Separating Misconception and Truth In Constipation Treatments

Repeated constipation is a problem faced by some 15-30% of the general population in the U.S. More than half experience a particular form known as idiopathic constipation. Despite the technical sound of the name, it actually means “that without known cause”. Therefore, most people have constipation which cannot be traced to cause, due largely to our lack of understanding of complex physiology of the gastrointestinal tract.

The incomplete understanding has lead not only to a proliferation of natural, reputable (such as osmotic and bulk laxatives) and disreputable treatments, but also spawned a number of myths about constipation in popular culture. A large number of these myths center around how certain precautions and activities can limit constipation. Let us consider a few of them here.

For example, one particular myth is that walking can help constipation because it stimulates the muscles that push food along the gastrointestinal tract. The constipated, slow movement is due to lack of physical activity. However a controlled study by some academics at a UC Irvine laboratory showed that there was no difference in constipation between a group that exercised an hour a day for 6 weeks versus a group that did not. Most people exercise less than an hour a day.

A second myth is that adding more fiber to the diet can cure constipation. The myth sounds quite reasonable as fiber is one of the major nutrients promoted by the FDA. Unfortunately, a review by researchers Fox-Orenstein and co-workers demonstrated that fiber therapy worked in about a third of all people. While normal amounts of fiber are necessary, for the large part constipation sufferers already get that amount and have constipation for other reasons.

The third myth we consider here is that having more water can help bulk up food to make it move quicker in the colon. However, studies reviewed by Muller-Lissner and co-workers demonstrated that there was no connection between water intake and constipation. The authors go on to theorize that perhaps in extreme cases of water deprivation there may be a constipation effect, the more common patient already has enough water and does not benefit by drinking more.

Lastly, the reader may recall that there are many advertisements these days touting colonic cleansers as the cure-all for constipation. Colonic cleansers are claimed to be remedies for toxin build-up, and general poor health. But almost every physician will tell their patients to take these claims with a grain of salt. Even the American Cancer Society has put out information warning people not to try these products.

Fortunately, of the above myths, most are harmless at worst. Drinking water, exercising and eating fiber are activities that promote general health even though they may not impact constipation directly.

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