Digestive Diseases and Sciences

, Volume 52, Issue 2, pp 313–316

Etiologic Factors of Chronic Constipation—Review of the Scientific Evidence

Review Article

Abstract

Geriatric patient educational material and a general practice review suggest insufficient dietary fiber intake, inadequate fluid intake, decrease physical activity, side effects of drugs, hypothyroidism, sex harmones and colorectal cancer obstructin may play a role in the pathogenesis of constipation. A search of recent literature, however, reveals that there is a paucity of evidence-based publications that address the etiologic factors of chronic constipation. Much of current writings on the subject may be based primarily on myths handed down from one generation to the next. In the absence of well-designed studies, there do not appear to be sufficient evidence-based information to implicate the above as major etilogic factors in the development of chronic constipation. The etiological role of each of these factors in the development of chronic constipation deserves to be assessed by modern techniques and methodologies. Funding agencies including the government and industry sponsors should support the development of evidence-based data sets. The understanding of the etiology of chronic constipation is the foundation on which cost-effective management strategies are to be built.

Keywords

Chronic constipation Etiology 

References

  1. 1.
    Geriatrics (2005) Patient handout. Does constipation ruin your day? What you eat, drink, and do can make a difference. Geriatrics 60(5):19Google Scholar
  2. 2.
    Schaefer DC, Cheskin LJ (1998) Constipation in the elderly. Am Family Phys 58(4):907–914Google Scholar
  3. 3.
    Annells M, Koch T (2003) Constipation and the preached trio: diet, fluid intake, exercise. Int J Nurs Studies 40(8):843–852CrossRefGoogle Scholar
  4. 4.
    Robson KM, Kiely DK, Lembo T (2000) Development of constipation in nursing home residents. Dis Colon Rectum 43(7):940–943PubMedCrossRefGoogle Scholar
  5. 5.
    Lindeman RD, Romero LJ, Liang HC, Baumgartner RN, Koehler KM, Garry PJ (2000) Do elderly persons need to be encouraged to drink more fluids? J Gerontol Ser A Biol Sci Med Sci 55(7):M361–M365Google Scholar
  6. 6.
    Anti M, Pignataro G, Armuzzi A, Valenti A, Iascone E, Marmo R, Lamazza A, Pretaroli AR, Pace V, Leo P, Castelli A, Gasbarrini G (1998) Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepato-Gastroenterology 45(21):727–732PubMedGoogle Scholar
  7. 7.
    Chung BD, Parekh U, Sellin JH (1999) Effect of increased fluid intake on stool output in normal healthy volunteers. J Clin Gastroenterol 28(1):29–32PubMedCrossRefGoogle Scholar
  8. 8.
    Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A (2005) Myths and misconceptions about chronic constipation. Am J Gastroenterol 100(1):232–242PubMedCrossRefGoogle Scholar
  9. 9.
    Towers AL, Burgio KL, Locher JL, Merkel IS, Safaeian M, Wald A (1994) Constipation in the elderly: influence of dietary, psychological, and physiological factors. J Am Geriatrics Soc 42(7):701–706Google Scholar
  10. 10.
    Dukas L, Willett WC, Giovannucci EL (2003) Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 98(8):1790–1796PubMedCrossRefGoogle Scholar
  11. 11.
    Arya LA, Novi JM, Shaunik A, Morgan MA, Bradley CS (2005) Pelvic organ prolapse, constipation, and dietary fiber intake in women: a case-control study. Am J Obst Gynecol 192(5):1687–1691CrossRefGoogle Scholar
  12. 12.
    Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A (1998) Effects of regular exercise in management of chronic idiopathic constipation. Dig Dis Sci 43(11):2379–2383PubMedCrossRefGoogle Scholar
  13. 13.
    van Dijk KN, de Vries CS, van den Berg PB, Dijkema AM, Brouwers JR, de Jong-van den Berg LT (1998) Constipation as an adverse effect of drug use in nursing home patients: an overestimated risk. Br J Clin Pharmacol 46(3):255–261PubMedCrossRefGoogle Scholar
  14. 14.
    Deen KI, Seneviratne SL, de Silva HJ (1999) Anorectal physiology and transit in patients with disorders of thyroid metabolism. J Gastroenterol Hepatol 14(4):384–387PubMedCrossRefGoogle Scholar
  15. 15.
    Xiao ZL, Pricolo V, Biancani P, Behar J (2005) Role of progesterone signaling in the regulation of G-protein levels in female chronic constipation. Gastroenterology 128(3):667–675PubMedCrossRefGoogle Scholar
  16. 16.
    Pepin C, Ladabaum U (2002) The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital, and a Veterans Administration medical center. Gastrointest Endosc 56(3):325–332PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  1. 1.Division of Gastroenterology, Research and Medical Services, Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, and Veterans Affairs Greater Los Angeles Healthcare System, and David Geffen School of MedicineUniversity of California at Los AngelesLos AngelesUSA
  2. 2.111G, VA Sepulveda Ambulatory Care CenterSepulvedaUSA

Personalised recommendations