Debunking Constipation Myths: The Truth About High Fiber Diets And Laxatives

"Chronic constipation is uncomfortable, but not dangerous," states lead author Stefan A. Müller-Lissner, MD. "This might be the reason why medical doctors often do not take it seriously. There are many unproven beliefs about constipation, but most of them are not tenable upon closer investigation with scientific methods."

According to the authors, although there is no doubt that fiber increases stool bulk and frequency, the role of dietary fiber to treat chronic constipation is exaggerated. A low fiber diet has been proven not to be the cause of constipation and the success of fiber intake as treatment is modest. The study reviewed conducted by Voderholzer et al showed that only 20% of slow transit patients benefited from fiber. Further data suggests that while many patients may be helped by a fiber-rich diet, some actually suffer from worse symptoms when increasing their fiber intake.

On the opposite end, not even increased fluids are guaranteed to help bowel activity. Fluid ingestion to treat chronic constipation is over-emphasized as well, according to Dr. Müller-Lissner, and the success of fluid treatment is probably none. Unless there is evidence of dehydration, there is no data supporting the fact that increasing fluid intake can successfully treat constipation. The article further addresses the myths behind chronic use of laxatives and whether these drugs can be linked to nerve damage and risks of colorectal or other cancers. Data shows that those on the market today are safe when appropriate drugs are prescribed and taken at recommended doses.

With this information, Dr. Müller-Lissner suggests that "patients may no longer be bothered by ineffective advice regarding fiber and fluid ingestion nor threatened by the side effects of laxatives. Also, unnecessary colonic resections may be avoided."

According to the American College of Gastroenterology, constipation is one of the most frequent gastrointestinal complaints in the US and Western countries. There are at least 2.5 million doctor visits for constipation in the US each year and hundreds of millions of dollars are spent for laxatives yearly. With chronic constipation, patients may suffer from constipation for weeks or have recurring bouts over long periods of time.

This study is published in the American Journal of Gastroenterology.

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About the Author

Professor Stefan Müller-Lissner is a Professor of Internal Medicine/Gastroenterology at Humboldt University, Berlin. He received his MD from the University of Marburg, Germany in 1976 and was trained in Munich, Germany and Zurich, Switzerland. Professor Müller-Lissner is a member of the working team on Rome II Criteria for Functional GI disorders, Associate editor of the German Journal of Gastroenterology, and member of the Editorial Board of Gut. He has published nearly 300 scientific papers and articles in national and international journals and books. His research interests include functional gastrointestinal disorders and the implementation of Evidence-based Medicine into clinical practice.

About The American Journal of Gastroenterology

The American Journal of Gastroenterology, the official publication of the American College of Gastroenterology, is THE clinical journal for all practicing gastroenterologists, hepatologists and GI endoscopists. With an impact factor of 4.172, it is the authoritative clinical source in the field of gastroenterology. With a broad-based, rigorous, interdisciplinary approach, the journal presents the latest important information in the field of gastroenterology including original manuscripts, meta-analyses and reviews, health economic papers, debates and consensus statements of clinical relevance in gastroenterology. The reports will highlight new observations and original research, results with innovative treatments and all other topics relevant to clinical gastroenterology. Case reports highlighting disease mechanisms or particularly important clinical observations and letters on articles published in the Journal are included.

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