Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “constipation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2001

Fecal continence in patients having undergone posterior sagittal anorectoplasty procedure for a high anorectal malformation improves at adolescence, as constipation disappears.

BACKGROUND/PURPOSE: Constipation is a major complication in patients who have undergone posterior sagittal anorectoplasty (PSARP) operation for a high anorectal malformation. Overflow incontinence is the main cause of fecal soiling in these patients. The aim of this study was to outline the natural history of constipation in patients with high anorectal malformations and relate this to the functional outcome at the end of the patient's growth period. METHODS: The study group consisted of 22 pubertal or postpubertal patients (median age 15; range, 13 to 25) with high or intermediate anorectal malformations repaired by PSARP procedure. The patients have been followed-up since birth. Constipation was defined as a need to use medical treatment or diet to ensure bowel emptying. Continence was classified as follows: grade 1, no soiling in any circumstances; grade 2, staining less than once a week, no fecal accidents; grade 3, staining more than once a week, no fecal accidents; grade 4, daily soiling or accidents, need for regular enemas, or the antegrade colonic enema procedure. All patients underwent anorectal manometry and magnetic resonance imaging of the spine and spinal cord. RESULTS: At the time of the study 2 (9%) of the 22 study group patients had constipation, but 15 (68%) had been constipated before puberty. Eleven patients (50%) were fully continent (grade 1) without constipation. Six of those had a history of constipation associated soiling. Three patients (14%) had occasional staining (grade 2) and no constipation. Two of them had been constipated with significant soiling before the onset of puberty. In the 5 (22%) patients with frequent staining (grade 3) the degree of soiling had decreased after the disappearance of constipation. Two of the 3 patients with poor outcome (grade 4) require regular enemas for recalcitrant constipation. Spinal cord anomalies were detected in 4 and abnormal sacrum in 15 patients. Of the anorectal manometric parameters, only the force of voluntary sphincter squeeze correlated with the functional result. CONCLUSION: In the majority of patients who underwent PSARP procedure for high anorectal malformation, constipation disappears at adolescence, and this is associated with improved fecal continence outcome.

Adolescent↗
PubMed2006

Does "stubbornness" have a role in pediatric constipation?

The objective of this study was to determine if children with constipation are more stubborn, both in general and specifically regarding toileting behaviors, than children without constipation. A secondary objective was to determine if constipated children who are more stubborn are less likely to respond to routine therapeutic interventions than less stubborn constipated children. One hundred one children aged 2 to 6 years, who were first-time presenters (never received treatment) to their primary care physician (PCP) with constipation, were compared with 84 nonconstipated control children of similar age range. Comparison measures included general stubbornness and toilet-specific stubbornness (active resistance to participating in appropriate toileting behaviors). Measures of stubbornness were generated from retrospective questionnaires, prospective toileting diaries completed by the parents, and direct experimenter observations. The constipated children were treated by their PCP for 2 months and then reassessed. Constipated children were perceived by their parents to be significantly more stubborn than control children generally and specifically in terms of toileting. Some study evidence suggested that constipated children who continued to have difficulties after 2 months of treatment by their PCPs were perceived by their parents to have significantly more general stubbornness than constipated children who responded to treatment. Parent-perceived toilet-specific stubbornness significantly improved after successful treatment of the constipation by their PCP. The finding that constipated children had more parent-perceived stubbornness than children without constipation is notable because it may play a role in the development and/or maintenance of this bowel dysfunction as well as being an obstacle in treatment compliance.

Adult↗
PubMed2004

Epidemiology of constipation in North America: a systematic review.

OBJECTIVE: The aim of this study was to systematically review the published literature regarding prevalence, risk factors, incidence, natural history, and the effect on quality of life of constipation in North America. METHODS: A computer-assisted search of MEDLINE, EMBASE, and Current Contents databases was performed independently by two investigators. Study selection criteria included the following: (1) North American population-based sample of adults with constipation; (2) publication in full manuscript form in English; and (3) report on the prevalence, incidence, and natural history of constipation or impact of constipation on quality of life. Eligible articles were reviewed in a duplicate, independent manner. Data extracted were compiled in tables and presented in descriptive form. RESULTS: The estimates of the prevalence of constipation in North America ranged from 1.9% to 27.2%, with most estimates from 12% to 19%. Prevalence estimates by gender support a female-to-male ratio of 2.2:1. Constipation appears to increase with increasing age, particularly after age 65. No true population-based incidence studies or natural history studies were identified. In one cohort, 89% of patients with constipation still reported constipation at 14.7 months follow-up. From limited data, quality of life appears to be diminished by constipation, but the clinical significance of this is unclear. CONCLUSIONS: Constipation is very common, as approximately 63 million people in North America meet the Rome II criteria for constipation. Minimal data are available regarding incidence, natural history, and quality of life in patients with constipation. Effort should be expended toward the study of these topics, particularly in the elderly, who are disproportionately affected by this condition.

Constipation↗
PubMed2006

Prevalence rates for constipation and faecal and urinary incontinence.

OBJECTIVE: To evaluate the prevalence rates for constipation and faecal and urinary incontinence in children attending primary care clinics in the United States. METHODS: Retrospective review of case records of all children, 4-17 years of age, seen for at least one health maintenance visit during a 6 month period and followed from birth or within the first 6 months of age in our clinics. We reviewed all charts for constipation, faecal incontinence and urinary incontinence. RESULTS: We included 482 children in the study, after excluding 39 children with chronic diseases. The prevalence rate for constipation was 22.6% and was similar in boys and girls. The constipation was functional in 18% and acute in 4.6%. The prevalence rate for faecal incontinence (> or =1/week) was 4.4%. The faecal incontinence was associated with constipation in 95% of our children. The prevalence rate for urinary incontinence was 10.5%; 3.3% for daytime only, 1.8% for daytime with night-time and 5.4% for night-time urinary incontinence. Faecal and urinary incontinence were significantly more commonly observed in children with constipation than in children without constipation. CONCLUSION: The prevalence rates were 22.6% for constipation, 4.4% for faecal incontinence and 10.5% for urinary incontinence in a US primary care clinic. Children with constipation had higher prevalence rates for faecal and urinary incontinence than children without constipation. Boys with constipation had higher rates of faecal incontinence than girls with constipation.

Adolescent↗
PubMed2004

Fiber (glucomannan) is beneficial in the treatment of childhood constipation.

OBJECTIVE: Constipation and encopresis are common problems in children. Still today, the role of fiber in the treatment of chronic constipation in childhood is controversial. The aim of our study was to evaluate whether fiber supplementation is beneficial in the treatment of children with functional constipation with or without encopresis. We used glucomannan as the fiber supplement. METHODS: We evaluated the effect of fiber (glucomannan, a fiber gel polysaccharide from the tubers of the Japanese Konjac plant) and placebo in children with chronic functional constipation with and without encopresis in a double-blind, randomized, crossover study. After the initial evaluation, the patients were disimpacted with 1 or 2 phosphate enemas if a rectal impaction was felt during rectal examination. Patients continued with their preevaluation laxative. No enemas were given during each treatment period. Fiber and placebo were given as 100 mg/kg body weight daily (maximal 5 g/day) with 50 mL fluid/500 mg for 4 weeks each. Parents were asked to have children sit on the toilet 4 times daily after meals and to keep a stool diary. Age, frequency of bowel movements into the toilet and into the undergarment, presence of abdominal pain, dietary fiber intake, medications, and the presence of an abdominal and/or a rectal fecal mass were recorded on a structured form at the time of recruitment and 4 weeks and 8 weeks later. Children were rated by the physician as successfully treated when they had > or =3 bowel movements/wk and < or =1 soiling/3 weeks with no abdominal pain in the last 3 weeks of each 4-week treatment period. Parents made a global assessments to whether they believed that the child was better during the first or second treatment period. RESULTS: Forty-six chronically constipated children were recruited into the study, but only 31 children completed the study. These 31 children (16 boys and 15 girls) were 4.5 to 11.7 years of age (mean: 7 +/- 2 years). All children had functional constipation; in addition, 18 had encopresis when recruited for the study. No significant side effects were reported during each 4-week treatment period. Significantly fewer children complained of abdominal pain and more children were successfully treated while on fiber (45%) as compared with placebo treatment (13%). Parents rated significantly more children (68%) as being better on fiber versus 13% as being better on placebo. The initial fiber intake was low in 22 (71%) children. There was no difference in the percentage of children with low fiber intake living in the United States (70%) and Italy (71%). Successful treatment (physician rating) and improvement (parent rating) were independent of low or acceptable initial fiber intake. The duration of chronic constipation ranged from 0.6 to 10 years (mean: 4.0 +/- 2.5 years). Duration of constipation did not predict response to fiber treatment. Children with constipation only were significantly more likely to be treated successfully with fiber (69%) than those with constipation and encopresis (28%). CONCLUSION: We found glucomannan to be beneficial in the treatment of constipation with and without encopresis in children. Symptomatic children who were already on laxatives still benefited from the addition of fiber. Therefore, we suggest that we continue with the recommendation to increase the fiber in the diet of constipated children with and without encopresis.

Child↗
PubMed1997

[Constipation].

Constipation may be due to drug intake, metabolic and endocrine abnormalities, neurogenic diseases, and gastro-intestinal lesions: in these cases, constipation is only the consequence of another disease. Constipation may be due to dietary or behavioural errors in a lot of patients: in these cases constipation is the consequence of the way of life of the patients. When these two first types of constipation have been ruled out, the constipation is a true constipation, described as chronic idiopathic constipation for which no organic cause may be found. This chronic constipation may be due to a delayed colonic transit secondary either to a colonic inertia in few cases or, at the opposite, to an increased colonic motility in a lot of people often associated with abdominal pain. Chronic constipation may be also due to an outlet obstruction, secondary to a megarectum, a megarecto-sigmoïd, a rectocele, or an abnormal anorectal motility (mainly anismus, often associated with sexual abuse in the past history). No single mechanism can be held responsible for chronic idiopathic constipation, but, whatever the mechanism and the type, constipation is also frequently a way to get help from the doctor.

Adult↗
PubMedDate not supplied

[Constipation in infants: influence of type of feeding and dietary fiber intake].

OBJECTIVE: To study the relationship between breast-feeding, dietary fiber intake and constipation in infants. METHODS: The study population consisted of 275 infants consecutively enrolled in two Primary Care Clinic in the city of Embu, in the Great São Paulo. The feeding pattern were classified in predominantly breast-feeding, partially breast and cow's milk feeding and artificial feeding. Constipation was defined by the elimination of hard stool associated with one of the following: painful or difficult defecation, hard or round cracked stools and less than three defecations a week. False constipation was defined by the elimination of soft stools without pain or difficulty but with less than three defecations a week. RESULTS: Constipation was found in 25.1% (69/275). False constipation was found only in the first semester of life in 5.1% of 159 infants. The prevalence of constipation was higher between 6 and 24 months (38.8%, 45/116) than in the first semester of life (15.1%, p=0.000). A model of logistic regression demonstrated that infants under artificial feeding were 4.53 times more liable to develop constipation than infants who were predominantly breastfed. The daily dietary fiber intake (g/day) was similar (p=0.57) among the constipated (median=9.0 g; 25th and 75th percentiles: 6.9-13.1 g) and non-constipated (median=8.8 g; 25th and 75th percentiles: 6.1-12.9 g). CONCLUSIONS: Dietary fiber intake was similar in constipated and non-constipated infants. Breast-feeding serves as a protection factor against the development of constipation in the first semester of life.

English Abstract↗
PubMed1994

Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation.

Idiopathic chronic constipation is a frequent and disabling symptom, but its pathophysiological grounds are still poorly understood. In particular, there is little knowledge about the relationships between distal (anorectal area) and proximal (colonic area) motor abnormalities in this condition, especially concerning high-amplitude propagated colonic activity. For this purpose, we studied 25 patients complaining of severe idiopathic constipation and categorized them as normal- or slow-transit constipation according to colonic transit time. Twenty-five age-matched controls were also studied. Investigations included standard anorectal motility testing and prolonged (24-hr) colonic motility studies. Analysis of results showed that both groups of constipated patients displayed significantly different (P < 0.05) minimum relaxation volumes of the internal anal sphincter, defecatory sensation thresholds, and maximum rectal tolerable volumes with respect to controls. Patients with normal-transit constipation also showed lower internal anal sphincter pressure with respect to slow-transit constipation and controls (P < 0.001 and P < 0.02, respectively). The daily number of high-amplitude propagated contractions (mass movements) as well as their amplitude and duration, was significantly reduced in both subgroups of constipated patients (P < 0.02 vs controls). We conclude that (1) in normal-transit constipation, motor abnormalities are not limited to the anorectal area; (2) patients with slow-transit constipation probably have a severe neuropathic rectal defect; (3) prolonged colonic motility studies may highlight further the functional abnormalities in constipated subjects; and (4) an approach taking into account proximal and distal colon motor abnormalities might be useful to understand pathophysiological grounds of chronic constipation and lead to better therapeutic approaches.

Adolescent↗
PubMed1993

Functional constipation and outlet delay: a population-based study.

BACKGROUND: Chronic constipation may result from many mechanisms including colonic inertia or rectosigmoid outlet delay, but risk factors for constipation in the community are poorly defined. The prevalence of and predictors for symptoms consistent with functional constipation and outlet delay were estimated. METHODS: An age- and gender-stratified random sample of 1,021 residents of Olmsted County, MN, aged 30-64 years, was mailed a valid self-report questionnaire; 835 responded (82%). These respondents were mailed a second questionnaire 12-20 months later that gathered data on symptoms compatible with functional constipation and outlet delay; 690 responded (83%). RESULTS: Self-reported constipation did not reliably identify functional constipation or outlet delay. The overall age- and gender-adjusted prevalences (per 100) of functional constipation and outlet delay were 19.2 (95% confidence interval [CI], 16.1-22.3) and 11.0 (95% CI, 8.7-13.3), respectively. Outlet delay but not functional constipation was more frequent in women. After adjusting for age, gender, and other symptoms, an increased usage of aspirin was associated with functional constipation but not outlet delay. CONCLUSIONS: In apparently healthy middle-aged persons, approximately 1 in 5 have symptoms compatible with functional constipation, and 1 in 10 may experience outlet delay, but these groups correspond poorly with self-reported constipation.

Adult↗
PubMed2005

Prevalence, symptoms and outcome of constipation in infants and toddlers.

OBJECTIVE: To determine the prevalence of constipation in children <or=2 years, describe the symptoms of constipation, and review how often specific interventions were effective. STUDY DESIGN: Retrospective chart review. RESULTS: Of 4,157 children <2 years of age, 185 children had constipation. The prevalence rate for constipation in the first year of life was 2.9%, and in the second year of life, the rate was 10.1%. Functional constipation was the cause in 97% of the children. Boys and girls were affected with equal frequency. Constipation was caused by an underlying organic disease in 1.6% of cases, and 97% of the children had functional constipation. Dietary changes and corn syrup were the initial treatment suggestions for 116 children; 93% of these children underwent follow-up examinations, and the constipation resolved in 25% of the children. Of 100 children treated with milk of magnesia or polyethylene glycol 3350 without electrolytes, 93 children underwent follow-up examinations, and the constipation was resolved with treatment in 92% of the children. CONCLUSIONS: Dietary changes, corn syrup, or both resolved constipation in 25% of children, and laxatives resolved constipation in 92% of children. Both milk of magnesia and polyethylene glycol were efficient and safe in infants and toddlers.

Cathartics↗
PubMed2006

Scintigraphic evaluation of colonic motility in patients with anorectal malformations and constipation.

BACKGROUND AND PURPOSE: Constipation is one of the major sequelae in patients after correction of anorectal anomalies (ARAs). The aim of the present work has been to assess the colonic transit time, using radioisotope scintigraphy, in patients operated for ARA and experiencing constipation in the follow-up. The results were compared with transit time from children with true functional constipation. METHODS: Twelve or 32 patients operated for ARA during the period 1994-2003 experienced mild or severe constipation (6 with high or intermediate form of ARA and 6 with low type) at follow-up. The mean age of this group was 5.8 years. Eighteen patients, mean age 6.7 years, with true functional constipation were studied as well. Colonic transit times were investigated using radioisotope scintigraphy. Normal values for colonic transit time were derived from historical controls. Radioisotope diethylenetriamine pentaacetic acid labelled with indium 111 was administered orally to determine a segmental colonic transit. Images of the abdomen have been taken at 6, 24, 48, and again at 72 hours, if radioactivity was not cleared from the colon. To quantify colonic transit, we calculated the geometric centre (GC) dividing the colon into anatomic regions. RESULTS: According to normal controls, 2 different type of delayed transit can be observed: (a) slow-transit constipation if GC at 48 hours is less than 4.1; (b) functional rectosigmoid obstruction (FRSO) if GC at 48 hours is 4.1 or more but less than 6.1 at 72 hours. Patients with functional constipation were divided into 2 groups: (a) slow-transit constipation in 12 patients with a GC at 48 hours of 3.7 +/- 0.5; (b) FRSO in 6 patients with a GC of 4.7 +/- 0.04 and 5.02 at 48 and 72 hours, respectively. Patients operated for high ARA had values characteristic of FRSO with GC at 48 hours of 5.1 +/- 0.8 and 4.75 +/- 0.5 at 72 hours. In low ARA, the transit times were similar to the ones observed in patients with high ARA at 48 hours with a GC of 4.9 +/- 0.5. CONCLUSIONS: Patients with ARA frequently have functional sequelae in the postoperative period such as constipation. According to our results, constipation seems to be secondary to segmental motility disorders limited to the rectosigmoid area, similar to constipated children with FRSO. No evidence of more generalised motility disturbance, as previously postulated, could be recorded.

Abnormalities, Multiple↗
PubMed2001

The prevalence of constipation in institutionalized people with intellectual disability.

Constipation is a common problem in people with intellectual disability (ID). Laxatives are frequently prescribed with disappointing results. The prevalence of constipation was investigated in a random population of 215 people with ID (IQ < 50) and constipation was correlated with clinical symptoms. All subjects were scored for bowel habits. Constipation was defined as having a bowel movement less than three times a week or the necessity of using laxatives more than three times a week. Further possible accompanying factors were evaluated. The control subjects were defined as individuals who did not use laxatives. Subjects with constipation were defined as patients and were compared to subjects without constipation (controls). One hundred and forty-nine out of 215 cases (69.3%) showed constipation. Constipation was significantly correlated with non-ambulancy, cerebral palsy, the use of anticonvulsive medication or benzodiazepines, H2-receptor antagonists or proton pump inhibitors, food refusal, and an IQ < 35. Fifty-eight per cent of the patients used bisacodyl or magnesium oxide, 39% lactulose, 13% sodiumlaurylsulphoacetate/sodium citrate/sorbitol and only 10% were given sodium phosphate enemas. Faecal soiling was found in 15% of subjects, while manual evacuation of faeces was performed in nearly 7% of cases. Constipation was randomly demonstrated in almost 70% of the population with ID. Subjects with the above-mentioned accompanying factors are especially at risk for constipation. Contrary to the general population, constipation in people with ID is associated with little use of phosphate enemas, microlax, a low incidence of faecal soiling and manual evacuation of faeces, suggesting an aetiology without distal faecal impaction. The regimen and effect of therapy has to be studied to define adequate treatment schedules.

Adolescent↗
PubMedDate not supplied

Symptom experiences of chronically constipated women with pelvic floor disorders.

PURPOSE: Chronic constipation is a frequent and bothersome problem in women with pelvic floor disorders, and standard treatment protocols are often ineffective. The purposes of this study were to describe the constipation symptom experience, perceived effectiveness of symptom-management strategies, and the lifestyle limitations associated with constipation symptoms among women with pelvic floor disorders. DESIGN: A cross-sectional descriptive design was used. SETTING: Participants were recruited from a tertiary-level outpatient urogynecology center. SAMPLE: Thirty women with pelvic floor disorders completed a self-administered instrument at the time of their clinic appointment. METHODS: The instrument included questions about the distress, frequency, intensity, and occurrence of constipation symptoms. In addition, the effectiveness of symptom-management strategies used to treat constipation and the lifestyle limitations associated with constipation were assessed. FINDINGS: The symptom experience of chronic constipation in these women included multiple distressing and uncomfortable symptoms that resulted in mild lifestyle limitations. Although self-management strategies were perceived to have limited effectiveness, the most effective strategies used by the women to manage constipation included use of laxatives, using their hand in or near the vagina or rectum to expel stool, and using an enema. CONCLUSIONS: More effective interventions are needed to promote satisfactory symptom management of chronic constipation for women with pelvic floor disorders. Further assessment of outcomes, including comfort and depression, may be warranted. IMPLICATIONS FOR PRACTICE: A more thorough assessment of constipation symptoms in this population is recommended. A combination of symptom-management strategies may be needed to relieve the multiple symptoms associated with constipation.

Adult↗
PubMed1989

Clinical epidemiology of chronic constipation.

Using health statistics from the United States and England and Wales, we review the epidemiology of constipation and possible etiologies of this disorder as suggested by its epidemiologic distribution. The analysis revealed that constipation is one of the most common chronic digestive disorders in the United States, affecting one of every 50 people. The occurrence of constipation increased with advancing age, showing an exponential increase in prevalence after the age of 65. The age distribution of constipation was similar in both sexes, but overall constipation was three times more common in women than in men. Constipation more frequently affected nonwhites than whites, and people from families with low income or less formal education. The characteristic epidemiologic pattern of constipation suggests the influence of environmental factors. Insufficient dietary fiber is widely believed to be a major cause of constipation, yet it is difficult to devise a mechanism by which dietary fiber alone could produce the marked differences observed between gender, race, and socioeconomic status. Recent evidence suggests that disruption of neural regulation of colonic motility plays an important role in the development of chronic constipation. This loss of neural regulation may result from mechanical damage to the pelvic nerves due to childbirth or pelvic surgery, exposure to environmental toxins (e.g., organochlorine insecticides or heavy metals), or possibly exposure to an infectious agent. Other environmental factors that may play a role in the pathogenesis of chronic constipation have not yet been elucidated. Consequently, studies examining the epidemiology of chronic constipation are important for providing insight into potential environmental risk factors relevant to the etiology of this disorder.

Age Factors↗
PubMed2005

Psychological evaluation of children with idiopathic constipation and their parents.

BACKGROUND: Constipation is one of the most common problems in childhood. In idiopathic constipation it is not possible to identify primary cause in every case. Child behavioral problems and disturbances in parent-child relationships have been cited as causes of constipation. Constipation is a source of anxiety to the child and to the family. The purpose of the present study was to evaluate psychological characteristics of constipated children and their parents. METHODS: Thirty-two otherwise healthy children with idiopathic constipation over 4 years old were prospectively evaluated between January 2002 and June 2003. The Child Behavior Checklist (CBCL) and Symptom Checklist-90 revised (SCL-90-R) were used to assess the psychological profiles of the children and the parents, respectively. Thirty children with inguinal hernia who had no constipation or other problems, and their parents were asked to complete the checklists as controls. The scores of the constipation group were compared statistically with those of the control group. RESULTS: In the constipation group there were 19 boys and 13 girls with a mean age of 7.3 years (4-14 years). All the patients responded to medical treatment. Constipated children and their parents were not found to have more behavior problems than the control group (P > 0.05). CONCLUSIONS: Children with idiopathic constipation and their parents do not show significant behavioral and emotional problems. Their psychological profiles are not different from the general population.

Case-Control Studies↗
PubMed2003

Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women.

Because the risk factors for constipation in the general population are poorly defined, we examined the association between age, body mass index, and selected lifestyle and dietary factors with the prevalence of constipation in the Nurses' Health Study.A total of 62,036 women, aged 36-61 yr and free of cancer, responded to mailed questionnaires in 1980 and 1982, which assessed bowel movement frequency, dietary, and lifestyle factors. Constipation was defined as two or fewer bowel movements weekly.A total of 3327 women (5.4%) were classified as having constipation. Age and body mass index were inversely associated with constipation (p for trend < 0.0001). In multivariate analysis, women who reported daily physical activity had a lower prevalence of constipation (prevalence ratio [PR] = 0.56, 95% CI = 0.44-0.70). Women in the highest quintile of dietary fiber intake (median intake 20 g/day) were less likely to experience constipation (PR = 0.64, 95% CI = 0.57-0.73) than women in the lowest quintile (median intake 7 g/day). The PR for constipation for women who both reported daily physical activity and were in the highest quintile of fiber intake was 0.32 (95% CI = 0.20-0.54) compared with those with physical activity less than once weekly and those who were in the lowest quintile of fiber intake. Higher frequency of aspirin intake was associated with an increasing prevalence of constipation (PR = 1.38, 95% CI = 1.17-1.62). Current smoking and alcohol use were inversely associated with constipation. Our data suggest that moderate physical activity and increasing fiber intake are associated with substantial reduction in the prevalence of constipation in women.

Adult↗
PubMed2005

Myths and misconceptions about chronic constipation.

There are many strongly held beliefs about constipation that are not evidence based. The purpose of this review is to address these beliefs concerning various aspects of constipation. There is no evidence to support the theory that diseases may arise via "autointoxication," whereby poisonous substances from stools within the colon are absorbed. Dolichocolon, defined as an elongated colon, should not be seen as a cause of constipation. The role of sex hormones altering gut function during the menstrual cycle appears to be minimal. During pregnancy they may play a role in slowing gut transit. Hypothyroidism can cause constipation, but among patients presenting with constipation, hypothyroidism is rare. A diet poor in fiber should not be assumed to be the cause of chronic constipation. Some patients may be helped by a fiber-rich diet but many patients with more severe constipation get worse symptoms when increasing dietary fiber intake. There is no evidence that constipation can successfully be treated by increasing fluid intake unless there is evidence of dehydration. In the elderly constipation may correlate with decreased physical activity, but many cofactors are likely to play a role. Intervention programs to increase physical activity as part of a broad rehabilitation program may help. It is unlikely that stimulant laxatives at recommended doses are harmful to the colon. A proportion of patients with chronic constipation is dependent of laxatives to achieve satisfactory bowel function, but this is not the result of prior laxative intake. Tolerance to stimulant laxatives is uncommon. There is no indication for the occurrence of "rebound constipation" after stopping laxative intake. While laxatives may be misused, there is no potential for addiction.

Cathartics↗
PubMed1997

Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood.

OBJECTIVES: To evaluate the frequency of urinary incontinence and urinary tract infection in children with chronic constipation and report on the resolution of these with treatment of the underlying constipation. METHODS: We evaluated the frequency of urinary incontinence and urinary tract infection in 234 chronic constipated and encopretic children before, and at least 12 months after, the start of treatment for constipation. RESULTS: Twenty-nine percent complained of daytime urinary incontinence and 34% of nighttime urinary incontinence. Urinary tract infection was present in 11% and was more commonly present in girls than in boys (33% vs 3%). Vesicoureteral reflux was present in four and megacystis in four of the 25 children who had a voiding cystourethrogram because of urinary tract infection. One girl who came in had constipation and acute urinary retention. The treatment for constipation consisted of disimpaction and maintenance treatment, which included the prevention of reaccumulation of stools and reconditioning to normal bowel habits through timed toilet sitting. Follow-up, at least 12 months after start of treatment for constipation, revealed that the constipation was relieved successfully in 52%. Relief of constipation resulted in disappearance of daytime urinary incontinence in 89% and nighttime urinary incontinence in 63% of patients, and disappearance of recurrent urinary tract infections in all patients who had no anatomic abnormality of the urinary tract. CONCLUSION: Urinary symptoms were found in a significant number of children who had functional constipation and encopresis. With treatment of the constipation, most patients became clean and dry and further recurrence of urinary tract infections was prevented.

Adolescent↗