We've all experienced those moments when our digestive system decides to take an unexpected pause, leaving us feeling bloated and maybe even a bit frustrated. It's that unsettling sensation of being backed up that has us feeling uncomfortable. But, beyond the physical discomfort, constipation brings with it a myriad of bothersome symptoms that can disrupt our daily lives. 

From the persistent abdominal pain to the bothersome feeling of fullness post-bathroom visits, constipation is both universally relatable and uniquely personal. 

Today, I want to talk about Trulance (plecanatide), a peptide used in adults to treat chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C).  

What is Trulance?

Trulance, known by its generic name plecanatide, is an important peptide for gut health. It is an FDA-approved medication designed to help alleviate symptoms associated with chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). CIC is long-term constipation with an unknown cause. IBS-C causes belly pain and constipation.

How does Trulance work?

Trulance works by targeting the guanylate cyclase-C (GC-C) in the lining of the gastrointestinal tract. GC-C is a protein that plays an important role in regulating fluid secretion and transit time (the time food is in your gut) in the intestines. Trulance activates GC-C, which increases the amount of fluid in your intestines and speeds up the movement of food through your gut. This softens the stool and promotes bowel movements, relieving bloating and stomach pain. 

What are the common side effects of Trulance?

Trulance is generally well-tolerated; however, some people may experience mild side effects. The most commonly reported side effect is diarrhea. Diarrhea often occurs within the first 4 weeks of taking the medication. Those with CIC have also reported sinus infections, upper respiratory tract infections (URI), bloating, gas, and stomach pain. Those with IBS-C have reported nausea, dizziness, URI, and urinary tract infection (UTI).  

It's important to remember that these effects are usually mild and tend to go away on their own as the body gets used to the medication.

What are the serious side effects of Trulance?

While uncommon, some potentially serious side effects associated with Trulance require immediate medical attention if experienced. These include severe diarrhea, dehydration, or bloody stools. 

Prolonged and severe diarrhea may lead to dehydration, presenting as increased thirst, dry mouth, reduced urine output, dizziness, or fainting. 

In clinical studies, this medication causes severe dehydration, leading to death in young animals. To be safe, children and adolescents should not take Trulance.

There have been rare instances of severe complications like bowel obstruction reported in patients with pre-existing conditions, particularly those predisposed to GI obstruction.

If someone has a history of blockages or structural abnormalities in the intestines, it's important to talk with a healthcare provider before starting Trulance. Monitoring for symptoms of GI obstruction, such as sudden or severe abdominal pain, nausea, vomiting, and inability to pass stool is recommended during treatment with Trulance.

How do I take Trulance?

Trulance is a convenient, once-daily oral tablet. It can be taken at any time of the day, with or without food. And it typically starts to work after a week of daily use. The typical dose for CIC and IBS-C is 3mg daily.

Thanks again for listening to The Peptide Podcast, we love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week!

Pro Tips

We're huge advocates of using daily greens in your routine to help with gut, skin, nail, bone, and joint health. We take AG1 (athletic greens) every day. Not only does it have vitamins, minerals, and a diverse range of whole-food sourced ingredients, but it also has probiotics to promote a healthy gut microbiome and adaptogens to help with focus and mood balance. It's vegan, paleo, and keto-friendly.