Chronic constipation: An evidence-based review

Journal of the American Board of Family Medicine

Volumn 24, Issue 4, 2011, Pages 436-451

  Leung, Lawrence ^a   Riutta, Taylor ^a   Kotecha, Jyoti ^a   Rosser, Walter ^a  

^a QUEEN S UNIVERSITY   (Canada)

Author keywords

Chronic constipation; Clinical review; Evidence based medicine; Family medicine; Gastrointestinal problems; Systematic review

Indexed keywords

ACETYLSALICYLIC ACID; ANTIDEPRESSANT AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BISACODYL; BOTULINUM TOXIN; CALCIUM CHANNEL BLOCKING AGENT; CHINESE DRUG; CHOLINERGIC RECEPTOR BLOCKING AGENT; DIURETIC AGENT; DOCUSATE SODIUM; HEMP SEED PILL; IRON; ISPAGULA; LACTULOSE; LAXATIVE; LINACLOTIDE; LUBIPROSTONE; MACROGOL; MAGNESIUM HYDROXIDE; METHYCELLULOSE; MINERAL OIL; OPIATE; PARACETAMOL; POLYCARBOPHIL CALCIUM; PROBIOTIC AGENT; PRUCALOPRIDE; SENNA EXTRACT; SORBITOL; TEGASEROD; UNCLASSIFIED DRUG; YUN CHANG CAPSULE;

ABDOMINAL DISCOMFORT; ABDOMINAL WALL MUSCULATURE; ALCOHOL CONSUMPTION; ANAL CANAL; ANUS FISSURE; ANUS SPHINCTER; ASPIRATION PNEUMONIA; BIFIDOBACTERIUM; BLOATING; BODY MASS; BRAN; CANCER RISK; CARDIOVASCULAR DISEASE; CHRONIC DISEASE; CLINICAL TRIAL (TOPIC); COLON CANCER; COLON RESECTION; COLONOSCOPY; COMORBIDITY; CONSTIPATION; DATA BASE; DEFECATION HABIT; DIARRHEA; DIETARY FIBER; DIGESTIVE SYSTEM MALFORMATION; DISEASE ASSOCIATION; DRUG EFFICACY; DRUG INDUCED HEADACHE; DRUG SAFETY; ELECTROLYTE DISTURBANCE; ENDOCRINE DISEASE; EXERCISE; FECES IMPACTION; FECES INCONTINENCE; FEEDBACK SYSTEM; FLATULENCE; FLUID INTAKE; GASTROINTESTINAL MOTILITY; GERIATRIC DISORDER; HEMORRHOID; HUMAN; HYPERMAGNESEMIA; INTESTINE; INTESTINE OBSTRUCTION; INTESTINE PERFORATION; IRRITABLE COLON; LACTOBACILLUS; LIFESTYLE MODIFICATION; LUMBOSACRAL PLEXUS; METABOLIC DISORDER; NAUSEA; NERVE INJURY; NEUROLOGIC DISEASE; NONHUMAN; PELVIC FLOOR MUSCLE TRAINING; PELVIC ORGAN PROLAPSE; PERISTALSIS; PERITONITIS; PREVALENCE; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SIDE EFFECT; SLOW COLON TRANSIT TIME; SMOKING; SYSTEMATIC REVIEW (TOPIC); TOTAL COLON RESECTION; TRADITIONAL MEDICINE; TREATMENT OUTCOME;

BIOFEEDBACK, PSYCHOLOGY; CHRONIC DISEASE; COMPLEMENTARY THERAPIES; CONSTIPATION; EVIDENCE-BASED MEDICINE; FAMILY PRACTICE; FEMALE; HUMANS; LAXATIVES; LIFE STYLE;

EID: 79960192297     PISSN: 15572625     EISSN: 15587118     Source Type: Journal    
DOI: 10.3122/jabfm.2011.04.100272     Document Type: Review

References (190)

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. (Pubitemid 12096922)
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.
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. (Pubitemid 33095352)
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.
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. (Pubitemid 26131442)
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. (Pubitemid 26026032)
7. Drossman DA. Rome III: the new criteria. Chin J Dig Dis 2006;7:181-5.
8. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130:1480-91.
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.
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.
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. (Pubitemid 38280299)
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.
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.
14. Bharucha AE. Update of tests of colon and rectal structure and function. J Clin Gastroenterol 2006;40:96-103. (Pubitemid 44378053)
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.
16. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004;99:750-9. (Pubitemid 38612817)
17. Bouras EP, Tangalos EG. Chronic constipation in the elderly. Gastroenterol Clin North Am 2009;38:463-80.
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. (Pubitemid 46327573)
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.
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.
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.
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.
23. van Wijk CM, Kolk AM. Sex differences in physical symptoms: the contribution of symptom perception theory. Soc Sci Medicine 1997;45:231-46. (Pubitemid 27270373)
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.
25. Shaheen NJ, Hansen RA, Morgan DR, et al. The burden of gastrointestinal and liver diseases, 2006. Am J Gastroenterol 2006;101:2128-38.
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.
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. (Pubitemid 46985500)
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. (Pubitemid 46985504)
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.
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.
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.
32. Petticrew M, Rodgers M, Booth A. Effectiveness of laxatives in adults. Qual Health Care 2001;10:268-73.
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. (Pubitemid 23078242)
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. (Pubitemid 24213188)
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. (Pubitemid 30485014)
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. (Pubitemid 350060611)
37. Patient handout. Does constipation ruin your day? What you eat, drink, and do can make a difference. Geriatrics 2005;60:19.
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.
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.
41. Prather CM. Subtypes of constipation: sorting out the confusion. Rev Gastroenterol Disord 2004;4(Suppl 2):S11-6.
42. Bannister JJ, Abouzekry L, Read NW. Effect of aging on anorectal function. Gut 1987;28:353-7. (Pubitemid 17039059)
43. Laurberg S, Swash M. Effects of aging on the anorectal sphincters and their innervation. Dis Colon Rectum 1989;32:737-42. (Pubitemid 19215922)
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.
45. Rao SS, Welcher KD, Leistikow JS. Obstructive defecation: a failure of rectoanal coordination. Am J Gastroenterol 1998;93:1042-50. (Pubitemid 29080947)
46. Rao SS. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastrointest Endosc Clin N Am 2009;19:117-39.
47. Hutson JM, McNamara J, Gibb S, Shin YM. Slow transit constipation in children. J Paediatr Child Health 2001;37:426-30. (Pubitemid 32996003)
48. Preston DM, Lennard-Jones JE. Severe chronic constipation of young women: 'idiopathic slow transit constipation.' Gut 1986;27:41-8.
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. (Pubitemid 39140634)
50. Bassotti G, Gaburri M, Imbimbo BP, et al. Colonic mass movements in idiopathic chronic constipation. Gut 1988;29:1173-9.
51. Stivland T, Camilleri M, Vassallo M, et al. Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology 1991;101:107-15.
52. Bannister JJ, Davison P, Timms JM, Gibbons C, Read NW. Effect of stool size and consistency on defecation. Gut 1987;28:1246-50. (Pubitemid 17156042)
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. (Pubitemid 15180521)
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. (Pubitemid 23175125)
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. (Pubitemid 35277321)
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.
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. (Pubitemid 40704231)
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.
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. (Pubitemid 39024515)
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. (Pubitemid 41820633)
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. (Pubitemid 35231645)
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. (Pubitemid 41602575)
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.
64. Sjolund K, Fasth S, Ekman R, et al. Neuropeptides in idiopathic chronic constipation (slow transit constipation). Neurogastroenterol Motil 1997;9:143-50. (Pubitemid 27421145)
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.
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. (Pubitemid 34507232)
67. Crane SJ, Talley NJ. Chronic gastrointestinal symptoms in the elderly. Clin Geriatr Med 2007;23:721-34. (Pubitemid 47513428)
68. Singh G, Vadhavkar S, Wang H. Complications and comorbidities of constipation in adults. Gastroenterology 2007;132(Suppl 2):A458.
69. Chong PS, Bartolo DC. Hemorrhoids and fissure in ano. Gastroenterol Clin North Am 2008;37:627-44.
70. Singh G, Kahler K, Bharathi V. Constipation in adults: complications and comorbidities. Gastroenterology 2005;128(Suppl 2):A154.
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.
72. Kuncharapu I, Majeroni BA, Johnson DW. Pelvic organ prolapse. Am Fam Physician 2010;81:1111-7.
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.
74. Narayanaswamy S, Walsh M. Calcified fecolith: a rare cause of large bowel obstruction. Emerg Radiol 2007;13:199-200. (Pubitemid 46088474)
75. Nee JM. Colonic obstruction secondary to impaction of a large calcified fecolith: report of a case. Dis Colon Rectum 1983;26:677-8. (Pubitemid 13007090)
76. Maull KI, Kinning WK, Kay S. Stercoral ulceration. Am Surg 1982;48:20-4. (Pubitemid 12205624)
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. (Pubitemid 43804525)
78. Sharma M, Agrawal A. Case report: stercoral sigmoid colonic perforation with fecal peritonitis. Indian J Radiol Imaging 2010;20:126-8.
79. Heffernan C, Pachter HL, Megibow AJ, Macari M. Stercoral colitis leading to fatal peritonitis: CT findings. AJR 2005;184:1189-93. (Pubitemid 43821895)
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. (Pubitemid 43329277)
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.
82. Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol 2005;100:232-42. (Pubitemid 41623292)
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. (Pubitemid 36959160)
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. (Pubitemid 46722855)
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. (Pubitemid 47217220)
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.
87. Leung FW. Etiologic factors of chronic constipation: review of the scientific evidence. Dig Dis Sci 2007;52:313-6. (Pubitemid 46202798)
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. (Pubitemid 40546909)
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. (Pubitemid 28531307)
90. Robson KM, Kiely DK, Lembo T. Development of constipation in nursing home residents. Dis Colon Rectum 2000;43:940-3. (Pubitemid 30464063)
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. (Pubitemid 28321047)
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.
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. (Pubitemid 43374515)
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.
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.
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.
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. (Pubitemid 30090993)
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. (Pubitemid 28247523)
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.
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. (Pubitemid 26042100)
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.
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. (Pubitemid 351496708)
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.
104. Hamilton JW, Wagner J, Burdick BB, Bass P. Clinical evaluation of methylcellulose as a bulk laxative. Dig Dis Sci 1988;33:993-8.
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. (Pubitemid 47477941)
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. (Pubitemid 46976282)
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. (Pubitemid 30106174)
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. (Pubitemid 33643475)
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. (Pubitemid 27114062)
110. Petticrew M, Watt I, Sheldon T. Systematic review of the effectiveness of laxatives in the elderly. Health Technol Assess 1997;1:1-52.
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. (Pubitemid 20384316)
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. (Pubitemid 47339801)
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. (Pubitemid 46631472)
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.
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. (Pubitemid 23291039)
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. (Pubitemid 23279322)
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. (Pubitemid 17068692)
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.
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. (Pubitemid 46763456)
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.
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.
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. (Pubitemid 44665253)
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. (Pubitemid 46160551)
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.
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.
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. (Pubitemid 351501123)
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. (Pubitemid 351677994)
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.
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.
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.
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. (Pubitemid 351749158)
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.
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. (Pubitemid 36570307)
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.
135. Frampton JE. Prucalopride. Drugs 2009;69:2463-76.
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.
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.
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.
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.
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.
142. Annells M, Koch T. Constipation and the preached trio: diet, fluid intake, exercise. Int J Nurs Stud 2003;40:843-52. (Pubitemid 37272257)
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. (Pubitemid 47561852)
144. Guntupalli KK, Francis PB. Unilateral lung infiltrate: lipoid pneumonia. Eur Respir J 1991;4:125-7.
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.
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. (Pubitemid 30305817)
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.
148. Staumont G, Frexinos J, Fioramonti J, Bueno L. Sennosides and human colonic motility. Pharmacology 1988;36(Suppl 1):49-56. (Pubitemid 18070158)
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.
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. (Pubitemid 23291038)
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.
152. Lubiprostone: RU 0211, SPI 0211. Drugs R D 2005;6:245-8.
153. Hussar DA. New drugs: lubiprostone, ranolazine, and anidulafungin. J Am Pharm Assoc 2006;46:411-4.
154. Tuteja AK, Rao SS. Lubiprostone for constipation and irritable bowel syndrome with constipation. Expert Rev Gastroenterol Hepatol 2008;2:727-33.
155. Kim HS. 5-Hydroxytryptamine4 receptor agonists and colonic motility. J Smooth Muscle Res 2009;45:25-9.
156. Grider JR, Foxx-Orenstein AE, Jin JG. 5-Hydroxy-tryptamine4 receptor agonists initiate the peristaltic reflex in human, rat, and guinea pig intestine. Gastroenterology 1998;115:370-80. (Pubitemid 28363429)
157. Tack J. Prucalopride: a new drug for the treatment of chronic constipation. Expert Rev Gastroenterol Hepatol 2009;3:337-43.
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.
159. Lembo AJ, Kurtz CB, Macdougall JE, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology 2010;138:886-95.
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. (Pubitemid 44356113)
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. (Pubitemid 38808419)
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.
163. Locke GR 3rd, Pemberton JH, Phillips SF. American Gastroenterological Association Medical Position Statement: guidelines on constipation. Gastroenterology 2000;119:1761-6. (Pubitemid 32198702)
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.
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. (Pubitemid 39529902)
166. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8.
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.
168. Li D, Browne LW, Ladabaum U. Melanosis coli. Clin Gastroenterol Hepatol 2009;7:A20.
169. Wittoesch JH, Jackman RJ, Mc DJ. Melanosis coli: general review and a study of 887 cases. Dis Colon Rectum 1958;1:172-80.
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.
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.
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.
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. (Pubitemid 20041145)
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. (Pubitemid 23304371)
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.
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.
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. (Pubitemid 19074843)
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.
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. (Pubitemid 26060196)
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. (Pubitemid 34851910)
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. (Pubitemid 32835269)
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. (Pubitemid 40755126)
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. (Pubitemid 30114078)
184. Siegers CP, von Hertzberg-Lottin E, Otte M, Schneider B. Anthranoid laxative abuse: a risk for colorectal cancer? Gut 1993;34:1099-101.
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. (Pubitemid 23291037)
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. (Pubitemid 30463574)
187. Jacobs EJ, White E. Constipation, laxative use, and colon cancer among middle-aged adults. Epidemiology 1998;9:385-91. (Pubitemid 28298359)
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. (Pubitemid 30305782)
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.
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.