New Report Clears Up Myths About Constipation

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Here's a news article that was posted on Health

by Reuters a little while ago.

Looks like physical activity is important.

New Report Clears Up Myths About Constipation

9 minutes ago Health - Reuters

By Charnicia E. Huggins

NEW YORK (Reuters Health) - The idea that chronic

constipation is the result of a low-fiber diet may be

one of the many myths and misconceptions about the

condition, according to a new review of the issue.

The same is true of the idea that consuming more

fluids will ease constipation, or that those who rely

on laxatives will become dependent on them.

" Defecation is a very private process rarely discussed

with the physician but more easily discussed with

friends, " study author Dr. Stefan A. Muller-Lissner of

Humboldt University in Berlin told Reuters Health.

" Therefore it is prone to unsubstantiated theories and

beliefs derived from subjective impressions and

unsystematic observations. "

He said " the role of fluid and dietary fiber intake is

overemphasized and there is an unsubstantiated fear

that laxative intake in reasonable doses were

unhealthy, "

Muller-Lissner and his colleagues address some of the

notions about constipation in a report published in

the American Journal of Gastroenterology.

They first debunk the myth that chronic constipation

may lead to autointoxication from the absorption of

poisonous substances backed up in the colon.

This belief was held even among the ancient Egyptians,

according to an inscription dating back to the 16th

century B.C., and in the early 20th century a famous

London surgeon asserted that all chronic diseases

result from autointoxication. Yet, there is no current

evidence to support such a theory, write

Muller-Lissner and his team, adding that some people

continue to undergo regular " colon cleansing " with

laxatives and enemas.

Fiber is known to add bulk to stool and to increase

the frequency of bowel movements, and many people

believe that a low-fiber diet can cause constipation.

Available research suggests people should not assume

this to be true, however, although a diet that is poor

in fiber may indeed contribute to chronic

constipation.

A high-fiber diet may alleviate the condition in some

patients, the researchers note, but those with severe

constipation may experience worsened symptoms upon

increasing their fiber intake.

In considering whether constipation is caused by a low

intake of fluids or if it can be improved by

increasing fluid intake, Muller-Lissner and his team

report that there is no evidence to support either

belief. Unless a person is dehydrated, increasing

fluid intake does not appear to treat constipation,

their review findings indicate.

The researchers also look into the possibility that a

sedentary lifestyle contributes to constipation and

that physical activity may be beneficial.

After reviewing several studies on the topic they

conclude that physical activity may affect bowel

function, but other factors such as diet and

personality may also play a role. Programs designed to

increase physical activity may not improve bowel

function among young patients with severe

constipation, but may help elderly individuals, when

combined with other aspects of " a broad rehabilitation

program, " the authors write.

Muller-Lissner and his team also investigate various

claims about the chronic use of laxatives, including

the idea that it may cause nerve or muscle damage in

the colon, may increase the risk of various cancers,

including colorectal cancer, and may cause users to

become dependent on laxatives.

Claims of nervous system damage caused by laxatives

have been based on " poorly documented experiments, "

they write, adding that it is " unlikely " that

laxatives taken at recommended doses will harm the

colon.

Also, while chronic constipation does appear to be

associated with increased colorectal cancer risk,

there is no evidence that the use of laxatives

independently increases a person's risk of the cancer.

As for the risk of developing dependency on laxatives,

there is no such potential, Muller-Lissner and his

colleagues state, although they acknowledge that

psychiatric patients may misuse them.

Individuals affected by constipation should " not be

bothered by a low stool frequency as such, "

Muller-Lissner concluded. " Try fiber, " he advised,

" and use laxatives if this does not work

sufficiently. "

SOURCE: American Journal of Gastroenterology, January

2005.

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