Constipation

Infrequent or difficult evacuation of FECES. These symptoms are associated with a variety of causes, including low DIETARY FIBER intake, emotional or nervous disturbances, systemic and structural disorders, drug-induced aggravation, and infections.

Also Known As:

Networked: 5162 relevant articles (604 outcomes, 774 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Irritable Bowel Syndrome (Syndrome, Irritable Bowel)
2.	Pain (Aches)
3.	Nausea
4.	Abdominal Pain (Pain, Abdominal)
5.	Vomiting

Experts

1.	Camilleri, Michael: 32 articles (08/2015 - 10/2004)
2.	Camilleri, M: 26 articles (11/2015 - 01/2000)
3.	Chey, William D: 20 articles (04/2015 - 08/2002)
4.	Rao, Satish S C: 20 articles (09/2014 - 07/2005)
5.	Zinsmeister, Alan R: 18 articles (04/2015 - 10/2004)
6.	Hutson, John M: 16 articles (12/2015 - 12/2002)
7.	Southwell, Bridget R: 16 articles (12/2015 - 10/2004)
8.	Tack, Jan: 15 articles (03/2015 - 08/2002)
9.	Kurtz, Caroline B: 15 articles (01/2015 - 09/2007)
10.	Burton, Duane: 14 articles (04/2015 - 10/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Constipation:

1.	tegaserod (Zelnorm)FDA Link 02/01/2007 - "Tegaserod was effective for improving constipation in the overall study populations; no significant adverse events were noted. " 11/01/2004 - "In conclusion, treatment of chronic constipation with tegaserod was associated with significant improvement in bowel frequency as well as other constipation symptoms. " 01/01/2007 - "Ten studies evaluated the efficacy of tegaserod on global gastrointestinal (GI) symptoms in patients with constipation-predominant IBS (C-IBS). " 01/01/2004 - "Seven studies evaluated the efficacy of tegaserod on global gastrointestinal (GI) symptoms in patients with constipation-predominant IBS (C-IBS). " 09/01/1999 - "Oral tegaserod 2 (p < 0.05) or 6mg twice daily improved symptoms of abdominal discomfort, bloating and constipation (assessed using a Subjects' Global Assessment Scale) compared with placebo in patients with constipation-predominant IBS in a double-blind, dose-ranging study. "
2.	Polyethylene Glycols (Polyethylene Glycol)FDA LinkGeneric 08/01/2005 - "PEG 3350 relieved constipation in most treated study subjects. " 03/01/2010 - "Polyethylene glycol (PEG) 3350 is commonly used and has been proven safe and effective for the treatment of chronic constipation and as a 4-day bowel preparation in children. " 02/15/2010 - "In constipation, the conservative therapeutic option is administration of macrogol (polyethylene glycol), which leads to marked improvement." 11/01/1999 - "One long-term study observed remission of constipation-related symptoms in more than 70% of the polyethylene glycol electrolyte solution treated patients, and the efficacy of the treatment was maintained over a 6-month period, despite progressive reduction of daily dosage." 07/01/2006 - "Polyethylene glycol increases bowel frequency in chronic constipation, but its overall efficacy against IBS is unclear. "
3.	prucaloprideIBA 09/07/2008 - "Prucalopride is one such new agent that is highly efficacious in managing chronic constipation. " 12/07/2013 - "The prucalopride study was in patients, largely women with idiopathic constipation showed improved spontaneous complete bowel movement (SCBM) at a dose of 2 mg a day with few adverse events reported. " 11/01/2013 - "In four randomized, double-blind, multicentre, 12-week trials in patients (predominantly women) with chronic constipation, oral prucalopride 2 mg once daily improved bowel function to a significantly greater extent than placebo, with a significantly greater proportion of prucalopride than placebo recipients achieving an average of ≥3 spontaneous, complete bowel movements per week (primary endpoint). " 02/01/2013 - "This integrated analysis of data from three double-blind phase III trials (ClinicalTrials.gov: NCT00488137, NCT00483886, NCT00485940) compared the efficacy and safety of prucalopride 2 mg once daily in women with chronic constipation [≤2 spontaneous complete bowel movements (SCBM) per week] in whom laxatives had failed to provide adequate relief with that in the all-patient (AP) population of men and women with chronic constipation who had or had not obtained relief from laxatives. " 05/29/2008 - "In this 12-week trial, we aimed to determine the efficacy of prucalopride, a selective, high-affinity 5-hydroxytryptamine4 receptor agonist, in patients with severe chronic constipation. "
4.	lubiprostoneFDA Link 01/01/2006 - "Significantly greater improvements occurred with lubiprostone than placebo in the degree of straining, stool consistency and constipation severity (where reported) in both pivotal studies (p < 0.05 for all comparisons at all timepoints). " 01/01/2006 - "In two pivotal, randomised, double-blind, multicentre phase III studies in patients with chronic idiopathic constipation, the frequency of spontaneous bowel movements (SBMs) was significantly greater in patients receiving lubiprostone 24microg twice daily than in those receiving placebo at each weekly timepoint throughout both 4-week studies (p < 0.05). " 11/21/2014 - "Both lubiprostone and Senna improved constipation-related symptoms and QOL in opioid-induced constipation, with no significant between-group differences." 11/01/2014 - "Pairwise comparisons showed significantly greater overall improvement for abdominal discomfort (P=0.047), straining (P<0.001), constipation severity (P=0.007), and stool consistency (P<0.001) with lubiprostone compared with placebo. " 04/01/2010 - "Lubiprostone-treated patients reported significant improvements in stool consistency, straining, and constipation severity at all weeks, and in abdominal bloating at week 1. Patient assessments of treatment effectiveness were significantly greater with lubiprostone compared with placebo at all weeks (P < 0.0004). "
5.	Lactulose (Duphalac)FDA LinkGeneric 10/01/2007 - "The clinical complete remission rate of constipation in the forlax and lactulose groups was 70% and 40% respectively (P < 0.05) by week 1 of treatment, and that was 72% and 41% respectively (P < 0.05) by week 2 of treatment. " 10/01/2007 - "The therapeutic effects, including bowel movement frequency, stool consistency, clinical complete remission rate of constipation and abdominal symptoms, and the safety of forlax and lactulose were evaluated at 1 and 2 weeks of treatment. " 07/01/2006 - "It is significantly more effective than lactulose as maintenance therapy, both in efficacy in treating constipation and efficacy in preventing the recurrence of faecal impaction." 09/01/1988 - "The observed effects indicate that lactulose yoghurt may be beneficial in the treatment or chronic constipation using dietary methods." 01/01/2014 - "PEG 4000 has superior efficacy to lactulose for the treatment of chronic constipation in young children and is well tolerated. "
6.	methylnaltrexoneFDA Link 09/07/2008 - "Subcutaneous methylnaltrexone has recently been shown to be highly effective in the management of opioid-related constipation, and was recently approved by the FDA. " 10/01/2013 - "This case series suggests that methylnaltrexone is safe and may be effective when given subcutaneously as a 0.15 mg/kg single dose to pediatric oncology patients with opioid-induced constipation." 02/01/2012 - "Methylnaltrexone has been shown to be effective for treating opioid-induced constipation (OIC) in chronic settings, but its effects on acute OIC have not been studied. " 05/01/2011 - "Methylnaltrexone is effective for opioid-induced constipation (OIC) in advanced illness patients. " 01/01/2009 - "Methylnaltrexone appears effective in the therapy of opioid-induced constipation and will be useful for patients failing to respond to traditional laxative regimens."
7.	linaclotideIBA 01/01/2015 - "Once-daily linaclotide (145 and 290 μg) significantly improved bowel and abdominal symptoms in chronic idiopathic constipation patients with moderate-to-severe baseline abdominal bloating; in particular, linaclotide significantly improved abdominal bloating compared to placebo, an important finding given the lack of agents available to treat abdominal bloating in chronic idiopathic constipation patients. " 10/01/2013 - "Linaclotide is superior to placebo for the treatment of both IBS-C and Chronic Idiopathic Constipation. " 05/01/2011 - "Linaclotide appears to be a well-tolerated and effective agent for many patients with chronic constipation and IBS-C. " 11/01/2013 - "The efficacy of linaclotide has been studied in both CIC and constipation-predominant IBS (IBS-C). " 03/01/2010 - "We assessed the safety and efficacy of a range of linaclotide doses in patients with chronic constipation. "
8.	Naloxone (Narcan)FDA LinkGeneric 08/01/2015 - "An international double-blind randomized placebo controlled study evaluated the safety and efficacy of four doses of a new sustained release naloxone capsule to treat Opioid Induced Constipation (OIC). " 10/01/2014 - "Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted." 10/01/2014 - "To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). " 03/01/1997 - "In conclusion, it was found that the treatment of opioid-induced constipation by administration of oral naloxone produced positive results. " 07/01/1992 - "Oral naloxone ameliorates opioid-induced constipation in opioid-dependent persons. "
9.	Cisapride (Propulsid)FDA Link 01/01/1996 - "To establish whether cisapride is beneficial in children with intractable constipation, an open trial was performed. " 08/01/2002 - "We conclude that cisapride is effective in the treatment of constipation in patients with PSS." 01/01/2000 - "Cisapride was effective in the treatment of children with constipation." 01/01/2000 - "To determine whether cisapride is effective in the treatment of children with constipation. " 01/01/1994 - "We conclude that cisapride is effective in the treatment of constipation in idiopathic PD."
10.	Morphine (MS Contin)FDA LinkGeneric 10/01/2004 - "Vilva, thus, offered significant protection against morphine induced constipation by way of augmenting mucus secretion." 06/01/2015 - "The combination of HgCl(2) and morphine improved morphine-induced constipation. " 06/01/2015 - "This study investigated the role of AQP3 in the colon in morphine-induced constipation. " 07/01/2011 - "The effectiveness of ATC on relieving morphine-induced constipation was investigated in an in vivo study by measuring the faecal number, faecal water content, and intestinal transit ratio. " 11/01/2008 - "In this study, we provide evidence that constipation may arise due to a lack of tolerance development to morphine in the colon. "

Therapies and Procedures

1.	Psychology Biofeedback (Biofeedback) 09/01/2003 - "Although most studies report positive results using biofeedback to treat constipation, quality research is lacking. " 01/01/2015 - "There was significant improvement in constipation-related symptoms after adaptive biofeedback. " 10/01/2014 - "The symptoms of constipation (sensation of incomplete evacuation, difficult and painful defecation), defecation facilitative manual maneuver frequency, pelvic floor muscles resting amplitude and strain amplitude decreased and squeezing amplitude improved significantly after biofeedback therapy in both groups with and without IBS (P < 0.001). " 09/01/2011 - "After biofeedback there was significant improvement in Wexner Constipation (12 (5-19) pretreatment vs 8 (4-14) posttreatment, P = .001), Wexner Incontinence (12 (3-15) pretreatment vs 4 (2-10) posttreatment, P < .001) and hospital depression scores (7 (3-11) pretreatment vs 5 (3-10) posttreatment, P = .015). " 02/01/2008 - "Conservative measures like high intake of fluids and fibers, laxatives, biofeedback and behavior modification therapy may be beneficial for treatment of constipation. "
2.	Enema (Enemas) 01/01/2010 - "Antegrade colonic enemas and intestinal diversion are highly effective in the management of children with intractable constipation." 01/01/2004 - "Children with diagnosed chronic constipation were treated conservatively (cleansing enemas, oral laxatives, diet) and good results were obtained in 30 patients. " 03/01/2003 - "In all patients antegrade enemas led to significant improvement of: bowel movements/wk (7.4 vs. 1.4, p < 0.001), soiling accidents/wk (1.1 vs. 6.1, p < 0.001), emotional health score (3.8 vs. 1.8, p < 0.001), overall health score (3.7 vs. 1.8, p < 0.001), number of medications for constipation (0.8 vs. 4.2, p < 0.001), number of missed school days/mo (1.3 vs. 10.5, p < 0.001), and number of physician office visits/yr (7.7 vs. 24.1, p < 0.002). " 11/01/2014 - "Milk and molasses enemas were found to be effective at relieving constipation in our population, with a success rate averaging 88% in patients given 5 to 6 mL/kg with an institutional guideline maximum of 135 mL. The success rate was found to vary with age, along with the amount of enema given. " 07/01/2004 - "The antegrade colonic enema is accepted as effective for management of intractable constipation in children when conventional bowel management has failed. "
3.	Colectomy 02/01/1996 - "Total abdominal colectomy with ileorectal anastomosis is highly effective in alleviating symptoms in patients with chronic idiopathic constipation." 04/07/1990 - "Subtotal colectomy with ileorectal anastomosis yields a good outcome in 70-100% of cases with slow transit constipation. " 07/01/1984 - "Although colectomy and ileorectal anastomosis gave good results for slow transit constipation, partial pelvic floor division provided satisfactory long-term improvement in only one of the 7 patients with the outlet syndrome." 12/15/2009 - "Subtotal colectomy with antiperistaltic cecoproctostomy appeared to be the superior treatment than the TAC-IRA for selected patients with slow transit constipation for improved functional outcomes and quality of life." 12/01/2008 - "Compared to the TAC-IRA, subtotal colectomy with end-to-end antiperistaltic cecoproctostomy for appropriately selected patients with STC resulted in relief of constipation, satisfactory functional outcome, and improved qualities of life."
4.	Massage (Reflexology) 02/01/2011 - "Both groups demonstrated a decrease in CSS score from Week 0 to Week 4, indicating an improvement in constipation symptoms; however, the massage group improved significantly more than the control groups (mean difference between groups in score change -5.0 (SD 1.5), 95% CI -8.1, -1.8; t = -3.28, df = 28, p = 0.003). " 02/01/2010 - "Reflexologists claim that reflexology can be beneficial in the treatment of constipation. " 03/29/2011 - "A review of observational studies, case reports and randomised controlled trials was carried out to determine whether abdominal massage is effective in relieving constipation. " 10/01/2011 - "Individual case reports show that massage has been effective for patients with constipation due to a variety of diagnosed physiologic abnormalities, as well as in patients with long-term functional constipation." 03/29/2011 - "To determine whether abdominal massage is effective for the relief of constipation. "
5.	Aftercare (After-Treatment) 10/01/2014 - "The clinical symptoms, gastrointestinal quality of life index, Wexner constipation score and nutritional status were all significantly improved after treatment. " 10/01/2009 - "Scores of constipation in terms of frequency, time, and difficulty degree of defecation, as well as stool properties, were all improved in both groups after treatment (P<0.01, P<0.05); the total score of constipation was 5.52 +/- 1.54 and 5.70 +/- 2.49 in the two groups respectively, which in the treated group was better, and showed significant difference compared with the score in the control group (P<0.01). " 10/01/1997 - "Bladder residue and upper renal tract dilatation after micturition were significantly more common in the group with constipation than in the improved after-treatment and control groups." 01/01/1994 - "The bladder residue and upper renal tract dilatation after micturition were significantly increased in the group with constipation and improved after treatment." 03/01/2009 - "In the 124 patients of the two observation groups, 52 (41.9%) were cured after treatment, they could normally discharge stool, 5 (4.0%) showed markedly effective with their constipation alleviated, but having occasional bowel slackened sensation. "