Chronic constipation and treatment options (Review)

Abstract

Chronic constipation (CC) is a highly prevalent heterogeneous disorder. Although CC is not known to be associated with the development of serious disease or with excess mortality, it considerably reduces the patients quality of life. In addition, it represents an economic burden to patients and society. The majority of patients with CC successfully manage the disorder by dietary management and the use of laxatives. Patients with functional CC (slow‑transit and non‑slow transit constipation) do not respond to laxatives and are a small fraction of the total population complaining of constipation. Regardless of the low number of these patients, the intractability of their symptoms causes psychological and social stress and greatly impairs their quality of life. Furthermore, these patients consume a disproportionate quantity of medical resources. It appears that these patients have a disturbance in the serotonin transmission system, which results in a cascade of alterations in a number of gut neuroendocrine hormones/transmitters. The effect of prucalopride, a serotonin receptor agonist, in this category of patients appears to be not only a pharmacological prokinetic action, but also a correction of a pre‑existing disturbance. Linaclotide, a member of the guanylin peptide family, binds to the ligand‑binding region of guanylate cyclase‑C on the luminal surface of gastrointestinal epithelia resulting in increased fluid secretion. This drug has also been found to be effective for the treatment of functional CC. In addition, biofeedback and sacral nerve stimulation are effective in the treatment of CC caused by pelvic floor disorders.

Pyrocatechol Removal From Aqueous Solutions by Using Azolla Filiculoides

“…It is rather mental and physical impairments associated with CC that affect quality of life of people (7). According to some studies, the impact of CC on quality of life is sometimes more severe than the effect of some other chronic disorders like asthma, cardiovascular diseases, and arthritis (8)(9)(10). Although in modern current medicine (MCM), CC is considered as a gastrointestinal symptom and morbidity than a risk factor for some other chronic disorders, some studies have presented the significant role of CC in development of some chronic severe diseases like cancer (11)(12)(13).…”

Transcutaneous Neuromodulation at Posterior Tibial Nerve and ST36 for Chronic Constipation

“…Chronic constipation is characterized by less frequency of bowel movements (<3 per week), difficult defecation, incomplete evacuation, and other accompanying symptoms [ 2 ]. It is considered to impair the quality of life and is associated with psychosocial problems [ 3 ]. The annual cost for each patient with chronic constipation is about $7522 in the U.S. [ 4 ].…”

Therapeutic Role of Natural Products Containing Tannin for Treatment of Constipation

“…Chronic constipation is a complex gastrointestinal disease that is characterized by infrequent bowel movements, difficult defecation, sensation of incomplete bowel evacuation, sensation of anorectal obstruction, and the need for excessive straining [1][2][3]. This disease can be roughly classified into three groups: (i) constipation in the elderly and cancer patients; (ii) constipation related to neuromuscular diseases and (iii) functional constipation [1]. Constipation can be caused by a variety of factors including insufficient dietary fiber or fluid intake, decreased physical activity, drug administration, colorectal cancer obstruction, and hypothyroidism [4].…”

“…Meanwhile, the most common types of drugs used to treat patients with chronic constipation can be classified into bulk laxatives, osmotic laxatives, emollient laxatives, and prokinetic and prosecretory agents [1,5,6]. Among these, stimulant laxatives such as bisacodyl and natrium picosulfate are commonly administered to chronic patients although they have some limitations including high costs and undesirable side effects [7].…”