Common Questions about Constipation; Myths and Misconceptions
In January 2005, Drs. Stefan Muller-Lissner of Germany, Michael Kamm of the U.K., Carmelo Scarpignato of Italy, and Arnold Wald of the U.S., all noted gastroenterologists and experts on the treatment of constipation, published a review article discussing various myths and misconceptions about constipation and its treatment. Though most of the issues discussed in the article are well understood by the medical practice community, they persist among the general public and are still promoted by those who are uninformed. Hence, a brief discussion of the review article is relevant.
Is it dangerous for stool to remain in the colon for a long time period? Can this cause other diseases?
This belief dates from ancient times. Now, colon cleansing (colonics) is promoted by some to maintain "colon health." However, there is no foundation in science for this theory.
Can changes in hormones cause constipation?
There is no evidence for a cause and effect relationship between hormones and constipation.
Is constipation caused by low intake of fiber or fluid?
Fiber clearly increases stool bulk and frequency, and decreases transit time in healthy people, and may benefit individuals with relatively minor or occasional constipation. However, for chronic or more severe constipation no significant benefit has been demonstrated.
So far, research does not support increasing fluid intake to relieve constipation, but dehydration should be avoided.
Is the long-term use of stimulant laxatives for constipation unhealthy or unsafe?
In the only controlled study conducted to date, constipated patients treated with stimulant laxatives did not develop damage to their colons when compared to controls who did not receive laxatives. Hence, it is unlikely that stimulant laxatives are harmful when used at recommended doses. Nevertheless, the use of excessive laxatives over long periods has led to some serious metabolic consequences.
Are stimulant laxatives habit forming?
Although tolerance to laxatives has not been well studied in humans, animal data do not support development of tolerance. There are no data that suggests that laxatives are addictive or habit forming. Overall, the available data indicates that laxatives are safe and effective treatments for constipation. If patients with constipation find that their treatments are becoming less effective, then it is time to consult a doctor about alternatives.