Review ArticleClinical Review

Chronic Constipation: An Evidence-Based Review

Lawrence Leung, Taylor Riutta, Jyoti Kotecha and Walter Rosser
The Journal of the American Board of Family Medicine July 2011, 24 (4) 436-451; DOI: https://doi.org/10.3122/jabfm.2011.04.100272

References

  1. ↵
    Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not seeking health care: use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 1982; 83: 529–34.
    OpenUrlPubMedWeb of Science
  2. ↵
    Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ. Variation of bowel habit in two population samples. Br Med J 1965; 2: 1095–9.
    OpenUrlFREE Full Text
  3. ↵
    Pare P, Ferrazzi S, Thompson WG, Irvine EJ, Rance L. An epidemiological survey of constipation in canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol 2001; 96: 3130–7.
    OpenUrlCrossRefPubMedWeb of Science
  4. ↵
    Heaton KW, Radvan J, Cripps H, Mountford RA, Braddon FE, Hughes AO. Defecation frequency and timing, and stool form in the general population: a prospective study. Gut 1992; 33: 818–24.
    OpenUrlAbstract/FREE Full Text
  5. ↵
    Herz MJ, Kahan E, Zalevski S, Aframian R, Kuznitz D, Reichman S. Constipation: a different entity for patients and doctors. Fam Pract 1996; 13: 156–9.
    OpenUrlAbstract/FREE Full Text
  6. ↵
    Ashraf W, Park F, Lof J, Quigley EM. An examination of the reliability of reported stool frequency in the diagnosis of idiopathic constipation. Am J Gastroenterol 1996; 91: 26–32.
    OpenUrlPubMedWeb of Science
  7. ↵
    Drossman DA. Rome III: the new criteria. Chin J Dig Dis 2006; 7: 181–5.
    OpenUrlCrossRefPubMed
  8. ↵
    Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006; 130: 1480–91.
    OpenUrlCrossRefPubMedWeb of Science
  9. ↵
    Brown WJ, Mishra G, Lee C, Bauman A. Leisure time physical activity in Australian women: relationship with well being and symptoms. Res Q Exerc Sport 2000; 71: 206–16.
    OpenUrlCrossRefPubMedWeb of Science
  10. ↵
    Digesu GA, Panayi D, Kundi N, Tekkis P, Fernando R, Khullar V. Validity of the Rome III criteria in assessing constipation in women. Int Urogynecol J Pelvic Floor Dysfunct 2010 Oct; 21(10): 1185–93.
    OpenUrlPubMed
  11. ↵
    Garrigues V, Galvez C, Ortiz V, Ponce M, Nos P, Ponce J. Prevalence of constipation: agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain. Am J Epidemiol 2004; 159: 520–6.
    OpenUrlAbstract/FREE Full Text
  12. ↵
    Cowlam S, Khan U, Mackie A, Varma JS, Yiannankou Y. Validity of segmental transit studies used in routine clinical practice, to characterize defaecatory disorder in patients with functional constipation. Colorectal Dis 2008; 10: 818–22.
    OpenUrlPubMed
  13. ↵
    Manabe N, Wong BS, Camilleri M, Burton D, McKinzie S, Zinsmeister AR. Lower functional gastrointestinal disorders: evidence of abnormal colonic transit in a 287 patient cohort. Neurogastroenterol Motil 2010 Mar; 22(3): 293–e82.
    OpenUrlCrossRefPubMed
  14. ↵
    Bharucha AE. Update of tests of colon and rectal structure and function. J Clin Gastroenterol 2006; 40: 96–103.
    OpenUrlCrossRefPubMed
  15. ↵
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG. A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America. J Pain Symptom Manage 2009; 37: 737–45.
    OpenUrlCrossRefPubMedWeb of Science
  16. ↵
    Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004; 99: 750–9.
    OpenUrlCrossRefPubMedWeb of Science
  17. ↵
    Bouras EP, Tangalos EG. Chronic constipation in the elderly. Gastroenterol Clin North Am 2009; 38: 463–80.
    OpenUrlCrossRefPubMedWeb of Science
  18. ↵
    Hosia-Randell H, Suominen M, Muurinen S, Pitkala KH. Use of laxatives among older nursing home residents in Helsinki, Finland. Drugs Aging 2007; 24: 147–54.
    OpenUrlCrossRefPubMedWeb of Science
  19. ↵
    Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol 2005; 100(Suppl 1): S5–21.
    OpenUrlCrossRefPubMed
  20. ↵
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Paul SM, Varma MG. Gender differences in self-reported constipation characteristics, symptoms, and bowel and dietary habits among patients attending a specialty clinic for constipation. Gend Med 2009; 6: 259–71.
    OpenUrlPubMed
  21. Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Talley NJ. Cumulative incidence of chronic constipation: a population-based study 1988–2003. Aliment Pharmacol Ther 2007; 26: 1521–8.
    OpenUrlPubMed
  22. ↵
    Kepenekci I, Keskinkilic B, Akinsu F, et al. Prevalence of pelvic floor disorders in the female population and the impact of age, mode of delivery, and parity. Dis Colon Rectum 2011; 54: 85–94.
    OpenUrlCrossRefPubMedWeb of Science
  23. ↵
    van Wijk CM, Kolk AM. Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Medicine 1997; 45: 231–46.
    OpenUrl
  24. ↵
    Shah ND, Chitkara DK, Locke GR, Meek PD, Talley NJ. Ambulatory care for constipation in the United States, 1993–2004. Am J Gastroenterol 2008; 103: 1746–53.
    OpenUrlCrossRefPubMedWeb of Science
  25. ↵
    Shaheen NJ, Hansen RA, Morgan DR, et al. The burden of gastrointestinal and liver diseases, 2006. Am J Gastroenterol 2006; 101: 2128–38.
    OpenUrlCrossRefPubMedWeb of Science
  26. ↵
    Rantis PC Jr, Vernava AM 3rd, Daniel GL, Longo WE. Chronic constipation: is the work-up worth the cost? Dis Colon Rectum 1997; 40: 280–6.
    OpenUrlPubMed
  27. ↵
    Nyrop KA, Palsson OS, Levy RL, et al. Costs of health care for irritable bowel syndrome, chronic constipation, functional diarrhoea and functional abdominal pain. Aliment Pharmacol Ther 2007; 26: 237–48.
    OpenUrlCrossRefPubMedWeb of Science
  28. ↵
    Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther 2007; 26: 227–36.
    OpenUrlCrossRefPubMed
  29. ↵
    O’Keefe EA, Talley NJ, Zinsmeister AR, Jacobsen SJ. Bowel disorders impair functional status and quality of life in the elderly: a population-based study. J Gerontol A Biol Sci Med Sci 1995; 50: M184–9.
    OpenUrlPubMed
  30. ↵
    Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Therapeutics 2010; 31: 938–49.
    OpenUrl
  31. ↵
    Leroi AM, Bernier C, Watier A, et al. Prevalence of sexual abuse among patients with functional disorders of the lower gastrointestinal tract. Int J Colorectal Dis 1995; 10: 200–6.
    OpenUrlCrossRefPubMed
  32. Petticrew M, Rodgers M, Booth A. Effectiveness of laxatives in adults. Qual Health Care 2001; 10: 268–73.
    OpenUrlFREE Full Text
  33. Campbell AJ, Busby WJ, Horwath CC. Factors associated with constipation in a community based sample of people aged 70 years and over. J Epidemiol Community Health 1993; 47: 23–6.
    OpenUrlAbstract/FREE Full Text
  34. ↵
    Towers AL, Burgio KL, Locher JL, Merkel IS, Safaeian M, Wald A. Constipation in the elderly: influence of dietary, psychological, and physiological factors. J Am Geriatr Soc 1994; 42: 701–6.
    OpenUrlPubMedWeb of Science
  35. Nehra V, Bruce BK, Rath-Harvey DM, Pemberton JH, Camilleri M. Psychological disorders in patients with evacuation disorders and constipation in a tertiary practice. Am J Gastroenterol 2000; 95: 1755–8.
    OpenUrlCrossRefPubMed
  36. ↵
    Chang JY, Locke GR, Schleck CD, Zinsmeister AR, Talley NJ. Risk factors for chronic constipation and a possible role of analgesics. Neurogastroenterol Motil 2007; 19: 905–11.
    OpenUrlPubMed
  37. ↵
    Patient handout. Does constipation ruin your day? What you eat, drink, and do can make a difference. Geriatrics 2005; 60: 19.
    OpenUrl
  38. ↵
    Frizelle F, Barclay M. Constipation in adults. Clin Evid (Online) 2007.
  39. ↵
    Pourhoseingholi MA, Kaboli SA, Pourhoseingholi A, et al. Obesity and functional constipation; a community-based study in Iran. J Gastrointest Liver Dis 2009; 18: 151–5.
    OpenUrl
  40. ↵
    Surrenti E, Rath DM, Pemberton JH, Camilleri M. Audit of constipation in a tertiary referral gastroenterology practice. Am J Gastroenterol 1995; 90: 1471–5.
    OpenUrlPubMed
  41. ↵
    Prather CM. Subtypes of constipation: sorting out the confusion. Rev Gastroenterol Disord 2004; 4(Suppl 2): S11–6.
    OpenUrlPubMed
  42. ↵
    Bannister JJ, Abouzekry L, Read NW. Effect of aging on anorectal function. Gut 1987; 28: 353–7.
    OpenUrlAbstract/FREE Full Text
  43. Laurberg S, Swash M. Effects of aging on the anorectal sphincters and their innervation. Dis Colon Rectum 1989; 32: 737–42.
    OpenUrlPubMedWeb of Science
  44. Akervall S, Nordgren S, Fasth S, Oresland T, Pettersson K, Hulten L. The effects of age, gender, and parity on rectoanal functions in adults. Scand J Gastroenterol 1990; 25: 1247–56.
    OpenUrlCrossRefPubMed
  45. ↵
    Rao SS, Welcher KD, Leistikow JS. Obstructive defecation: a failure of rectoanal coordination. Am J Gastroenterol 1998; 93: 1042–50.
    OpenUrlCrossRefPubMedWeb of Science
  46. ↵
    Rao SS. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastrointest Endosc Clin N Am 2009; 19: 117–39.
    OpenUrlCrossRefPubMed
  47. ↵
    Hutson JM, McNamara J, Gibb S, Shin YM. Slow transit constipation in children. J Paediatr Child Health 2001; 37: 426–30.
    OpenUrlPubMed
  48. ↵
    Preston DM, Lennard-Jones JE. Severe chronic constipation of young women: ‘idiopathic slow transit constipation.’ Gut 1986; 27: 41–8.
    OpenUrlAbstract/FREE Full Text
  49. ↵
    Herve S, Savoye G, Behbahani A, Leroi AM, Denis P, Ducrotte P. Results of 24-h manometric recording of colonic motor activity with endoluminal instillation of bisacodyl in patients with severe chronic slow transit constipation. Neurogastroenterol Motil 2004; 16: 397–402.
    OpenUrlPubMed
  50. ↵
    Bassotti G, Gaburri M, Imbimbo BP, et al. Colonic mass movements in idiopathic chronic constipation. Gut 1988; 29: 1173–9.
    OpenUrlAbstract/FREE Full Text
  51. ↵
    Stivland T, Camilleri M, Vassallo M, et al. Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology 1991; 101: 107–15.
    OpenUrlPubMedWeb of Science
  52. ↵
    Bannister JJ, Davison P, Timms JM, Gibbons C, Read NW. Effect of stool size and consistency on defecation. Gut 1987; 28: 1246–50.
    OpenUrlAbstract/FREE Full Text
  53. ↵
    Lanfranchi GA, Bazzocchi G, Brignola C, Campieri M, Labo G. Different patterns of intestinal transit time and anorectal motility in painful and painless chronic constipation. Gut 1984; 25: 1352–7.
    OpenUrlAbstract/FREE Full Text
  54. ↵
    Bassotti G, Chiarioni G, Imbimbo BP, et al. Impaired colonic motor response to cholinergic stimulation in patients with severe chronic idiopathic (slow transit type) constipation. Dig Dis Sci 1993; 38: 1040–5.
    OpenUrlCrossRefPubMedWeb of Science
  55. ↵
    Tomita R, Tanjoh K, Fujisaki S, Ikeda T, Fukuzawa M. Regulation of the enteric nervous system in the colon of patients with slow transit constipation. Hepatogastroenterology 2002; 49: 1540–4.
    OpenUrlPubMed
  56. ↵
    Hagiwara N, Tomita R. Pathophysiology of chronic constipation of the slow transit type from the aspect of the type of rectal movements. Hepatogastroenterology 2008; 55: 1298–303.
    OpenUrlPubMed
  57. ↵
    Bassotti G, de Roberto G, Castellani D, Sediari L, Morelli A. Normal aspects of colorectal motility and abnormalities in slow transit constipation. World J Gastroenterol 2005; 11: 2691–6.
    OpenUrlPubMedWeb of Science
  58. ↵
    Bassotti G, Morelli A, Whitehead WE. Abnormal rectosigmoid myoelectric response to eating in patients with severe idiopathic constipation (slow-transit type). Dis Colon Rectum 1992; 35: 753–6.
    OpenUrlPubMed
  59. ↵
    Hanani M, Fellig Y, Udassin R, Freund HR. Age-related changes in the morphology of the myenteric plexus of the human colon. Auton Neurosci 2004; 113: 71–8.
    OpenUrlPubMed
  60. ↵
    Bassotti G, Villanacci V, Maurer CA, et al. The role of glial cells and apoptosis of enteric neurones in the neuropathology of intractable slow transit constipation. Gut 2006; 55: 41–6.
    OpenUrlAbstract/FREE Full Text
  61. ↵
    Wedel T, Spiegler J, Soellner S, et al. Enteric nerves and interstitial cells of Cajal are altered in patients with slow-transit constipation and megacolon. Gastroenterology 2002; 123: 1459–67.
    OpenUrlCrossRefPubMedWeb of Science
  62. ↵
    Lee JI, Park H, Kamm MA, Talbot IC. Decreased density of interstitial cells of Cajal and neuronal cells in patients with slow-transit constipation and acquired megacolon. J Gastroenterol Hepatol 2005; 20: 1292–8.
    OpenUrlCrossRefPubMedWeb of Science
  63. ↵
    King SK, Sutcliffe JR, Ong SY, et al. Substance P and vasoactive intestinal peptide are reduced in right transverse colon in pediatric slow-transit constipation. Neurogastroenterol Motil 2010 Aug; 22(8): 883–92, e234.
    OpenUrlCrossRefPubMed
  64. ↵
    Sjolund K, Fasth S, Ekman R, et al. Neuropeptides in idiopathic chronic constipation (slow transit constipation). Neurogastroenterol Motil 1997; 9: 143–50.
    OpenUrlCrossRefPubMed
  65. Liu L, Shang F, Morgan MJ, King DW, Lubowski DZ, Burcher E. Cyclooxygenase-dependent alterations in substance P-mediated contractility and tachykinin NK1 receptor expression in the colonic circular muscle of patients with slow transit constipation. J Pharmacol Exp Ther 2009; 329: 282–9.
    OpenUrlAbstract/FREE Full Text
  66. ↵
    Tomita R, Fujisaki S, Ikeda T, Fukuzawa M. Role of nitric oxide in the colon of patients with slow-transit constipation. Dis Colon Rectum 2002; 45: 593–600.
    OpenUrlCrossRefPubMed
  67. ↵
    Crane SJ, Talley NJ. Chronic gastrointestinal symptoms in the elderly. Clin Geriatr Med 2007; 23: 721–34.
    OpenUrlCrossRefPubMed
  68. ↵
    Singh G, Vadhavkar S, Wang H. Complications and comorbidities of constipation in adults. Gastroenterology 2007; 132(Suppl 2): A458.
    OpenUrl
  69. ↵
    Chong PS, Bartolo DC. Hemorrhoids and fissure in ano. Gastroenterol Clin North Am 2008; 37: 627–44.
    OpenUrlPubMed
  70. ↵
    Singh G, Kahler K, Bharathi V. Constipation in adults: complications and comorbidities. Gastroenterology 2005; 128(Suppl 2): A154.
    OpenUrl
  71. ↵
    Mitra D, Davis KL, Baran RW. Healthcare costs and clinical sequelae associated with constipation in a managed care population. Am J Gastroenterol 2007; 102: 2.
    OpenUrl
  72. ↵
    Kuncharapu I, Majeroni BA, Johnson DW. Pelvic organ prolapse. Am Fam Physician 2010; 81: 1111–7.
    OpenUrlPubMed
  73. ↵
    Jeon MJ, Chung SM, Jung HJ, Kim SK, Bai SW. Risk factors for the recurrence of pelvic organ prolapse. Gynecol Obstet Invest 2008; 66: 268–73.
    OpenUrlPubMed
  74. ↵
    Narayanaswamy S, Walsh M. Calcified fecolith: a rare cause of large bowel obstruction. Emerg Radiol 2007; 13: 199–200.
    OpenUrlPubMed
  75. ↵
    Nee JM. Colonic obstruction secondary to impaction of a large calcified fecolith: report of a case. Dis Colon Rectum 1983; 26: 677–8.
    OpenUrlPubMed
  76. ↵
    Maull KI, Kinning WK, Kay S. Stercoral ulceration. Am Surg 1982; 48: 20–4.
    OpenUrlPubMedWeb of Science
  77. ↵
    Lundy JB, Gadacz TR. Massive fecal impaction presenting with megarectum and perforation of a stercoral ulcer at the rectosigmoid junction. South Med J 2006; 99: 525–7.
    OpenUrlPubMed
  78. ↵
    Sharma M, Agrawal A. Case report: stercoral sigmoid colonic perforation with fecal peritonitis. Indian J Radiol Imaging 2010; 20: 126–8.
    OpenUrlPubMed
  79. ↵
    Heffernan C, Pachter HL, Megibow AJ, Macari M. Stercoral colitis leading to fatal peritonitis: CT findings. AJR 2005; 184: 1189–93.
    OpenUrlPubMed
  80. ↵
    Huang WS, Wang CS, Hsieh CC, Lin PY, Chin CC, Wang JY. Management of patients with stercoral perforation of the sigmoid colon: report of five cases. World J Gastroenterol 2006; 12: 500–3.
    OpenUrlPubMedWeb of Science
  81. ↵
    Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam Pract 2004; 17: 59–67.
    OpenUrlCrossRefPubMed
  82. ↵
    Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol 2005; 100: 232–42.
    OpenUrlCrossRefPubMedWeb of Science
  83. ↵
    Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 2003; 98: 1790–6.
    OpenUrlCrossRefPubMedWeb of Science
  84. ↵
    Murakami K, Sasaki S, Okubo H, Takahashi Y, Hosoi Y, Itabashi M. Association between dietary fiber, water and magnesium intake and functional constipation among young Japanese women. Eur J Clin Nutr 2007; 61: 616–22.
    OpenUrlPubMed
  85. ↵
    Okubo H, Sasaki S, Murakami K, et al. Dietary patterns associated with functional constipation among Japanese women aged 18 to 20 years: a cross-sectional study. J Nutr Sci Vitaminol (Tokyo) 2007; 53: 232–8.
    OpenUrlPubMed
  86. ↵
    Lindeman RD, Romero LJ, Liang HC, Baumgartner RN, Koehler KM, Garry PJ. Do elderly persons need to be encouraged to drink more fluids? J Gerontol A Biol Sci Med Sci 2000; 55: M361–5.
    OpenUrlAbstract/FREE Full Text
  87. ↵
    Leung FW. Etiologic factors of chronic constipation: review of the scientific evidence. Dig Dis Sci 2007; 52: 313–6.
    OpenUrlCrossRefPubMed
  88. ↵
    De Schryver AM, Keulemans YC, Peters HP, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol 2005; 40: 422–9.
    OpenUrlCrossRefPubMedWeb of Science
  89. ↵
    Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A. Effects of regular exercise in management of chronic idiopathic constipation. Dig Dis Sci 1998; 43: 2379–83.
    OpenUrlCrossRefPubMedWeb of Science
  90. ↵
    Robson KM, Kiely DK, Lembo T. Development of constipation in nursing home residents. Dis Colon Rectum 2000; 43: 940–3.
    OpenUrlCrossRefPubMed
  91. ↵
    Anti M, Pignataro G, Armuzzi A, et al. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepatogastroenterology 1998; 45: 727–32.
    OpenUrlPubMed
  92. ↵
    Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K. Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial. Am J Gastroenterol 2010; 105: 890–6.
    OpenUrlCrossRefPubMed
  93. ↵
    Chiarioni G, Whitehead WE, Pezza V, Morelli A, Bassotti G. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology 2006; 130: 657–64.
    OpenUrlCrossRefPubMedWeb of Science
  94. ↵
    Simon MA, Bueno AM. Behavioural treatment of the dyssynergic defecation in chronically constipated elderly patients: a randomized controlled trial. Appl Psychophysiol Biofeedback 2009; 34: 273–7.
    OpenUrlCrossRefPubMed
  95. ↵
    Amenta M, Cascio MT, Di Fiore P, Venturini I. Diet and chronic constipation: benefits of oral supplementation with symbiotic zir fos (Bifidobacterium longum W11 + FOS Actilight). Acta Biomed 2006; 77: 157–62.
    OpenUrlPubMed
  96. ↵
    An HM, Baek EH, Jang S, et al. Efficacy of lactic acid bacteria (LAB) supplement in management of constipation among nursing home residents. Nutr J 2010; 9: 5.
    OpenUrlCrossRefPubMed
  97. ↵
    Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000; 78: 80–8.
    OpenUrlCrossRefPubMed
  98. ↵
    McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther 1998; 12: 491–7.
    OpenUrlCrossRefPubMedWeb of Science
  99. Cheskin LJ, Kamal N, Crowell MD, Schuster MM, Whitehead WE. Mechanisms of constipation in older persons and effects of fiber compared with placebo. J Am Geriatr Soc 1995; 43: 666–9.
    OpenUrlPubMed
  100. Ashraf W, Park F, Lof J, Quigley EM. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Aliment Pharmacol Ther 1995; 9: 639–47.
    OpenUrlPubMedWeb of Science
  101. Tomas-Ridocci M, Anon R, Minguez M, Zaragoza A, Ballester J, Benages A. [The efficacy of Plantago ovata as a regulator of intestinal transit: a double-blind study compared to placebo]. Rev Esp Enferm Dig 1992; 82: 17–22.
    OpenUrlPubMed
  102. ↵
    Sturtzel B, Elmadfa I. Intervention with dietary fiber to treat constipation and reduce laxative use in residents of nursing homes. Ann Nutr Metab 2008; 52(Suppl 1): 54–6.
    OpenUrlPubMed
  103. ↵
    Sturtzel B, Mikulits C, Gisinger C, Elmadfa I. Use of fiber instead of laxative treatment in a geriatric hospital to improve the wellbeing of seniors. J Nutr Health Aging. 2009; 13: 136–9.
    OpenUrlCrossRefPubMedWeb of Science
  104. ↵
    Hamilton JW, Wagner J, Burdick BB, Bass P. Clinical evaluation of methylcellulose as a bulk laxative. Dig Dis Sci 1988; 33: 993–8.
    OpenUrlCrossRefPubMedWeb of Science
  105. ↵
    Sakakibara R, Yamaguchi T, Uchiyama T, et al. Calcium polycarbophil improves constipation in primary autonomic failure and multiple system atrophy subjects. Mov Disord 2007; 22: 1672–3.
    OpenUrlCrossRefPubMed
  106. ↵
    Dipalma JA, Cleveland MV, McGowan J, Herrera JL. A randomized, multicenter, placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation. Am J Gastroenterol 2007; 102: 1436–41.
    OpenUrlCrossRefPubMed
  107. DiPalma JA, DeRidder PH, Orlando RC, Kolts BE, Cleveland MB. A randomized, placebo-controlled, multicenter study of the safety and efficacy of a new polyethylene glycol laxative. Am J Gastroenterol 2000; 95: 446–50.
    OpenUrlCrossRefPubMedWeb of Science
  108. Cleveland MV, Flavin DP, Ruben RA, Epstein RM, Clark GE. New polyethylene glycol laxative for treatment of constipation in adults: a randomized, double-blind, placebo-controlled study. South Med J 2001; 94: 478–81.
    OpenUrlPubMedWeb of Science
  109. ↵
    Tramonte SM, Brand MB, Mulrow CD, Amato MG, O’Keefe ME, Ramirez G. The treatment of chronic constipation in adults: a systematic review. J Gen Intern Med 1997; 12: 15–24.
    OpenUrlCrossRefPubMedWeb of Science
  110. ↵
    Petticrew M, Watt I, Sheldon T. Systematic review of the effectiveness of laxatives in the elderly. Health Technol Assess 1997; 1: 1–52.
    OpenUrl
  111. ↵
    Lederle FA, Busch DL, Mattox KM, West MJ, Aske DM. Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose. Am J Med 1990; 89: 597–601.
    OpenUrlCrossRefPubMedWeb of Science
  112. ↵
    Kutsal E, Aydemir C, Eldes N, et al. Severe hypermagnesemia as a result of excessive cathartic ingestion in a child without renal failure. Pediatr Emerg Care 2007; 23: 570–2.
    OpenUrlCrossRefPubMedWeb of Science
  113. ↵
    Kienzle-Horn S, Vix JM, Schuijt C, Peil H, Jordan CC, Kamm MA. Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation. Curr Med Res Opin 2007; 23: 691–9.
    OpenUrlCrossRefPubMed
  114. ↵
    Kienzle-Horn S, Vix JM, Schuijt C, Peil H, Jordan CC, Kamm MA. Efficacy and safety of bisacodyl in the acute treatment of constipation: a double-blind, randomized, placebo-controlled study. Aliment Pharmacol Ther 2006; 23: 1479–88.
    OpenUrlCrossRefPubMed
  115. ↵
    Passmore AP, Davies KW, Flanagan PG, Stoker C, Scott MG. A comparison of Agiolax and lactulose in elderly patients with chronic constipation. Pharmacology 1993; 47(Suppl 1): 249–52.
    OpenUrlCrossRefPubMed
  116. ↵
    Passmore AP, Wilson-Davies K, Stoker C, Scott ME. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. BMJ 1993; 307: 769–71.
    OpenUrlAbstract/FREE Full Text
  117. ↵
    Marlett JA, Li BU, Patrow CJ, Bass P. Comparative laxation of psyllium with and without senna in an ambulatory constipated population. Am J Gastroenterol 1987; 82: 333–7.
    OpenUrlPubMed
  118. ↵
    Johanson JF, Morton D, Geenen J, Ueno R. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally-acting type-2 chloride channel activator, in patients with chronic constipation. Am J Gastroenterol 2008; 103: 170–7.
    OpenUrlPubMedWeb of Science
  119. Johanson JF, Ueno R. Lubiprostone, a locally acting chloride channel activator, in adult patients with chronic constipation: a double-blind, placebo-controlled, dose-ranging study to evaluate efficacy and safety. Aliment Pharmacol Ther 2007; 25: 1351–61.
    OpenUrlPubMedWeb of Science
  120. Barish CF, Drossman D, Johanson JF, Ueno R. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci 2010; 55: 1090–7.
    OpenUrlCrossRefPubMed
  121. ↵
    Lin SR, Ke MY, Luo JY, et al. A randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of tegaserod in patients from China with chronic constipation. World J Gastroenterol 2007; 13: 732–9.
    OpenUrlPubMed
  122. Muller-Lissner S, Kamm MA, Musoglu A, Earnest DL, Dunger-Baldauf C, Shetzline MA. Safety, tolerability, and efficacy of tegaserod over 13 months in patients with chronic constipation. Am J Gastroenterol 2006; 101: 2558–69.
    OpenUrlPubMed
  123. Fried M, Johanson JF, Gwee KA, Wagner A, Pecher E, Rueegg P. Efficacy of tegaserod in chronic constipation in men. Am J Gastroenterol 2007; 102: 362–70.
    OpenUrlCrossRefPubMed
  124. Quigley EM, Wald A, Fidelholtz J, Boivin M, Pecher E, Earnest D. Safety and tolerability of tegaserod in patients with chronic constipation: pooled data from two phase III studies. Clin Gastroenterol Hepatol 2006; 4: 605–13.
    OpenUrlCrossRefPubMed
  125. ↵
    Brandt LJ. The FDA’s decision-making process: isn’t it time to temper the principle of protective paternalism? Am J Gastroenterol 2008; 103: 1226–7.
    OpenUrlCrossRefPubMedWeb of Science
  126. ↵
    Schiller LR, Johnson DA. Balancing drug risk and benefit: toward refining the process of FDA decisions affecting patient care. Am J Gastroenterol 2008; 103: 815–9.
    OpenUrlCrossRefPubMedWeb of Science
  127. ↵
    Chey WD, Pare P, Viegas A, Ligozio G, Shetzline MA. Tegaserod for female patients suffering from IBS with mixed bowel habits or constipation: a randomized controlled trial. Am J Gastroenterol 2008; 103: 1217–25.
    OpenUrlPubMed
  128. ↵
    Loughlin J, Quinn S, Rivero E, et al. Tegaserod and the risk of cardiovascular ischemic events: an observational cohort study. J Cardiovasc Pharmacol Ther 2010; 15: 151–7.
    OpenUrlAbstract/FREE Full Text
  129. ↵
    Anderson JL, May HT, Bair TL, Muhlestein JB, Horne BD, Carlquist JF. Lack of association of tegaserod with adverse cardiovascular outcomes in a matched case-control study. J Cardiovasc Pharmacol Ther 2009; 14: 170–5.
    OpenUrlAbstract/FREE Full Text
  130. ↵
    Camilleri M, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Safety assessment of prucalopride in elderly patients with constipation: a double-blind, placebo-controlled study. Neurogastroenterol Motil 2009; 21(12): 1256–e117.
    OpenUrlCrossRefPubMed
  131. ↵
    Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med 2008; 358: 2344–54.
    OpenUrlCrossRefPubMed
  132. Quigley EM, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation: a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2009; 29: 315–28.
    OpenUrlCrossRefPubMedWeb of Science
  133. Coremans G, Kerstens R, De Pauw M, Stevens M. Prucalopride is effective in patients with severe chronic constipation in whom laxatives fail to provide adequate relief: results of a double-blind, placebo-controlled clinical trial. Digestion 2003; 67: 82–89.
    OpenUrlCrossRefPubMedWeb of Science
  134. Dubois D, Gilet H, Viala-Danten M, Tack J. Psychometric performance and clinical meaningfulness of the Patient Assessment of Constipation-Quality of Life questionnaire in prucalopride (RESOLOR) trials for chronic constipation. Neurogastroenterol Motil 2010; 22: e54–63.
    OpenUrlCrossRefPubMed
  135. ↵
    Frampton JE. Prucalopride. Drugs 2009; 69: 2463–76.
    OpenUrlPubMed
  136. ↵
    Jia G, Meng MB, Huang ZW, et al. Treatment of functional constipation with the Yun-chang capsule: a double-blind, randomized, placebo-controlled, dose-escalation trial. J Gastroenterol Hepatol 2010; 25: 487–93.
    OpenUrlPubMed
  137. ↵
    Cheng CW, Bian ZX, Zhu LX, Wu JC, Sung JJ. Efficacy of a Chinese herbal proprietary medicine (Hemp Seed Pill) for functional constipation. Am J Gastroenterol 2011; 106: 120–9.
    OpenUrlPubMed
  138. ↵
    Lin LW, Fu YT, Dunning T, et al. Efficacy of traditional Chinese medicine for the management of constipation: a systematic review. J Altern Complement Med 2009; 15: 1335–46.
    OpenUrlPubMed
  139. ↵
    Arebi N, Kalli T, Howson W, Clark S, Norton C. Systematic review of abdominal surgery for chronic idiopathic constipation. Colorectal Dis Oct 22, 2010 [Epub ahead of print].
  140. ↵
    Faried M, El Nakeeb A, Youssef M, Omar W, El Monem HA. Comparative study between surgical and non-surgical treatment of anismus in patients with symptoms of obstructed defecation: a prospective randomized study. J Gastrointest Surg 2010; 14: 1235–43.
    OpenUrlPubMed
  141. ↵
    Farid M, Youssef T, Mahdy T, et al. Comparative study between botulinum toxin injection and partial division of puborectalis for treating anismus. Int J Colorectal Dis 2009; 24: 327–34.
    OpenUrlPubMed
  142. ↵
    Annells M, Koch T. Constipation and the preached trio: diet, fluid intake, exercise. Int J Nurs Stud 2003; 40: 843–52.
    OpenUrlCrossRefPubMed
  143. ↵
    Zanetti G, Marchiori E, Gasparetto TD, Escuissato DL, Soares Souza A Jr. Lipoid pneumonia in children following aspiration of mineral oil used in the treatment of constipation: high-resolution CT findings in 17 patients. Pediatr Radiol 2007; 37: 1135–9.
    OpenUrlCrossRefPubMedWeb of Science
  144. ↵
    Guntupalli KK, Francis PB. Unilateral lung infiltrate: lipoid pneumonia. Eur Respir J 1991; 4: 125–7.
    OpenUrlAbstract/FREE Full Text
  145. ↵
    Staiano A. Use of polyethylene glycol solution in functional and organic constipation in children. Ital J Gastroenterol Hepatol 1999; 31(Suppl 3): S260–3.
    OpenUrlPubMed
  146. Corazziari E, Badiali D, Bazzocchi G, et al. Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut 2000; 46: 522–6.
    OpenUrlAbstract/FREE Full Text
  147. ↵
    Badiali D, Corazziari E. Use of low dose polyethylene glycol solutions in the treatment of functional constipation. Ital J Gastroenterol Hepatol 1999; 31(Suppl 3): S245–8.
    OpenUrlPubMed
  148. ↵
    Staumont G, Frexinos J, Fioramonti J, Bueno L. Sennosides and human colonic motility. Pharmacology 1988; 36(Suppl 1): 49–56.
    OpenUrlPubMed
  149. ↵
    Wilkins JL, Hardcastle JD. The mechanism by which senna glycosides and related compounds stimulate peristalsis in the human colon. Br J Surg 1970; 57: 864.
    OpenUrlPubMed
  150. ↵
    Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre + senna on colonic transit in loperamide-induced constipation. Pharmacology 1993; 47(Suppl 1): 242–8.
    OpenUrlPubMed
  151. ↵
    Manabe N, Cremonini F, Camilleri M, Sandborn WJ, Burton DD. Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. Aliment Pharmacol Ther 2009; 30: 930–6.
    OpenUrlCrossRefPubMed
  152. ↵
    Lubiprostone: RU 0211, SPI 0211. Drugs R D 2005; 6: 245–8.
    OpenUrlCrossRefPubMed
  153. ↵
    Hussar DA. New drugs: lubiprostone, ranolazine, and anidulafungin. J Am Pharm Assoc 2006; 46: 411–4.
    OpenUrl
  154. ↵
    Tuteja AK, Rao SS. Lubiprostone for constipation and irritable bowel syndrome with constipation. Expert Rev Gastroenterol Hepatol 2008; 2: 727–33.
    OpenUrlPubMed
  155. ↵
    Kim HS. 5-Hydroxytryptamine4 receptor agonists and colonic motility. J Smooth Muscle Res 2009; 45: 25–9.
    OpenUrlPubMed
  156. ↵
    Grider JR, Foxx-Orenstein AE, Jin JG. 5-Hydroxytryptamine4 receptor agonists initiate the peristaltic reflex in human, rat, and guinea pig intestine. Gastroenterology 1998; 115: 370–80.
    OpenUrlCrossRefPubMedWeb of Science
  157. ↵
    Tack J. Prucalopride: a new drug for the treatment of chronic constipation. Expert Rev Gastroenterol Hepatol 2009; 3: 337–43.
    OpenUrlPubMed
  158. ↵
    Johnston JM, Kurtz CB, Drossman DA, et al. Pilot study on the effect of linaclotide in patients with chronic constipation. Am J Gastroenterol 2009; 104: 125–32.
    OpenUrlCrossRefPubMed
  159. ↵
    Lembo AJ, Kurtz CB, Macdougall JE, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology 2010; 138: 886–95.
    OpenUrlCrossRefPubMed
  160. ↵
    Khalif IL, Quigley EM, Konovitch EA, Maximova ID. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Dig Liver Dis 2005; 37: 838–49.
    OpenUrlCrossRefPubMed
  161. ↵
    Borody TJ, Warren EF, Leis SM, Surace R, Ashman O, Siarakas S. Bacteriotherapy using fecal flora: toying with human motions. J Clin Gastroenterol 2004; 38: 475–83.
    OpenUrlCrossRefPubMedWeb of Science
  162. ↵
    American College of Gastroenterology Chronic Constipation Task Force. An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol 2005; 100(Suppl 1): S1–4.
    OpenUrlCrossRefPubMed
  163. ↵
    Locke GR 3rd, Pemberton JH, Phillips SF. American Gastroenterological Association Medical Position Statement: guidelines on constipation. Gastroenterology 2000; 119: 1761–6.
    OpenUrlCrossRefPubMed
  164. ↵
    Southwell BR, Clarke MC, Sutcliffe J, Hutson JM. Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods. Pediatr Surg Int 2009; 25: 559–72.
    OpenUrlCrossRefPubMed
  165. ↵
    Lundin E, Karlbom U, Westlin JE, et al. Scintigraphic assessment of slow transit constipation with special reference to right- or left-sided colonic delay. Colorectal Dis 2004; 6: 499–505.
    OpenUrlCrossRefPubMed
  166. ↵
    Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003; 349: 1360–8.
    OpenUrlCrossRefPubMedWeb of Science
  167. ↵
    Elshazly WG, El Nekady Ael A, Hassan H. Role of dynamic magnetic resonance imaging in management of obstructed defecation case series. Int J Surg 2010; 8: 274–82.
    OpenUrlPubMed
  168. ↵
    Li D, Browne LW, Ladabaum U. Melanosis coli. Clin Gastroenterol Hepatol 2009; 7: A20.
    OpenUrlPubMed
  169. ↵
    Wittoesch JH, Jackman RJ, Mc DJ. Melanosis coli: general review and a study of 887 cases. Dis Colon Rectum 1958; 1: 172–80.
    OpenUrlPubMed
  170. ↵
    Villanacci V, Bassotti G, Cathomas G, et al. Is pseudomelanosis coli a marker of colonic neuropathy in severely constipated patients? Histopathology 2006; 49: 132–7.
    OpenUrlPubMed
  171. ↵
    Walker NI, Bennett RE, Axelsen RA. Melanosis coli: a consequence of anthraquinone-induced apoptosis of colonic epithelial cells. Am J Pathol 1988; 131: 465–76.
    OpenUrlPubMed
  172. ↵
    Orlando FA, Tan D, Baltodano JD, et al. Aberrant crypt foci as precursors in colorectal cancer progression. J Surg Oncol 2008; 98: 207–13.
    OpenUrlCrossRefPubMed
  173. Bird RP, McLellan EA, Bruce WR. Aberrant crypts, putative precancerous lesions, in the study of the role of diet in the aetiology of colon cancer. Cancer Surv 1989; 8: 189–200.
    OpenUrlPubMedWeb of Science
  174. Magnuson BA, Carr I, Bird RP. Ability of aberrant crypt foci characteristics to predict colonic tumor incidence in rats fed cholic acid. Cancer Res 1993; 53: 4499–504.
    OpenUrlAbstract/FREE Full Text
  175. Pretlow TP, O’Riordan MA, Pretlow TG, Stellato TA. Aberrant crypts in human colonic mucosa: putative preneoplastic lesions. J Cell Biochem Suppl 1992; 16G: 55–62.
    OpenUrlPubMed
  176. Figueiredo IN, Figueiredo PN, Stadler G, Ghattas O, Araujo A. Variational image segmentation for endoscopic human colonic aberrant crypt foci. IEEE Trans Med Imaging 2010; 29: 998–1011.
    OpenUrlPubMed
  177. Tudek B, Bird RP, Bruce WR. Foci of aberrant crypts in the colons of mice and rats exposed to carcinogens associated with foods. Cancer Res 1989; 49: 1236–40.
    OpenUrlAbstract/FREE Full Text
  178. ↵
    Mascolo N, Mereto E, Borrelli F, et al. Does senna extract promote growth of aberrant crypt foci and malignant tumors in rat colon? Dig Dis Sci 1999; 44: 2226–30.
    OpenUrlCrossRefPubMedWeb of Science
  179. ↵
    Mereto E, Ghia M, Brambilla G. Evaluation of the potential carcinogenic activity of Senna and Cascara glycosides for the rat colon. Cancer Lett 1996; 101: 79–83.
    OpenUrlCrossRefPubMedWeb of Science
  180. ↵
    Nascimbeni R, Donato F, Ghirardi M, Mariani P, Villanacci V, Salerni B. Constipation, anthranoid laxatives, melanosis coli, and colon cancer: a risk assessment using aberrant crypt foci. Cancer Epidemiol Biomarkers Prev 2002; 11: 753–7.
    OpenUrlAbstract/FREE Full Text
  181. ↵
    Borrelli F, Mereto E, Capasso F, et al. Effect of bisacodyl and cascara on growth of aberrant crypt foci and malignant tumors in the rat colon. Life Sci 2001; 69: 1871–7.
    OpenUrlCrossRefPubMedWeb of Science
  182. ↵
    Borrelli F, Capasso R, Aviello G, et al. Senna and the formation of aberrant crypt foci and tumors in rats treated with azoxymethane. Phytomedicine 2005; 12: 501–5.
    OpenUrlCrossRefPubMedWeb of Science
  183. ↵
    van Gorkom BA, Karrenbeld A, van Der Sluis T, Koudstaal J, de Vries EG, Kleibeuker JH. Influence of a highly purified senna extract on colonic epithelium. Digestion 2000; 61: 113–20.
    OpenUrlCrossRefPubMedWeb of Science
  184. ↵
    Siegers CP, von Hertzberg-Lottin E, Otte M, Schneider B. Anthranoid laxative abuse: a risk for colorectal cancer? Gut 1993; 34: 1099–101.
    OpenUrlAbstract/FREE Full Text
  185. ↵
    Nusko G, Schneider B, Muller G, Kusche J, Hahn EG. Retrospective study on laxative use and melanosis coli as risk factors for colorectal neoplasma. Pharmacology 1993; 47(Suppl 1): 234–41.
    OpenUrlCrossRefPubMedWeb of Science
  186. Dukas L, Willett WC, Colditz GA, Fuchs CS, Rosner B, Giovannucci EL. Prospective study of bowel movement, laxative use, and risk of colorectal cancer among women. Am J Epidemiol 2000; 151: 958–64.
    OpenUrlAbstract/FREE Full Text
  187. Jacobs EJ, White E. Constipation, laxative use, and colon cancer among middle-aged adults. Epidemiology 1998; 9: 385–91.
    OpenUrlCrossRefPubMedWeb of Science
  188. Nusko G, Schneider B, Schneider I, Wittekind C, Hahn EG. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000; 46: 651–55.
    OpenUrlAbstract/FREE Full Text
  189. ↵
    Nusko G, Schneider B, Ernst H, Wittekind C, Hahn EG. Melanosis coli: a harmless pigmentation or a precancerous condition? Z Gastroenterol 1997; 35: 313–8.
    OpenUrlPubMed
  190. ↵
    Morales MA, Hernandez D, Bustamante S, Bachiller I, Rojas A. Is senna laxative use associated to cathartic colon, genotoxicity, or carcinogenicity? J Toxicol 2009; 2009: 287247.
    OpenUrlPubMed
Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section