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Chronic Constipation

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Constipation

Abstract

Chronic constipation, whether identified based on patient or provider perspective or Rome criteria, is a common problem in the United States. It is distinguished from irritable bowel syndrome with constipation as abdominal pain in relation to the altered bowel habits is not a primary symptom. This chapter reviews the epidemiology and pathophysiology of chronic constipation and its subtypes, identifies salient features in its diagnosis and evaluation, and informs the reader of current and future management options.

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References

  1. Herz MJ, Kahan E, Zalevski S, Aframian R, Kuznitz D, Reichman S. Constipation: a different entity for patients and doctors. Fam Pract. 1996;13:156–9.

    CAS  PubMed  Google Scholar 

  2. Sandler RS, Drossman DA. Bowel habits in young adults not seeking health care. Dig Dis Sci. 1987;32:841–5.

    CAS  PubMed  Google Scholar 

  3. Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ. Variation of bowel habit in two population samples. Br Med J. 1965;2:1095–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  4. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480–91.

    PubMed  Google Scholar 

  5. Digesu GA, Panayi D, Kundi N, Tekkis P, Fernando R, Khullar V. Validity of the Rome III criteria in assessing constipation in women. Int Urogynecol J. 2010;21:1185–93.

    PubMed  Google Scholar 

  6. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750–9.

    PubMed  Google Scholar 

  7. Burkitt DP, Walker AR, Painter NS. Dietary fiber and disease. JAMA. 1974;229:1068–74.

    CAS  PubMed  Google Scholar 

  8. Peppas G, Alexiou VG, Mourtzoukou E, Falagas ME. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol. 2008;8:5.

    PubMed Central  PubMed  Google Scholar 

  9. Mason HJ, Serrano-Ikkos E, Kamm MA. Psychological morbidity in women with idiopathic constipation. Am J Gastroenterol. 2000;95:2852–7.

    CAS  PubMed  Google Scholar 

  10. Merkel IS, Locher J, Burgio K, Towers A, Wald A. Physiologic and psychologic characteristics of an elderly population with chronic constipation. Am J Gastroenterol. 1993;88:1854–9.

    CAS  PubMed  Google Scholar 

  11. Irvine EJ, Ferrazzi S, Pare P, Thompson WG, Rance L. Health-related quality of life in functional GI disorders: focus on constipation and resource utilization. Am J Gastroenterol. 2002;97:1986–93.

    CAS  PubMed  Google Scholar 

  12. Martin BC, Barghout V, Cerulli A. Direct medical costs of constipation in the United States. Manag Care Interface. 2006;19:43–9.

    PubMed  Google Scholar 

  13. Trinkley KE, Porter K, Nahata MC. Prescribing patterns for the outpatient treatment of constipation in the United States. Dig Dis Sci. 2010;55:3514–20.

    PubMed  Google Scholar 

  14. Harari D, Gurwitz JH, Avorn J, Bohn R, Minaker KL. Bowel habit in relation to age and gender. Findings from the National Health Interview Survey and clinical implications. Arch Intern Med. 1996;156:315–20.

    CAS  PubMed  Google Scholar 

  15. Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Dig Dis Sci. 1989;34:606–11.

    CAS  PubMed  Google Scholar 

  16. Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol. 1989;11:525–36.

    CAS  PubMed  Google Scholar 

  17. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology. 1990;98:380–6.

    CAS  PubMed  Google Scholar 

  18. Johanson JF. Geographic distribution of constipation in the United States. Am J Gastroenterol. 1998;93:188–91.

    CAS  PubMed  Google Scholar 

  19. Voderholzer WA, Schatke W, Muhldorfer BE, Klauser AG, Birkner B, Muller-Lissner SA. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol. 1997;92:95–8.

    CAS  PubMed  Google Scholar 

  20. Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005;100:232–42.

    PubMed  Google Scholar 

  21. Palit S, Lunniss PJ, Scott SM. The physiology of human defecation. Dig Dis Sci. 2012;57:1445–64.

    PubMed  Google Scholar 

  22. Sikirov D. Comparison of straining during defecation in three positions: results and implications for human health. Dig Dis Sci. 2003;48:1201–5.

    PubMed  Google Scholar 

  23. Rao SS, Kavlock R, Rao S. Influence of body position and stool characteristics on defecation in humans. Am J Gastroenterol. 2006;101:2790–6.

    PubMed  Google Scholar 

  24. Sadler TW. Digestive system. In: Langman’s medical embryology. Philadelphia: Lippincott William & Wilkins; 2006.

    Google Scholar 

  25. Sanders KM. Interstitial cells of Cajal at the clinical and scientific interface. J Physiol. 2006;576(Pt 3):683–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  26. Bassotti G, Germani U, Morelli A. Human colonic motility: physiological aspects. Int J Colorectal Dis. 1995;10:173–80.

    CAS  PubMed  Google Scholar 

  27. Szmulowicz UM, Hull TL. Colonic physiology. In: Beck DE, Roberts PL, Saclarides TJ, Senagore AJ, Stamos MJ, Wexner SD, editors. The ASCRS textbook of colon and rectal surgery. New York: Springer; 2011. p. 23–39.

    Google Scholar 

  28. Huizinga JD, Stern HS, Chow E, Diamant NE, El Sharkawy TY. Electrophysiologic control of motility in the human colon. Gastroenterology. 1985;88:500–11.

    CAS  PubMed  Google Scholar 

  29. Bassotti G, Iantorno G, Fiorella S, Bustos-Fernandez L, Bilder CR. Colonic motility in man: features in normal subjects and in patients with chronic idiopathic constipation. Am J Gastroenterol. 1999;94:1760–70.

    CAS  PubMed  Google Scholar 

  30. Sarna SK. Colonic motility: from bench to bedside. Morgan & Claypool Life Sciences: San Rafael (CA); 2010.

    Google Scholar 

  31. Garcia D, Hita G, Mompean B, Hernandez A, Pellicer E, Morales G, Parrilla P. Colonic motility: electric and manometric description of mass movement. Dis Colon Rectum. 1991;34:577–84.

    CAS  PubMed  Google Scholar 

  32. Narducci F, Bassotti G, Gaburri M, Morelli A. Twenty four hour manometric recording of colonic motor activity in healthy man. Gut. 1987;28:17–25.

    CAS  PubMed Central  PubMed  Google Scholar 

  33. Bassotti G, Gaburri M. Manometric investigation of high-amplitude propagated contractile activity of the human colon. Am J Physiol. 1988;255:G660–4.

    CAS  PubMed  Google Scholar 

  34. Jouet P, Coffin B, Lemann M, Gorbatchef C, Franchisseur C, Jian R, Rambaud JC, Flourie B. Tonic and phasic motor activity in the proximal and distal colon of healthy humans. Am J Physiol. 1998;274:G459–64.

    CAS  PubMed  Google Scholar 

  35. Bassotti G, Gaburri M, Imbimbo BP, Morelli A, Whitehead WE. Distension-stimulated propagated contractions in human colon. Dig Dis Sci. 1994;39:1955–60.

    CAS  PubMed  Google Scholar 

  36. Rao SS, Beaty J, Chamberlain M, Lambert PG, Gisolfi C. Effects of acute graded exercise on human colonic motility. Am J Physiol. 1999;276:G1221–6.

    CAS  PubMed  Google Scholar 

  37. Wright SH, Snape Jr WJ, Battle W, Cohen S, London RL. Effect of dietary components on gastrocolonic response. Am J Physiol. 1980;238:G228–32.

    CAS  PubMed  Google Scholar 

  38. Rao SS, Kavelock R, Beaty J, Ackerson K, Stumbo P. Effects of fat and carbohydrate meals on colonic motor response. Gut. 2000;46:205–11.

    CAS  PubMed Central  PubMed  Google Scholar 

  39. Proano M, Camilleri M, Phillips SF, Brown ML, Thomforde GM. Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol. 1990;258:G856–62.

    CAS  PubMed  Google Scholar 

  40. Miller R, Lewis GT, Bartolo DC, Cervero F, Mortensen NJ. Sensory discrimination and dynamic activity in the anorectum: evidence using a new ambulatory technique. Br J Surg. 1988;75:1003–7.

    CAS  PubMed  Google Scholar 

  41. Shahid S, Ramzan Z, Maurer AH, Parkman HP, Fisher RS. Chronic idiopathic constipation: more than a simple colonic transit disorder. J Clin Gastroenterol. 2012;46:150–4.

    PubMed  Google Scholar 

  42. Surrenti E, Rath DM, Pemberton JH, Camilleri M. Audit of constipation in a tertiary referral gastroenterology practice. Am J Gastroenterol. 1995;90:1471–5.

    CAS  PubMed  Google Scholar 

  43. Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003;349:1360–8.

    CAS  PubMed  Google Scholar 

  44. Grotz RL, Pemberton JH, Talley NJ, Rath DM, Zinsmeister AR. Discriminant value of psychological distress, symptom profiles, and segmental colonic dysfunction in outpatients with severe idiopathic constipation. Gut. 1994;35:798–802.

    CAS  PubMed Central  PubMed  Google Scholar 

  45. Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S. Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology. 1991;101:107–15.

    CAS  PubMed  Google Scholar 

  46. Rao SS, Sadeghi P, Beaty J, Kavlock R. Ambulatory 24-hour colonic manometry in slow-transit constipation. Am J Gastroenterol. 2004;99:2405–16.

    PubMed  Google Scholar 

  47. Herve S, Savoye G, Behbahani A, Leroi AM, Denis P, Ducrotte P. Results of 24-h manometric recording of colonic motor activity with endoluminal instillation of bisacodyl in patients with severe chronic slow transit constipation. Neurogastroenterol Motil. 2004;16:397–402.

    CAS  PubMed  Google Scholar 

  48. Bassotti G, Chistolini F, Nzepa FS, Morelli A. Colonic propulsive impairment in intractable slow-transit constipation. Arch Surg. 2003;138:1302–4.

    PubMed  Google Scholar 

  49. Dinning PG, Zarate N, Hunt LM, Fuentealba SE, Mohammed SD, Szczesniak MM, Lubowski DZ, Preston SL, Fairclough PD, Lunniss PJ, Scott SM, Cook IJ. Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation. Neurogastroenterol Motil. 2010;22:e340–9.

    CAS  PubMed  Google Scholar 

  50. Rao SS, Sadeghi P, Batterson K, Beaty J. Altered periodic rectal motor activity: a mechanism for slow transit constipation. Neurogastroenterol Motil. 2001;13:591–8.

    CAS  PubMed  Google Scholar 

  51. Gomez-Pinilla PJ, Gibbons SJ, Sarr MG, Kendrick ML, Shen KR, Cima RR, Dozois EJ, Larson DW, Ordog T, Pozo MJ, Farrugia G. Changes in interstitial cells of cajal with age in the human stomach and colon. Neurogastroenterol Motil. 2011;23:36–44.

    CAS  PubMed Central  PubMed  Google Scholar 

  52. Phillips RJ, Powley TL. Innervation of the gastrointestinal tract: patterns of aging. Auton Neurosci. 2007;136:1–19.

    PubMed Central  PubMed  Google Scholar 

  53. Rao SS, Go JT. Treating pelvic floor disorders of defecation: management or cure? Curr Gastroenterol Rep. 2009;11:278–87.

    PubMed Central  PubMed  Google Scholar 

  54. Rao SS, Welcher KD, Leistikow JS. Obstructive defecation: a failure of rectoanal coordination. Am J Gastroenterol. 1998;93:1042–50.

    CAS  PubMed  Google Scholar 

  55. De Medici A, Badiali D, Corazziari E, Bausano G, Anzini F. Rectal sensitivity in chronic constipation. Dig Dis Sci. 1989;34:747–53.

    PubMed  Google Scholar 

  56. Baldi F, Ferrarini F, Corinaldesi R, Balestra R, Cassan M, Fenati GP, Barbara L. Function of the internal anal sphincter and rectal sensitivity in idiopathic constipation. Digestion. 1982;24:14–22.

    CAS  PubMed  Google Scholar 

  57. Rao SS. Constipation: evaluation and treatment of colonic and anorectal motility disorders. Gastroenterol Clin North Am. 2007;36:687–711.

    PubMed  Google Scholar 

  58. Landmann RG, Wexner SD. Paradoxical puborectalis contraction and increased perineal descent. Clin Colon Rectal Surg. 2008;21:138–45.

    PubMed Central  PubMed  Google Scholar 

  59. Karlbom U, Edebol Eeg-Olofsson K, Graf W, Nilsson S, Pahlman L. Paradoxical puborectalis contraction is associated with impaired rectal evacuation. Int J Colorectal Dis. 1998;13:141–7.

    CAS  PubMed  Google Scholar 

  60. Lunniss PJ, Gladman MA, Benninga MA, Rao SS. Pathophysiology of evacuation disorders. Neurogastroenterol Motil. 2009;21 Suppl 2:31–40.

    PubMed  Google Scholar 

  61. Rao SS, Tuteja AK, Vellema T, Kempf J, Stessman M. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol. 2004;38:680–5.

    PubMed  Google Scholar 

  62. Preston DM, Lennard-Jones JE. Severe chronic constipation of young women: ‘idiopathic slow transit constipation’. Gut. 1986;27:41–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  63. Leung L, Riutta T, Kotecha J, Rosser W. Chronic constipation: an evidence-based review. J Am Board Fam Med. 2011;24:436–51.

    PubMed  Google Scholar 

  64. Koch A, Voderholzer WA, Klauser AG, Muller-Lissner S. Symptoms in chronic constipation. Dis Colon Rectum. 1997;40:902–6.

    CAS  PubMed  Google Scholar 

  65. Walter SA, Kjellstrom L, Nyhlin H, Talley NJ, Agreus L. Assessment of normal bowel habits in the general adult population: the Popcol study. Scand J Gastroenterol. 2010;45:556–66.

    PubMed  Google Scholar 

  66. Saad RJ, Rao SS, Koch KL, Kuo B, Parkman HP, McCallum RW, Sitrin MD, Wilding GE, Semler JR, Chey WD. Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls. Am J Gastroenterol. 2010;105:403–11.

    PubMed  Google Scholar 

  67. American College of Gastroenterology Chronic Constipation Task Force. An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol. 2005;100 Suppl 1:S1–4.

    Google Scholar 

  68. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32:920–4.

    CAS  PubMed  Google Scholar 

  69. Degen LP, Phillips SF. How well does stool form reflect colonic transit? Gut. 1996;39:109–13.

    CAS  PubMed Central  PubMed  Google Scholar 

  70. O’Donnell LJ, Virjee J, Heaton KW. Detection of pseudodiarrhoea by simple clinical assessment of intestinal transit rate. BMJ. 1990;300:439–40.

    PubMed Central  PubMed  Google Scholar 

  71. Vorobyov GI, Achkasov SI, Biryukov OM. Clinical features’ diagnostics and treatment of Hirschsprung’s disease in adults. Colorectal Dis. 2010;12:1242–8.

    CAS  PubMed  Google Scholar 

  72. Chan AO, Lam KF, Hui WM, Leung G, Wong NY, Lam SK, Wong BC. Influence of positive family history on clinical characteristics of functional constipation. Clin Gastroenterol Hepatol. 2007;5:197–200.

    PubMed  Google Scholar 

  73. Talley NJ. How to do and interpret a rectal examination in gastroenterology. Am J Gastroenterol. 2008;103:820–2.

    PubMed  Google Scholar 

  74. Tantiphlachiva K, Rao P, Attaluri A, Rao SS. Digital rectal examination is a useful tool for identifying patients with dyssynergia. Clin Gastroenterol Hepatol. 2010;8:955–60.

    PubMed  Google Scholar 

  75. Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol. 2005;100 Suppl 1:S5–21.

    PubMed  Google Scholar 

  76. Qureshi W, Adler DG, Davila RE, Egan J, Hirota WK, Jacobson BC, Leighton JA, Rajan E, Zuckerman MJ, Fanelli R, Wheeler-Harbaugh J, Baron TH, Faigel DO. ASGE guideline: guideline on the use of endoscopy in the management of constipation. Gastrointest Endosc. 2005;62:199–201.

    PubMed  Google Scholar 

  77. Bharucha AE, Wald AM. Anorectal disorders. Am J Gastroenterol. 2010;105:786–94.

    PubMed Central  PubMed  Google Scholar 

  78. Rao SS, Kuo B, McCallum RW, Chey WD, DiBaise JK, Hasler WL, Koch KL, Lackner JM, Miller C, Saad R, Semler JR, Sitrin MD, Wilding GE, Parkman HP. Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation. Clin Gastroenterol Hepatol. 2009;7:537–44.

    PubMed  Google Scholar 

  79. Dinning PG, Benninga MA, Southwell BR, Scott SM. Paediatric and adult colonic manometry: a tool to help unravel the pathophysiology of constipation. World J Gastroenterol. 2010;16:5162–72.

    PubMed Central  PubMed  Google Scholar 

  80. Rao SS, Singh S. Clinical utility of colonic and anorectal manometry in chronic constipation. J Clin Gastroenterol. 2010;44:597–609.

    PubMed  Google Scholar 

  81. Minguez M, Herreros B, Sanchiz V, Hernandez V, Almela P, Anon R, Mora F, Benages A. Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation. Gastroenterology. 2004;126:57–62.

    PubMed  Google Scholar 

  82. Reiner CS, Tutuian R, Solopova AE, Pohl D, Marincek B, Weishaupt D. MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value. Br J Radiol. 2011;84:136–44.

    CAS  PubMed Central  PubMed  Google Scholar 

  83. Emmanuel A. Current management strategies and therapeutic targets in chronic constipation. Therap Adv Gastroenterol. 2011;4:37–48.

    PubMed Central  PubMed  Google Scholar 

  84. Graham DY, Moser SE, Estes MK. The effect of bran on bowel function in constipation. Am J Gastroenterol. 1982;77:599–603.

    CAS  PubMed  Google Scholar 

  85. Ashraf W, Park F, Lof J, Quigley EM. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Aliment Pharmacol Ther. 1995;9:639–47.

    CAS  PubMed  Google Scholar 

  86. Tack J, Camilleri M, Chang L, Chey WD, Galligan JJ, Lacy BE, Muller-Lissner S, Quigley EM, Schuurkes J, De Maeyer JH, Stanghellini V. Systematic review: cardiovascular safety profile of 5-HT(4) agonists developed for gastrointestinal disorders. Aliment Pharmacol Ther. 2012;35:745–67.

    CAS  PubMed Central  PubMed  Google Scholar 

  87. Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med. 2008;358:2344–54.

    CAS  PubMed  Google Scholar 

  88. Tack J, van Outryve M, Beyens G, Kerstens R, Vandeplassche L. Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives. Gut. 2009;58:357–65.

    CAS  PubMed  Google Scholar 

  89. Quigley EM, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation—a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2009;29:315–28.

    CAS  PubMed  Google Scholar 

  90. Menees S, Saad R, Chey WD. Agents that act luminally to treat diarrhoea and constipation. Nat Rev Gastroenterol Hepatol. 2012;9:661–74.

    CAS  PubMed  Google Scholar 

  91. Barish CF, Drossman D, Johanson JF, Ueno R. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010;55:1090–7.

    CAS  PubMed  Google Scholar 

  92. Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011;60:209–18.

    PubMed  Google Scholar 

  93. Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K. Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial. Am J Gastroenterol. 2010;105:890–6.

    PubMed Central  PubMed  Google Scholar 

  94. Rao SS, Seaton K, Miller M, Brown K, Nygaard I, Stumbo P, Zimmerman B, Schulze K. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clin Gastroenterol Hepatol. 2007;5:331–8.

    PubMed  Google Scholar 

  95. Heymen S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead WE. Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation. Dis Colon Rectum. 2007;50:428–41.

    PubMed  Google Scholar 

  96. Chiarioni G, Salandini L, Whitehead WE. Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation. Gastroenterology. 2005;129:86–97.

    PubMed  Google Scholar 

  97. Wiesel PH, Dorta G, Cuypers P, Herranz M, Kreis ME, Schnegg JF, Jornod P. Patient satisfaction after biofeedback for constipation and pelvic floor dyssynergia. Swiss Med Wkly. 2001;131:152–6.

    CAS  PubMed  Google Scholar 

  98. Pourmomeny AA, Emami MH, Amooshahi M, Adibi P. Comparing the efficacy of biofeedback and balloon-assisted training in the treatment of dyssynergic defecation. Can J Gastroenterol. 2011;25:89–92.

    PubMed Central  PubMed  Google Scholar 

  99. Muller-Lissner S, Tack J, Feng Y, Schenck F, Specht GR. Levels of satisfaction with current chronic constipation treatment options in Europe—an internet survey. Aliment Pharmacol Ther. 2013;37:137–45.

    CAS  PubMed  Google Scholar 

  100. Johanson JF, Kralstein J. Chronic constipation: a survey of the patient perspective. Aliment Pharmacol Ther. 2007;25:599–608.

    CAS  PubMed  Google Scholar 

  101. Fernandez-Banares F. Nutritional care of the patient with constipation. Best Pract Res Clin Gastroenterol. 2006;20:575–87.

    CAS  PubMed  Google Scholar 

  102. Marteau P, Cuillerier E, Meance S, Gerhardt MF, Myara A, Bouvier M, Bouley C, Tondu F, Bommelaer G, Grimaud JC. Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women: a double-blind, randomized, controlled study. Aliment Pharmacol Ther. 2002;16:587–93.

    CAS  PubMed  Google Scholar 

  103. Yang YX, He M, Hu G, Wei J, Pages P, Yang XH, Bourdu-Naturel S. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol. 2008;14:6237–43.

    PubMed Central  PubMed  Google Scholar 

  104. Koebnick C, Wagner I, Leitzmann P, Stern U, Zunft HJ. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol. 2003;17:655–9.

    PubMed  Google Scholar 

  105. Quigley EM. Probiotics in the management of functional bowel disorders: promise fulfilled? Gastroenterol Clin North Am. 2012;41:805–19.

    PubMed  Google Scholar 

  106. Collins B, Norton C, Maeda Y. Percutaneous tibial nerve stimulation for slow transit constipation: a pilot study. Colorectal Dis. 2012;14:e165–70.

    CAS  PubMed  Google Scholar 

  107. Kamm MA, Dudding TC, Melenhorst J, Jarrett M, Wang Z, Buntzen S, Johansson C, Laurberg S, Rosen H, Vaizey CJ, Matzel K, Baeten C. Sacral nerve stimulation for intractable constipation. Gut. 2010;59:333–40.

    PubMed  Google Scholar 

  108. Queralto M, Vitton V, Bouvier M, Abysique A, Portier G. Interferential therapy: a new treatment for slow transit constipation. a pilot study in adults. Colorectal Dis. 2013;15:e35–9.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA

    Siddharth P. Sura M.D., M.P.H.

  2. Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, Suite-1264, Atlanta, GA, 30322, USA

    Jennifer Christie M.D.

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  1. Siddharth P. Sura M.D., M.P.H.
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Correspondence to Jennifer Christie M.D. .

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Editors and Affiliations

  1. School of Medicine, University of Connecticut, Farmington, Connecticut, USA

    Suzanne Rose, MD, MSEd

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Sura, S.P., Christie, J. (2014). Chronic Constipation. In: Rose, MD, MSEd, S. (eds) Constipation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0332-0_3

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