Chronic constipation is uncomfortable, but not dangerous

Jan 4 2005

There are a lot of common myths about constipation treatment. An article in the January issue of The American Journal of Gastroenterology dispels those myths and clears numerous misconceptions regarding chronic constipation. From a high fiber diet to taking laxatives, researchers address the common beliefs concerning various aspects of the condition and review results based on medical trials.

"Chronic constipation is uncomfortable, but not dangerous," states lead author Stefan A. Müller-Lissner, MD. "This might be the reason why medical doctors often do not take it seriously. There are many unproven beliefs about constipation, but most of them are not tenable upon closer investigation with scientific methods."

According to the authors, although there is no doubt that fiber increases stool bulk and frequency, the role of dietary fiber to treat chronic constipation is exaggerated. A low fiber diet has been proven not to be the cause of constipation and the success of fiber intake as treatment is modest. The study reviewed conducted by Voderholzer et al showed that only 20% of slow transit patients benefited from fiber. Further data suggests that while many patients may be helped by a fiber-rich diet, some actually suffer from worse symptoms when increasing their fiber intake.

On the opposite end, not even increased fluids are guaranteed to help bowel activity. Fluid ingestion to treat chronic constipation is over-emphasized as well, according to Dr. Müller-Lissner, and the success of fluid treatment is probably none. Unless there is evidence of dehydration, there is no data supporting the fact that increasing fluid intake can successfully treat constipation. The article further addresses the myths behind chronic use of laxatives and whether these drugs can be linked to nerve damage and risks of colorectal or other cancers. Data shows that those on the market today are safe when appropriate drugs are prescribed and taken at recommended doses.

With this information, Dr. Müller-Lissner suggests that "patients may no longer be bothered by ineffective advice regarding fiber and fluid ingestion nor threatened by the side effects of laxatives. Also, unnecessary colonic resections may be avoided."

According to the American College of Gastroenterology, constipation is one of the most frequent gastrointestinal complaints in the US and Western countries. There are at least 2.5 million doctor visits for constipation in the US each year and hundreds of millions of dollars are spent for laxatives yearly. With chronic constipation, patients may suffer from constipation for weeks or have recurring bouts over long periods of time.