Dai H, et al. Association of anxiety status and anxiety duration with constipation in adult Americans: NHANES 2007–2010. BMC Gastroenterol. 2025;25(1):31. doi:10.1186/s12876-024-03575-3
4. Huang Y, Wang Y, Xu B, et al. The association between constipation and anxiety: a cross-sectional study and Mendelian randomization analysis. Front Psychiatry. 2025;16:1543692. doi:10.3389/fpsyt.2025.1543692
5. Wang P, Shen X, Wang Y, et al. Association between constipation and major depression in adult Americans: evidence from NHANES 2005–2010. Front Psychiatry. 2023;14:1152435. doi:10.3389/fpsyt.2023.1152435
6. Adibi P, Abdoli M, Daghaghzadeh H, et al. Relationship between depression and constipation: results from a large cross-sectional study in adults. Korean J Gastroenterol. 2022;80(2):77-84. doi:10.4166/kjg.2022.038
7. Xu J, Wang L, Chen X, et al. New understanding on the pathophysiology and treatment of constipation in Parkinson’s disease. Front Aging Neurosci. 2022;14:917499. doi:10.3389/fnagi.2022.917499
8. Faaborg PM, Finnerup NB, Christensen P, et al. Abdominal pain: a comparison between neurogenic bowel dysfunction and chronic idiopathic constipation. Gastroenterol Res Pract. 2013;2013:365037. doi:10.1155/2013/365037
9. Wiesel PH, Norton C, Glickman S, et al. Pathophysiology and management of bowel dysfunction in multiple sclerosis. Eur J Gastroenterol Hepatol. 2001;13(4):441-448. doi:10.1097/00042737-200104000-00025
10. Lindberg G, Hamid SS, Malfertheiner P, et al. World Gastroenterology Organisation global guideline: constipation — a global perspective. J Clin Gastroenterol. 2011;45(6):483-487. doi:10.1097/MCG.0b013e31820fb914

*According to international guidelines, saline laxatives, especially polyethylene glycol (PEG), are effective treatments for chronic constipation (Evidence: strong. Recommendation: strong). PEG is referred to as macrogol in European clinical practice.^10-11

^10. Lindberg G, Hamid SS, Malfertheiner P, et al. World Gastroenterology Organisation global guideline: constipation — a global perspective. J Clin Gastroenterol. 2011;45(6):483-487. doi:10.1097/MCG.0b013e31820fb914
^11. Serra J, Pohl D, Azpiroz F, et al. European Society of Neurogastroenterology and Motility guidelines on functional constipation in adults. Neurogastroenterol Motil. 2020;32:e13762. doi:10.1111/nmo.13762

12. Bellini M et al. BMC Gastroenterol. 2017;17(1):11. 13. Lin JN et al. Geriatr Nurs. 2024;58:368–372.