Your new experience awaits. Try the new design now and help us make it even better

PERSPECTIVE article

Front. Pharmacol.

Sec. Gastrointestinal and Hepatic Pharmacology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1662224

This article is part of the Research TopicNew Insights into the Management of Chronic Idiopathic Constipation: From Physiopathology to Novel Therapeutic StrategiesView all 3 articles

THE MACROGOL REVOLUTION IN THE TREATMENT OF CHRONIC CONSTIPATION A SHORT HISTORY OF LAXATIVES

Provisionally accepted
  • Humanitas Research Hospital, Rozzano, Italy

The final, formatted version of the article will be published soon.

The difficulty of treating constipation has accompanied humanity through the centuries. Until 1990, numerous remedies were proposed to alleviate the condition; however, due to their aggressive nature or side effects, they were mainly used occasionally or for short periods. When used chronically, there was a high risk of adverse events, sometimes even severe ones.Macrogol, a polyethylene glycol polymer of 3500-4000 Daltons, due to its unique physicochemical water binding properties , has revolutionized the treatment of constipation.Macrogol bound to water molecules passes through the entire gastrointestinal tract without being absorbed and metabolized, and without causing significant absorption of water or electrolytes. It is not toxic and does not affect the colonic mucosa. Ultimately, the macrogolwater structure remains unchanged during its transit through the gastrointestinal tract, and, carrying its bound water, increases the luminal volume in the colon with a scarce osmotic effect in the gut lumen. Notably, it has mild adverse effects and no severe adverse effects even when administered long-term or in large amounts.Macrogol changed the paradigm of constipation treatment in the '90s. In the macrogol era, it is now possible to initiate treatment in functional, organic, and secondary constipation. In the macrogol era, the chronic constipation algorithm has shifted to become therapeutic first, then diagnostic, without risks for the patient, who can immediately benefit from the treatment. Macrogol offers the possibility to perform long-term treatment, to be safely used in children, in elderly subjects, during pregnancy, and in the presence of irreversible secondary and organic constipation.

Keywords: Macrogol, Polyethylene glycol,, Constipation, Laxatives, childhood, Elderly, Pregnancy

Received: 08 Jul 2025; Accepted: 04 Aug 2025.

Copyright: © 2025 Corazziari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Enrico Stefano Corazziari, Humanitas Research Hospital, Rozzano, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.