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About - Constipation

A condition in which the stool becomes hard and dry. A person who is constipated usually has fewer than three bowel movements in a week. Bowel movements may be painful.

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Stimulant laxatives for constipation and soiling in children

Constipation is a common childhood disorder traditionally treated with a combination of medical and behavioural approaches. There is insufficient evidence on the use and effectiveness of stimulant laxatives for the treatment of childhood constipation. More research is required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Comparing Drugs for Chronic Constipation

How do the drugs used to treat chronic constipation and irritable bowel syndrome with predominant constipation compare?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 1, 2007

Interventions for treating constipation in pregnancy

Mild laxatives help relieve constipation in pregnancy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Polyethylene Glycol should be used in preference to Lactulose in the treatment of Chronic Constipation.

Constipation is a common clinical problem, encompassing much more than reduced stool frequency. In this review we compared two commonly used osmotic laxatives, Lactulose and Polyethylene Glycol (PEG).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Laxatives for the management of constipation in people receiving palliative care

People with an incurable illness may receive palliative care, which involves making the person as comfortable as possible by controlling pain and other distressing symptoms. People receiving palliative care commonly experience constipation. This is as a result of the use of medicines (e.g. morphine) for pain control, as well as disease, dietary and mobility factors. There is a wide range of laxatives available. The aim of this review was to determine what we know about the effectiveness of laxatives for the management of constipation in people receiving palliative care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

No clear evidence that Cisapride relieves symptoms related to constipation or irritable bowel disease.

Cisapride has been used as a prokinetic to treat constipation, but was found to have some serious side effects and was directly associated with fatalities from those side effects. Though it has been removed from the market and has not been used in most of the world's health institutes, it can still be prescribed in certain situations and is easily purchased through dealers on the Internet. We conducted a systematic review to assess whether or not cisapride actually relieves constipation and controls the symptoms of irritable bowel disease, in addition to looking at whether or not these effects are worth its use compared to the risk of cisapride's dangerous side effects. Through a detailed look at the literature, we found no clear evidence to suggest that cisapride has a role in controlling symptoms related to constipation or IBS and believe its not worth the risk of its possibly fatal arrhythmia side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Tegaserod for the treatment of irritable bowel syndrome and chronic constipation

Irritable bowel syndrome (IBS) is a chronic, relapsing condition characterized by the presence of abdominal pain and disturbed bowel habit. Symptoms of chronic constipation frequently resemble those of constipation‐predominant IBS. Tegaserod (4 or 12 mg/day for 12 weeks), a drug that stimulates smooth muscle in the gastrointestinal tract, produces some benefit over placebo when used to treat IBS where constipation is a major symptom. Patients taking tegaserod reported an overall improvement in their IBS symptoms, an increase in number of bowel movements per day and a reduction in number of days without bowel movements. It is not clear if tegaserod improves symptoms such as abdominal pain, bloating, stool consistency and straining. When used to treat chronic constipation, the frequency of bowel movements increased with tegaserod, but increases over those seen with placebo were small. Diarrhea occurred more often among individuals taking high dose tegaserod (12 mg/day). Further studies are needed to assess the effect of tegaserod on quality of life. More information is needed on its effectiveness in men, as most of the studies involved women.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Laxatives for the management of childhood constipation

Functional childhood constipation is a common problem. The term functional constipation is used when no underlying organic cause can be identified for the symptoms. Symptoms typically include decreased frequency of bowel movements, faecal incontinence and a change in consistency of stools. Despite the widespread use of laxatives by health professionals to manage constipation in children, there has been a long standing lack of evidence to support this practice.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Sacral nerve stimulation for treating faecal incontinence and constipation in adults

Importance of the review/Background: Faecal incontinence occurs when a person passes stools without the usual control. Constipation is harder to define but generally describes a situation in which a person feels that their bowel opening is unsatisfactory (usually a combination of difficulty or infrequency of passing stools). Both conditions can severely affect people's quality of life. There are many non‐surgical treatments for both conditions but occasionally surgery is required when other options fail. Sacral nerve stimulation (SNS) is a relatively new treatment for these conditions. It involves implanting a battery‐powered stimulator unit in the buttock. This is connected to electrodes which rest on the nerves in the lower spine. The stimulator then continuously sends impulses to the nerves and muscles that control the bowel and anus. Initially, a temporary electrode lead is connected to a portable battery unit outside the body. If symptoms are improved enough, this is replaced by the implanted battery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Management of faecal incontinence and constipation in adults with central nervous system diseases

Individuals with central nervous system disease or injury have a much higher risk of loss of bowel control and severe constipation than other people. This is called neurogenic bowel dysfunction (NBD). It can be very difficult to treat constipation without causing bowel leakage, or to prevent bowel leakage without causing constipation. The time spent on emptying the bowel is nearly always much greater for these individuals. Bowel problems like this cause a lot of anxiety and distress and can reduce the quality of life of those who suffer them. This review of research about NBD could be of interest to individuals with any damage to the central nervous system caused by disease or injury, or present at birth, which has a long term effect on how their bowel works.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Dioctyl Sulfosuccinate or Docusate (Calcium or Sodium) for the Prevention or Management of Constipation: A Review of the Clinical Effectiveness [Internet]

Constipation has many definitions and is often described differently depending on the population queried. Many physicians define constipation as a reduction in the frequency of bowel movements to fewer than three times per week while patients identify more with the symptoms associated with constipation such as difficulty passing stool, hard stool consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely. It can substantially affect quality of life and be debilitating. It is estimated that between 2% to 27% of the population are affected depending upon the definition of constipation used.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: June 26, 2014
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Treatments for Constipation: A Review of Systematic Reviews [Internet]

Constipation has many definitions and is often described differently depending on the population queried. Physicians may define constipation as a reduction in the frequency of bowel movements to fewer than three times per week while patients identify more with the symptoms associated with constipation such as difficulty passing stool, hard stool consistency, feelings of abdominal cramping, and feelings of incomplete stool passage. Causes of constipation may be primary (idiopathic) or secondary to other factors such as diet, medication, or medical conditions. Constipation can affect anyone as a minor annoyance but up to a quarter of the population experiences it chronically or severely. It can substantially affect quality of life and be debilitating. It is estimated that between 2% to 27% of the population are affected depending upon the definition of constipation used.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 17, 2014
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Prucalopride for treatment of chronic constipation: a systematic review

Bibliographic details: Hou Y, Gu YF, Zhu BY.  Prucalopride for treatment of chronic constipation: a systematic review. World Chinese Journal of Digestology 2014; 22(4): 588-595 Available from: http://www.wjgnet.com/1009-3079/22/588.asp

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Drug Class Review: Constipation Drugs: Final Report [Internet]

Chronic constipation is a disorder characterized by unsatisfactory defecation that results from infrequent stools, difficult stool passage, or both over a time period of at least 12 weeks. In this report, we review the general and comparative effectiveness, safety, and tolerability of drugs for chronic constipation. Our review covers the use of the following in adults and children with chronic constipation and Irritable Bowel Syndrome, constipation-predominant (IBS-C): docusate calcium, docusate sodium, lactulose, lubiprostone, polyethylene glycol 3350, psyllium, and tegaserod.

Drug Class Reviews - Oregon Health & Science University.

Version: September 2007
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Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care

Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. Children and young people and their families are often given conflicting advice and practice is inconsistent, making treatment potentially less effective and frustrating for all concerned. Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management. Implementation of this guideline will provide a consistent, coordinated approach and will improve outcomes for children and young people.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Efficacy of Chinese herbal medicines in treating chronic functional constipation: a systematic review

Bibliographic details: Ma JZ, Liu SN, Wu TX, Shi L.  Efficacy of Chinese herbal medicines in treating chronic functional constipation: a systematic review. Chinese Journal of Evidence-Based Medicine 2010; 10(10): 1213-1221

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Interventions for treating postpartum constipation

Women may experience constipation during the postpartum period. Consipation is defined as a functional bowel disorder that is characterised by pain and discomfort, straining, hard lumpy stools and a sense of incomplete bowel evacuation. Haemorrhoids, pain at the episiotomy site, effects of pregnancy hormones and iron supplementation can increase the risk of postpartum constipation; as can damage to the anal sphincter or pelvic floor muscles during childbirth. It is a source of concern to the new mother who is recovering from the stress of delivery. The discomfort does not only affect the mother's health, but also impacts on the new baby's well‐being, since it needs most of the mother's attention at this time.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions for treating constipation in pregnancy

The term 'constipation' is defined as difficulty in passing stool and reduced frequency of bowel movements. It is characterised by discomfort, excessive straining, hard or lumpy stools, a sensation of incomplete evacuation, and infrequent bowel movements. Constipation is a common symptom experienced during pregnancy. This can result from a combination of factors, including changes in hormones during pregnancy affecting the digestive system, reduced physical activity and changes in dietary habits during pregnancy. In addition, as the baby grows it can press on the mother's intestines and cause digestive delays/obstructions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Biofeedback (use of equipment to retrain the muscles around the anus and coordinated pushing) for the treatment of chronic constipation in adults

Chronic constipation (inability to achieve satisfactory bowel emptying for a prolonged period with no apparent medical cause) can be an embarrassing and socially restricting problem. There are many possible causes, including an inability to relax the muscles which control bowel movements. ’Biofeedback’, where computer equipment or a rectal balloon is used to show people how to coordinate and use the muscles properly, is often recommended.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Transcutaneous electrical stimulation (TES) for treating long‐term constipation in children.

We reviewed the evidence about the effectiveness and safety of TES in improving constipation in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

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