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Health Condition

Constipation

About This Condition

Constipation is a condition in which a person experiences a change in normal bowel habits, characterized by a decrease in frequency and/or passage of hard, dry stools. Constipation can also refer to difficult defecation or to sluggish action of the bowels.

The most common cause of constipation is dietary, which is discussed below. However, constipation may be a component of irritable bowel syndrome or other conditions ranging from drug side effects to physical immobility. Serious diseases, including colon cancer, may sometimes first appear as bowel blockage leading to acute constipation. However, constipation itself does not appear to increase the risk of colon cancer, contrary to popular opinion.1

Although dietary and other natural approaches discussed below are often effective, individuals with constipation should be evaluated by a doctor to rule out potentially serious causes.

Symptoms

Symptoms of constipation include infrequent stools, hard stools, and excessive straining to move the bowels. Frequency of bowel movements and severity of symptoms may vary from person to person.

Other Therapies

Healthcare practitioners often recommend increased dietary fiber and fluid intake to shorten bowel transit time and increase stool weight. Use of laxatives beyond one week is discouraged, due to weakening of the colon and fluid retention. Laxative abuse is common in the elderly and among people with eating disorders.

References

1. Dukas L, Platz EA, Colditz GA, et al. Bowel movement, use of laxatives and risk of colorectal adenomatous polyps among women (United States). Cancer Causes Control 2000;11:907-14.

2. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 104-5.

3. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 52-4.

4. Cockerell KM, Watkins AS, Reeves LB, et al. Effects of linseeds on the symptoms of irritable bowel syndrome: a pilot randomised controlled trial. J Hum Nutr Diet 2012;25:435-43. doi: 10.1111/j.1365-277X.2012.01263.x.

5. Passaretti S, Franzoni M, Comin U, et al. Action of glucomannans on complaints in patients affected with chronic constipation: a multicentric clinical evaluation. Ital J Gastroenterol 1991;23:421-5.

6. Marzio L, Del Bianco R, Donne M, et al. Mouth-to-cecum transit time in patients affected by chronic constipation: effect of glucomannan. Am J Gastroenterol 1989;84:888-91.

7. Marsicano LJ, Berrizbeitia ML, Mondelo A. Use of glucomannan dietary fiber in changes in intestinal habit. G E N 1995;49:7-14 [in Spanish].

8. Signorelli P, Croce P, Dede A. A clinical study of the use of a combination of glucomannan with lactulose in the constipation of pregnancy. Minerva Ginecol 1996;48:577-82 [in Italian].

9. Staianno A, Simeone D, Giudice ED, et al. Effect of the dietary fiber glucomannan on chronic constipation in neurologically impaired children. J Pediatr 2000;136:41-5.

10. Koebnick C, Wagner I, Leitzmann P, Stern U, Zunft HJF. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol 2003;17:655-9.

11. Ojetti V, Ianiro G, Tortora A, et al. The effect of Lactobacillus reuteri supplementation in adults with chronic functional constipation: a randomized, double-blind, placebo-controlled trial. J Gastrointestin Liver Dis 2014;23:387–91.

12. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

13. Passmore AP, Davies KW, Flanagan PG, et al. A comparison of Agiolax and Lactulose in elderly patients with chronic constipation. Pharmacol 1993;47(suppl 1):249-52.

14. Kinnunen O, Winblad I, Koistinen P, Salokannel J. Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients. Pharmacol 1993;47(suppl 1):253-5.

15. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre+senna on colonic transit in loperamide-induced constipation. Pharmacol 1993;47(suppl 1):242-8.

16. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

17. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998:95-8.

18. Weiss RF. Herbal Medicine. Hippokrates Verlag GmbH, Stuttgart, Germany, 1988:105-111

19. Kocharatana P, et al. Clinical trial of maeng-lak seeds used as a bulk laxative. Maharaj Nakornratchasima Hosp Med Bull 1985;9:120-36.

20. Muangman V, Siripraiwan S, Ratanaolarn K, et al. A clinical trial of Ocimum canum Sims seeds as a bulk laxative in elderly post-operative patients. Ramathibodi Med J 1985;8:154-8.

21. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998:95-8.

22. Kocharatana P, et al. Clinical trial of maeng-lak seeds used as a bulk laxative. Maharaj Nakornratchasima Hosp Med Bull 1985;9:120-36.

23. Muangman V, Siripraiwan S, Ratanaolarn K, et al. A clinical trial of Ocimum canum Sims seeds as a bulk laxative in elderly post-operative patients. Ramathibodi Med J 1985;8:154-8.

24. Young RW, Beregi JS Jr. Use of chlorophyllin in the care of geriatric patients. J Am Geriatr Soc 1980;28:46-7.

25. Kangmei C, Shulian Z, Ying Z. Auriculoacupuncture therapy—a traditional Chinese method of treatment. J Tradit Chin Med 1992;12:308-10.

26. Xuemin S. Clinical observations on 50 cases of obstipation treated with acupuncture. J Tradit Chin Med 1982;2:162.

27. Fischer MV, Behr A, Reumont J. Acupuncture—a therapeutic concept in the treatment of painful conditions and functional disorders. Report on 971 cases. Acupunct Electrother Res 1984;9:11-29.

28. Shuli C. Clinical application of acupoint tianshu. J Tradit Chin Med 1992;12:52-4.

29. Klauser AG, Rubach A, Bertsche O, Muller-Lissner SA. Body acupuncture: effect on colonic function in chronic constipation. Z Gastroenterol 1993;31:605-8 [in German].

30. Heymen S, Wexner SD, Vickers D, et al. Prospective, randomized trial comparing four biofeedback techniques for patients with constipation. Dis Colon Rectum 1999;42:1388-93.

31. Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow's milk and chronic constipation in children. N Engl J Med 1998;339:1100-4.

32. Daher S, Solé D, de Morias MB. Cow's milk and chronic constipation in children. N Engl J Med 1999;340:891.

33. Shah N, Lindley K, Milla P. N Engl J Med 199918;340:891-2.

34. Morais MB, Vítolo MR, Aguirre ANC, Fagundes-Nteo U. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. J Pediatr Gastroenterol Nutr 1999;29:132-5.

35. Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. BMJ 1988;296:615-7.

36. Marcus SN, Heaton KW. Effects of a new, concentrated wheat fibre preparation on intestinal transit, deoxycholic acid metabolism and the composition of bile. Gut 1986;27:893-900.

37. Oettl GJ. Effect of moderate exercise on bowel habit. Gut 1991;32:941-4.

38. Bingham SA, Cummings JH. Effect of exercise and physical fitness on large intestinal function. Gastroenterology 1989;97:1389-99.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.