Constipation

Attributes

Commonality is common Incidence is approximately 1 in 50 people

Further Tests

Our Records are Incomplete for Further Tests

 

Constipation

 

Constipation is a common condition when an individual gets less than or equal to three bowel movements in a span of a week which can be accompanied by painful defecation. An acute one or recent onset constipation usually necessitates medical attention than one that is experienced for a long duration since there could be an underlying serious medical disease such as tumor. When the constipation is associated with bothersome symptoms like bleeding, intense abdominal pain and unexplained weight loss, consult to a physician is advised. ^{[1] [2]}

Epidemiology

People of all ages and of any race can experience constipation. Women and elderly more frequently experience the condition. ^[3]

Causes

There are a lot of suggested reasons behind constipation. The condition is thought to occur when the large bowel or colon absorbs too much water or when there is poor muscle contraction of the colon leading to reduced movement of the fecal material. Also, people who take in less fiber are more prone to develop constipation since fibers promote bowel movement. Some experts also suggest that physical inactivity which is common among elderly makes them more likely to be constipated. Some milk, dairy products and certain drugs like opioids, anticonvulsants, calcium channel blockers, antidepressants and diuretics are known to cause constipation. Other causes of constipation include pregnancy, overuse of laxatives, not drinking enough water, not going to the toilet when there is an urge to defecate and medical conditions like neurological disorders, cancer and metabolic diseases. ^[4]

Signs and Symptoms

Symptoms include infrequent bowel movement, difficulty passing, excessive straining during defecation, abdominal pain, vomiting and feeling of incomplete evacuation.  The stools are frequently described as hard and dry. Some patients may need to use manual evacuation measures such as finger manipulation. ^{[3] [5]}

Diagnosis

Constipation may be worrisome but most cases are not serious. Literature varies on the suggested right span of time to see a doctor. Some say two weeks of experiencing the symptoms while others say three. Medical history and physical examination especially rectal exam are needed. Laboratory tests that can be done include blood tests, barium studies and colonoscopy. ^[3]

Treatment

A clear understanding of the underlying cause is essential. Remedies may include dietary fiber, laxatives, enemas and suppositories. Lifestyle change is imperative like eating more fiber and drinking more water. ^[4]

                                               

References:

1.      http://www.nlm.nih.gov/medlineplus/constipation.html

2.      http://www.medicinenet.com/constipation/article.htm

3.      http://www.webmd.com/digestive-disorders/digestive-diseases-constipation

4.      http://www.medicalnewstoday.com/articles/150322.php

5.      http://www.mayoclinic.com/health/constipation/DS00063/DSECTION=symptoms

 

 

 

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Strychnos Nux-Vomica (Maqianzi, Poison Nut) [1, 28, 29, 30]:

WARNING! This substance is HIGHLY POISONOUS. The seeds contain Strychnine, which may cause convulsions, breathing difficulties and death, even if as little as 5 milligrams is ingested

Recommendation: Strongly against (There is no evidence in the form of clinical trials which reports the effectiveness of Strychnos Nux-Vomica, because it is highly poisonous to humans, and is not recommended.)

Grade of Evidence: Very low quality of evidence

Psyllium (Isphagula, Plantago Psyllium) [1, 22, 23, 24, 25, 26, 27]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Strongly in favor (Clinical trials have shown that Psyllium is effective in treating constipation)

Grade of Evidence: High level of evidence

Pokeweed Antiviral Protein (PAP) [1, 17, 18, 19, 20, 21]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Warning! All parts of the plant, Pokeweed (Phytolacca Americana), is poisonous and should not be ingested. Thoroughly cooking the plant reduces that toxicity. The effects of the improperly prepared plant include vomiting, diarrhoea, cramps, headache, confusion, convulstions, low blood pressure, heart block and death. Only plant extracts (PAP) or thoroughly prepared plants should be ingested, and even then, under professional medical guidance.

Recommendation: No recommendation (There is insufficient evidence to support claims that PAP helps to treat constipation)

Grade of Evidence: Very low of evidence

Mugwort (Artemisa Vulgaris) [1, 14, 15, 16]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat constipation. More research is needed.)

Grade of Evidence: Very low quality of evidence

Kampo [1, 12, 13]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (There is insufficient evidence to support claims that Kampo helps in the treatment of prostatitis)

Grade of Evidence: Low level quality of evidence

Goldenseal (Hydrastis Canadensis) [1, 5, 6, 7, 8, 9, 10, 11]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (There is insufficient evidence to support claims that Goldenseal helps to treat constipation. More studies are needed. Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers and vomiting.)

Grade of Evidence: Low quality of evidence

Flaxseed Oil  [1, 2, 3, 4]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation  (There is insufficient evidence to support claims that flaxseed oil helps to treat constipation)

Grade of Evidence: Low quality of evidence

Red Pepper (Capsaicin):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that red peppers help to treat or prevent constipation)

Grade of Evidence: Very low quality of evidence

Aloe Vera:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (Evidence shows that Aloe may help relieve constipation, however it has many possible side effects if taken by mouth, and at least one report suggests that Aloe taken by mouth may increase cancer risk)

Grade of Evidence: Low quality of evidence

Colonic Irrigation:

Recommendation: Strongly against (colonic irrigation used in patients with constipation is NOT RECOMENDED because it has potentially harmful effects, and can be dangerous)

Grade of Evidence: Low quality of evidence

Castor Oil:

Recommendation: Weakly in favor (Castor Oil is taken as a conventional medicine to be used as a laxative, which is useful in some types of constipation)

Grade of Evidence: High quality of evidence

Phosphate Solution Enema [31, 32]:

Recommendation: No recommendation (There is insufficient evidence to support claims that phosphate solution enema is effective in treating constipation. There are serious risks involved using phosphate solution enema and it is advised to consult a medical professional prior to use)

Grade of Evidence: Low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/flaxseed

3. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-flaxseed.html

4. http://nccam.nih.gov/health/flaxseed/index.htm

5. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/goldenseal

6. http://nccam.nih.gov/health/goldenseal/

7. Tierra Michael (1998): The Way of Herbs. New York, Pocket Books

8. Grieve M. (1971): A Modern Herbal. New York, Dover Publications, Inc

9. Mills S. and Bone K. (2000): Principles and Practice of Phytotherapy. Philadelphia, Churchill Livingstone

10. Tice Raymond (1997): Goldenseal and Two of its constituent alkaloids: berberine and hydrastine Research Triangle Park, National Institute of Environmental Health Sciences, in Seiger E: Review of Toxilogical Literature

11. http://www.henriettesherbal.com/eclectic/ellingwood/hydrastis.html

12. Shibata, Yoshiharu and Jean Wu. "Kampo Treatment for Climacteric Disorders: A Handbook for Practitioners." Paradigm Publications, 1997

13. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kampo

14. Anliker MD, Borelli S, Wüthrich B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis. 2002;46:72-74.

15. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mugwort

16. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

17. http://www.cbif.gc.ca/pls/pp/ppack.info?p_psn=12&p_type=all&p_sci=sci&p_x=px

18. http://www.pfaf.org/user/Plant.aspx?LatinName=Phytolacca+americana

19. http://www.ncbi.nlm.nih.gov/pubmed/315368

20. http://www.nlm.nih.gov/medlineplus/ency/article/002874.htm

21. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pokeweed

22. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-psyllium.html

23. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601104.html

24. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A17913

25. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/psyllium

26. http://www.mayoclinic.com/health/cholesterol-lowering-supplements/CL00013/METHOD=print

27. http://www.ageless.co.za/herb-psyllium.htm

28. David Michael Wood et al. Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data. Critical Care October 2002 Vol 6 No 5

29. Arnold, M.D., Harry L. (1968). Poisonous Plants of Hawaii. Tokyo, Japan: Charles E. Tuttle Co.. p. 20. ISBN 0804804745.

30. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/strychnos-nux-vomica

31. http://www.nursingtimes.net/Journals/2012/12/04/o/y/k/040504The-use-of-phosphate-enemas--in-the-treatment-of-constipation.pdf

32. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641812/

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