In what scenario would you stack a patient on multiple laxatives (ex: Linzess + Prucalopride) if they have an incomplete response to single agent therapies?

This is a relatively common clinical scenario. Although there are no studies to support this approach—and likely never will be—I often combine a prokinetic agent, such as prucalopride, with a secretagogue in refractory cases of constipation. My preferred initial combination is prucalopride with plec...

When I am considering combining multiple agents, I like to take a step back and ensure we understand the physiology so we can appropriately target the treatment. Is there a rectal evacuation disorder present? In this case, we need to address this first with physical therapy and biofeedback. Is there...