The DOI matches its Crossref record; 170 of the 170 references it cites were found in a registry or an index.
Mechanisms, Evaluation, and Management of Chronic Constipation
Open accessAbstract
With a worldwide prevalence of 15%, chronic constipation is one of the most frequent gastrointestinal diagnoses made in ambulatory medicine clinics, and is a common source cause for referrals to gastroenterologists and colorectal surgeons in the United States. Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic constipation is either a primary disorder (such as normal transit, slow transit, or defecatory disorders) or a secondary one (due to medications or, in rare cases, anatomic alterations). Colonic sensorimotor disturbances and pelvic floor dysfunction (such as defecatory disorders) are the most widely recognized pathogenic mechanisms. Guided by efficacy and cost, management of constipation should begin with dietary fiber supplementation and stimulant and/or osmotic laxatives, as appropriate, followed, if necessary, by intestinal secretagogues and/or prokinetic agents. Peripherally acting μ-opiate antagonists are another option for opioid-induced constipation. Anorectal tests to evaluate for defecatory disorders should be performed in patients who do not respond to over-the-counter agents. Colonic transit, followed if necessary with assessment of colonic motility with manometry and/or a barostat, can identify colonic dysmotility. Defecatory disorders often respond to biofeedback therapy. For specific patients, slow-transit constipation may necessitate a colectomy. No studies have compared inexpensive laxatives with newer drugs with different mechanisms. We review the mechanisms, evaluation, and management of chronic constipation. We discuss the importance of meticulous analyses of patient history and physical examination, advantages and disadvantages of diagnostic testing, guidance for individualized treatment, and management of medically refractory patients.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For prucalopride, a selective agonist of serotonin 5-HT 4 receptors, the recommended dose is 2 mg once daily in adults and 1 mg daily in individuals with severe renal impairment (ie, creatinine clearance <30 mL/min). 80”
From American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation (2023) · cites this paper as [80]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Lacy, B. E., Mearin, F., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.02.031 · Cited by 2,866
Self-citationPeery, A. F., Crockett, S. D., Murphy, C. C., Lund, J. L., Dellon, E. S., Williams, J. L., Jensen, E. T., Shaheen, N. J., Barritt, A. S., Lieber, S. R., et al. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.08.063 · Cited by 1,619
Epidemiology of constipation in children and adults: A systematic review
Mugie, S. M., Benninga, M. A., & Lorenzo, C. D. (2011) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2010.12.010 · Cited by 945
Simplified assessment of segmental colonic transit
Metcalf, A. M., Phillips, S. F., Zinsmeister, A. R., MacCarty, R. L., Beart, R. W., & Wolff, B. G. (1987) · Gastroenterology · doi:10.1016/0016-5085(87)90837-7 · Cited by 928
American Gastroenterological Association Technical Review on Constipation
Bharucha, A. E., Pembérton, J. H., & Locke, G. R. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.10.028 · Cited by 924
Self-citationFunctional anorectal disorders.
Bharucha, A., Wald, A., Enck, P., & Rao, S. S. C. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.064 · Cited by 770
Self-citationDefecography in normal volunteers: results and implications.
Shorvon, P. J., McHugh, S., Diamant, N. E., Somers, S., & Stevenson, G. W. (1989) · Gut · doi:10.1136/gut.30.12.1737 · Cited by 756
Ford, A. C., Quigley, E. M. M., Lacy, B. E., Lembo, A. J., Saito, Y. A., Schiller, L. R., Soffer, E. E., Spiegel, B. M. R., & Moayyedi, P. (2014) · American Journal of Gastroenterology · doi:10.1038/ajg.2014.202 · Cited by 747
Self-citationMyths and Misconceptions About Chronic Constipation
Müller-Lissner, S. A., Kamm, M. A., Scarpignato, C., & Wald, A. M. (2005) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2005.40885.x · Cited by 616
Sphincter denervation in anorectal incontinence and rectal prolapse.
Parks, A. G., Swash, M., & Urich, H. (1977) · Gut · doi:10.1136/gut.18.8.656 · Cited by 552
Flagged first, then by citations
Research works printed but not linked: 1
- Diamant, 1999, American Gastroenterological Association medical position statement on anorectal testing techniques, Gastroenterology, 116, 732, 10.1016/S0016-5085(99)70194-0 · DOI
Cited by
Sorted by citations
Items 201–300 of 654
Baidoo, N., Sanger, G. J., & Belai, A. (2022) · Acta Histochemica · doi:10.1016/j.acthis.2022.151958 · Cited by 8
Wu, S., Jin, T., Ma, B., Ji, Y. S., Huang, X., Wang, P., Liu, X., Владимирович, К. Б., Liu, X., & Ma, K. (2023) · Cancer Medicine · doi:10.1002/cam4.4922 · Cited by 8
The management of delirium in the older adult in advanced nursing practice
Carey, E., Furlong, E., & Smith, R. (2022) · British Journal of Nursing · doi:10.12968/bjon.2022.31.2.76 · Cited by 7
Wu, L.-Q., Yuan, Q., Wu, L., Xia, H. H., Zhong, M., Liu, T., Ye, X., Luo, D.-P., Xu, J., Xie, W.-R., et al. (2023) · BMC Gastroenterology · doi:10.1186/s12876-023-02929-7 · Cited by 7
“FC is symptom-based, non-organic in origin, and commonly diagnosed by Rome IV diagnostic [2, 3], and the symptoms of FC vary among different patients [4].”
BackgroundKirindage, K. G. I. S., Jayasinghe, A. M. K., Jang, M., Lee, K.-J., Yun, H.-J., Ahn, G., & Oh, J.-Y. (2024) · Journal of Microbiology and Biotechnology · doi:10.4014/jmb.2407.07036 · Cited by 9
Li, X., Bian, C., Dai, H., Chen, X., Qian, H., & Zhang, D. (2025) · BMC Gastroenterology · doi:10.1186/s12876-024-03575-3 · Cited by 7
MicroRNA regulation of enteric nervous system development and disease
Holland, A. M., Jehoul, R., Vranken, J., Wohl, S. G., & Boesmans, W. (2025) · Trends in Neurosciences · doi:10.1016/j.tins.2025.02.004 · Cited by 7
Luo, J., Xu, Q., Xu, S., Zhai, L., Yuan, C., & Bian, Z. (2025) · Current Gastroenterology Reports · doi:10.1007/s11894-025-00967-7 · Cited by 8
“The prevalence of IBS-C and FC is higher in women than men [1, 44, 83], which is consistent with women being more susceptible to stress-related disorders and other comorbid diseases such as fibromyalgia and migraine [84, 85].”
Luo, M.-C., Xie, P.-W., Deng, X., Fan, J.-H., & Xiong, L.-S. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16960 · Cited by 7
Liu, T., Wang, Z., Li, Y., Kang, X., Wang, X., Ren, G., Lv, Y., Li, J., Liu, Y., Liang, S., et al. (2025) · United European Gastroenterology Journal · doi:10.1002/ueg2.70041 · Cited by 7
Wu, B., Wu, J., Bai, X., Zhou, Q., & Wang, X. (2025) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2025.120479 · Cited by 7
Modulation of Intestinal Smooth Muscle Cell Function by BL-99 Postbiotics in Functional Constipation
Zhao, W., Liu, M., Lan, H., Wang, R., Hung, W., He, J., & Fang, B. (2025) · Foods · doi:10.3390/foods14193441 · Cited by 7
“Intestinal dysmotility is a fundamental physiological and pathological feature of FC [33].”
Na, S., Zhang, X., Zhou, Y., Li, J., Qiu, B., Li, X., Bao, N.-M., & Yu, J. (2025) · Carbohydrate Polymers · doi:10.1016/j.carbpol.2025.124541 · Cited by 7
Laxative effect of Wenyang Yiqi Decoction on loperamide-induced astriction model mice
Su, Y., Zhu, R., Pang, C.-X., He, Z., Wu, B.-S., & Wang, X.-P. (2023) · Annals of Translational Medicine · doi:10.21037/atm-23-6 · Cited by 6
Diagnostic performance of dynamic MR defecography in assessment of dyssynergic defecation
Thanaracthanon, P., Sasiwimonphan, K., Sunthornram, A., Harisinghani, M. G., & Chulroek, T. (2023) · Abdominal Radiology · doi:10.1007/s00261-023-04010-z · Cited by 7
Current Management of Chronic Constipation in Japan
Masaoka, T. (2023) · The Keio Journal of Medicine · doi:10.2302/kjm.2022-0036-ir · Cited by 7
Lin, T., Wu, C., Fan, Y., Chang, Y., Ho, H. J., & Chen, Y. (2022) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2021.12.016 · Cited by 7
Dang, C., Zhao, K., Xun, Y., Feng, L., Zhang, D., Cui, L., Cui, Y., Jia, X., & Wang, S. (2022) · Current Microbiology · doi:10.1007/s00284-022-02906-5 · Cited by 7
“Constipation or diarrhea are typical gastrointestinal symptoms, which can be induced by many factors, such as diet[1], medication[2], chemotherapy, and depression.”
BackgroundAberrant intrinsic functional brain networks in patients with functional constipation
Xiang, Y., Yu, J., Li, Y., Cong, J., Wang, C., Fan, R., Wang, W., Zhou, L., Xu, C., Liu, Y., et al. (2022) · Neuroradiology · doi:10.1007/s00234-022-03064-y · Cited by 7
“The prevalence of FCon is approximately 15% in the global population [4].”
BackgroundWheat peptides with different hydrolysis degree have similar relief effect in constipated mice
Wang, Q., Shen, F., Zhang, J., Zhuang, J., & Feng, F. (2023) · Food Bioscience · doi:10.1016/j.fbio.2023.102459 · Cited by 6
Ferrari, L., Cuinas, K., Hainsworth, A. J., Darakhshan, A., Schizas, A. M. P., Kelleher, C., & Williams, A. B. (2022) · Neurogastroenterology & Motility · doi:10.1111/nmo.14343 · Cited by 7
A Practical Approach to the Diagnosis and Treatment of Abdominal Bloating and Distension.
Cangemi, D. J., & Lacy, B. E. (2022) · PubMed Central · Cited by 7
Self-citationLiang, X., Wan, D., Cai, Y., Yue, W., Wang, X., Zhou, H., Zhou, R., Du, Q., Juan, X., & Zhang, S. (2023) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2023/6506244 · Cited by 8
“Additionally, constipation can aggravate the imbalance of intestinal microbes and even cause colon cancer, accelerate aging, and promote a variety of intestinal diseases [2, 3, 35].”
BackgroundSacral Neuromodulation for defecation disorders after non oncologic pelvic surgery
Martellucci, J., Annicchiarico, A., Scheiterle, M., Trompetto, M., & Prosperi, P. (2023) · International Journal of Colorectal Disease · doi:10.1007/s00384-023-04567-7 · Cited by 6
“The management of CC is varied and strictly dependent on the etiology of the CC itself with treatments ranging from the simple modification of lifestyles and eating habits [11, 15–18], to use of transanal irrigation (TAI) [16, 19–22] and even surgery [13, 15–17, 23, 24].”
BackgroundMethodSystemic pharmacotherapy approaches for the treatment of systemic sclerosis
Donato, S. D., McMahan, Z. H., & Hughes, M. (2025) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2025.2470846 · Cited by 6
“The new secretagogues agents including, Lubiprostone, Linaclotide, and Plecanatide, effectively treat chronic constipation [113].”
Nakajima, A., Umeyama, M., Higashikawa, M., Shimada, Y., & Arai, Y. (2025) · SAGE Open Medicine · doi:10.1177/20503121251321659 · Cited by 6
Tan, S., Peng, C., Lin, X., Peng, C., Yang, Y., Liu, S., Huang, L., Bian, Y., Li, Y., & Chen, X. (2025) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2025.1565801 · Cited by 6
Jiang, M., Wang, C., Chen, J., Wu, G., Liu, W., Li, T., & Wang, X. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1672600 · Cited by 6
Bai, X., Wang, Y., Wang, K., Chu, W., & Bai, T. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1615297 · Cited by 6
Zhu, H., Wang, H., Zhang, Q., Bai, J.-F., Wang, M., Du, S.-Y., & Zhang, Y. (2025) · World Journal of Gastroenterology · doi:10.3748/wjg.v31.i40.112637 · Cited by 6
Chronic constipation that resulted in fecal impaction and colon perforation: A case report
Alburakan, A. A., Alshunaifi, A., AlRabah, R., Alshammari, S. A., Alnasser, S., & Nouh, T. A. (2022) · Medicine · doi:10.1097/md.0000000000030206 · Cited by 6
Zhang, R., Lin, X., Song, Y., Tuo, Y., Mu, G., & Jiang, S. (2023) · Journal of Functional Foods · doi:10.1016/j.jff.2023.105636 · Cited by 6
Xiang, Y., Yu, J., Li, Y., Cong, J., Wang, C., Fan, R., Wang, W., Zhou, L., Xu, C., Li, Y., et al. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1241993 · Cited by 6
“Functional constipation (FCon) is a common functional gastrointestinal disorder (FGID) affecting approximately 15% of the global population (Bharucha and Lacy, 2020).”
BackgroundLü, Y., Zhou, X., Wu, Y., Cui, Q., Tian, X., Yi, H., Gong, P., & Zhang, L. (2023) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.202200846 · Cited by 8
Chen, K., Zhou, Z., Nie, Y., Cao, Y., Yang, P., Zhang, Y., Xu, P., Yu, Q., Shen, Y., Ma, W., et al. (2024) · Brazilian Journal of Microbiology · doi:10.1007/s42770-024-01276-3 · Cited by 12
Shen, X.-L., Zhou, X.-T., Ren, M., Shi, X. G., Zhang, H.-Z., Wang, Y., & Yang, M. (2024) · Clinics and Research in Hepatology and Gastroenterology · doi:10.1016/j.clinre.2024.102410 · Cited by 6
Tan, L., Qin, W., Liao, J., Liu, Y., & Yan, L. (2024) · Medicine · doi:10.1097/md.0000000000039863 · Cited by 6
“[13] Long-term constipation can not only increase the risk of anorectal diseases such as anal fissure and hemorrhoids, but also induce complications such as mental disorders, cardiovascular and cerebrovascular diseases.”
BackgroundZhang, N., Guo, D., Guo, N., Yang, D., Yan, H., Yao, J., Xiao, H., Shao, M., Guan, Y., & Zhang, G. (2024) · Journal of Chromatography B · doi:10.1016/j.jchromb.2024.124331 · Cited by 6
Huang, Y., Wang, Y., Xu, B., Zeng, Y., Chen, P., Huang, Y., & Liu, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1543692 · Cited by 8
“Constipation is another prevalent health issue, often presenting as reduced bowel movement frequency, dif fi culty in defecation, and incomplete evacuation (3).”
Luo, J., To, W. L. W., Xu, Q., Zhang, J., Ma, Y., Chow, S., Yu, D. J., Yuan, C., & Bian, Z. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03774-6 · Cited by 7
Involvement of the Peripheral μ-Opioid Receptor in Tramadol-Induced Constipation in Rodents
Yasufuku, K., Koike, K., Kobayashi, M., Chiba, H., Kitaura, M., Takenouchi, S., Hasegawa, M., Morioka, Y., Mishima, H., Suzuki, T., et al. (2021) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.b21-00474 · Cited by 6
Li, H., Guo, C., Gao, J., & Yao, H. (2022) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s344375 · Cited by 6
“The duration and frequency of biofeedback treatment affect the dosage and efficacy of biofeedback therapy.(37) It is necessary to carry out more high-quality randomized controlled trials to determine the primary treatment option for biofeedback therapy and provide guidance for clinicians caring for this population in…”
Vollebregt, P. F., Wiklendt, L., Burgell, R., Chaichanavichkij, P., Dinning, P. G., Knowles, C. H., & Scott, S. (2022) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001794 · Cited by 5
“It remains uncertain whether abnormal urge perception leads to symptoms of constipation, or whether CC itself, stool withholding behavior or other symptoms such as pain or trauma may result in abnormal urge perception (39,40).”
BackgroundAlqahtani, O. M., AlSamghan, A. S., Alsaleem, S. A., Alyahya, A. A. S., Alrazhi, F. S., Alshahrani, A. S., Alasmari, A. S. M., Saeed, A. A., Qawwadi, R. A. N., Alotayfi, B. M., et al. (2022) · World Family Medicine Journal/Middle East Journal of Family Medicine · doi:10.5742/mewfm.2022.95251375 · Cited by 6
Zhao, Y., Zhang, C., Yu, L., Tian, F., Zhao, J., Zhang, H., Chen, W., & Zhai, Q. (2022) · Food & Function · doi:10.1039/d2fo02675a · Cited by 6
Zhou, W., Triadafilopoulos, G., Gurland, B., Halawi, H., Becker, L. S., García, P., Nguyen, L. A. B., Miglis, M. G., Muppidi, S., Sinn, D.-I., et al. (2023) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.13755 · Cited by 6
“strain during bowel movements, feeling of blockage in the rectum, sensation of incomplete defecation, and the requirement for digital manipulation to facilitate rectal evacuation also indicate constipation.(19) While these symptoms may suggest presence of defecatory dysfunction, anorectal physiologic tests such as ano…”
BackgroundZhang, J., Li, D., Tian, Q., Ding, Y., Jiang, H., Xin, G., Cheng, S., Tang, S., Jin, C., Tian, J., et al. (2023) · Food Innovation and Advances · doi:10.48130/fia-2023-0001 · Cited by 6
Yang, L., Zong, Y., Meng, F., Wu, Y., & Zhang, S. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16844 · Cited by 5
“Various types are available, including osmotic, stimulant, and secretory laxatives, as well as prokinetics [7, 8].”
Wang, Y., Zhang, Y. L., Wang, Q., Fan, Y., Li, W., Liu, M., Zhang, X., Zhou, W., Wang, M., Jiang, S., et al. (2024) · Journal of Chromatography B · doi:10.1016/j.jchromb.2024.124218 · Cited by 5
Human colonic EVs induce murine enteric neuroplasticity via the lncRNA GAS5/miR-23/NMDA NR2B axis
Zhou, Q., Yang, L., Verne, Z. T., Zhang, B. B., Fields, J. Z., Thacker, A. T., & Verne, G. N. (2025) · JCI Insight · doi:10.1172/jci.insight.178631 · Cited by 5
Mo, L.-Y., Ma, K.-Y., Li, Y., Song, J.-F., Song, Q., & Wang, L. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1550880 · Cited by 5
Snih, G. M. A., Bailey, K. R., Oblizajek, N. R., & Bharucha, A. E. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.05.005 · Cited by 5
Self-citationHe, P., Chen, S., Lyu, C., An, R., & Wang, D. (2025) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.70140 · Cited by 6
“Globally, CC and FC affect approximately 15% and 10.1% of the population, respectively, making them among the most prevalent gastrointestinal complaints [4, 5].”
InfluentialKessoku, T., Ishihara, Y., Takahashi, K., Dang, T. H., Ohira, M., Horiuchi, M., Shibata, C., Uchida, A., Toriumi, Y., Misawa, N., et al. (2025) · Neurogastroenterology & Motility · doi:10.1111/nmo.70106 · Cited by 5
Pugliesi, R. A., Barberi, M. T., Roccella, G., Gullo, G., Billone, V., Chitoran, E., Cucinella, G., Vernuccio, F., Cannella, R., & Re, G. L. (2025) · Diagnostics · doi:10.3390/diagnostics15131625 · Cited by 8
“In women, the anorectal angle decreases during contraction and increases during defecation by approximately 15–20 ◦ [67].”
Modified Cellulose for Intestinal Health
Xu, M., Zhao, J., Wang, H., & Xue-bing, H. (2025) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.5c06202 · Cited by 5
Gut microbial ammonia enhances colonic acetylcholine levels to regulate intestinal motility
Chen, H., Wang, Z., Zhao, Y., Yang, W., Huang, J., & Yu, Z. (2026) · Nature Microbiology · doi:10.1038/s41564-026-02269-8 · Cited by 5
Youn, J. W., Joo, H., Kim, S., Oh, J., Yoo, H., Ko, J. S., Moon, J. S., Hahn, J. W., & Yon, D. K. (2026) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000001029 · Cited by 6
“Its presentation and diagnosis vary across regions owing to variations in diet, culture, language, and health literacy (5).”
Fu, H., Fan, D., Wang, J., Kou, R., Wang, Y., Wu, Y., & Wang, S. (2024) · Food Quality and Safety · doi:10.1093/fqsafe/fyae043 · Cited by 6
Wang, L.-S., Wu, J.-X., Zhang, F., Huang, Y., Jiang, Y.-X., & Li, Y. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1455824 · Cited by 5
“Prolonged constipation can cause abdominal spasms and worsen defecation difficulties, which can markedly impact a patient’s quality of life (4) and increase the risk of other GI diseases, such 2 Materials and methods”
Jang, J. H., Chang, Y. B., Kim, S. M., Han, K., Sim, W., Hong, K., Suh, H. J., & Han, S. (2024) · Food & Function · doi:10.1039/d4fo04237a · Cited by 6
Cui, G., Jiao, X., Wang, Z., & Zhang, Z. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1502341 · Cited by 5
Seo, J., Jung, K. W., Kim, S. H., Hong, S. W., Hwang, S. W., Park, S. H., Yang, D., Ye, B. D., Byeon, J., Myung, S.-J., et al. (2025) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm24019 · Cited by 5
“22 Further research is needed to clarify the mechanisms underlying this relationship.”
Wang, Y., Kuo, B., Berschback, M. A., Huttenhower, C., Chan, A. T., & Staller, K. D. (2025) · Gastroenterology · doi:10.1053/j.gastro.2025.06.020 · Cited by 10
Leven PRO-CR mediates 5-HT and gut microbiota via TPH1 to improve slow-transit constipation
Xia, F., He, Q., Wang, S., He, M., Fang, P., & Yu, Y. (2025) · Molecular Immunology · doi:10.1016/j.molimm.2025.07.007 · Cited by 5
Transcutaneous Vagal Nerve Stimulation for Gastrointestinal Disorders
Yin, J. (2025) · Journal of Translational Gastroenterology · doi:10.14218/jtg.2025.00024 · Cited by 6
“32,33 Three clinical trials have investigated taVNS for GI motility.”
Gomez-Escudero, O. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.103734 · Cited by 10
Mistretta, F., Damiani, N., Campanella, D., Mazzetti, S., Gulino, A., Cappello, G., & Regge, D. (2022) · La radiologia medica · doi:10.1007/s11547-022-01514-4 · Cited by 5
Morphological and morphometric characteristics of the subcompensated dolichocolon
Шевченко, Т. І., Борота, А. В., Сергеевич, Ш. Д., Alyamani, N. J., & Abramyan, A. A. (2022) · Journal of Anatomy and Histopathology · doi:10.18499/2225-7357-2022-11-2-62-69 · Cited by 5
Cui, H., Wang, Q., Feng, C., Guo, C., Zhang, J., Bu, X., & Duan, Z. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.1040371 · Cited by 6
“The pathophysiology of constipation is quite complicated; the primary causes are inherent problems of colonic sensorimotor disturbances and pelvic floor dysfunction, whereas secondary causes are associated with medications, organic disease, and systemic disease (Andrews and Storr, 2011; Girirajan et al., 2011).”
BackgroundHigashimori, A., Maeda, N., Nakatani, M., Yamamoto, I., Yanagida, T., Kin, D., Matsumoto, Y., Morimoto, K., Sasaki, E., Fukuda, T., et al. (2023) · Digestive Diseases and Sciences · doi:10.1007/s10620-023-08089-8 · Cited by 5
“…transit, were not associated with inadequate BP. Straining during defecation has been reported to be a surrogate marker of defecatory disorders [9–11 , 15 In addition, chronic use of stimulant laxatives was an independent predictor of inadequate BP, which is another novel finding of this study.”
BackgroundResultBassotti, G. (2023) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2023.2267968 · Cited by 5
Serra, J., Alcedo, J., Barber, C., & Ríos, C. C. D. L. (2024) · Revista Española de Enfermedades Digestivas · doi:10.17235/reed.2024.10242/2024 · Cited by 5
Froehner, I., Jorge, J. M. N., Marques, C. F. S., Santos, V. L. C. D. G., & Jukemura, J. (2023) · ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) · doi:10.1590/0102-672020230067e1785 · Cited by 7
“Conversely, in the groups that involved patients, the vast majority of volunteers are male, reinforcing the lower prevalence of intestinal chronic constipation in this gender 4,16 .”
BackgroundInfluentialHaraguchi, T., & Emoto, T. (2024) · Sensors · doi:10.3390/s24103054 · Cited by 5
“The prevalence of constipation is estimated to be approximately 15% globally [1].”
BackgroundShi, G.-Q., Lian, H.-N., Wang, X., Xia, J.-Q., Wang, H., Ma, L., Xiao, Z.-L., & Zhou, J. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1555790 · Cited by 5
“…diagnosis in patients with cancer requires excluding chemotherapy-related ileus, radiation-induced intestinal paralysis, infectious enteritis, peritoneal metastasis, and carcinomatous peritonitis, then paraneoplastic syndrome antibody testing must be performed clarify the diagnosis further (17).”
Predictors of laxative use in inpatients with schizophrenia on clozapine
Sazhin, V., & Pushkal, P. (2021) · Australasian Psychiatry · doi:10.1177/10398562211042368 · Cited by 5
Caetano, A. C., Costa, D., Mendes, S., Correia‐Pinto, J., & Rolanda, C. (2022) · United European Gastroenterology Journal · doi:10.1002/ueg2.12221 · Cited by 5
“Associated factors such as gender, age, dietary habits, physical inactivity, socioeconomic level, psychological parameters and vaginal delivery were frequently implicated in the development of CC according to available literature.(1,13,14) Regarding dietary habits, there are data suggesting that the Mediterranean diet…”
BackgroundMethodChen, X., Liu, G., Zhao, L. X., Du, L., Xie, J., & Wei, D. (2022) · Food Bioengineering · doi:10.1002/fbe2.12029 · Cited by 6
Belik, B. M., & Ковалев, А. Н. (2022) · Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) · doi:10.21518/1995-1477-2022-19-2-96-105 · Cited by 6
Zhu, Q., Iwai, R., Okaguchi, T., Shirasaka, Y., & Tamai, I. (2023) · Food & Function · doi:10.1039/d3fo00510k · Cited by 5
Diagnosis and treatment of constipation: A clinical update based on the Rome IV criteria
Luporini, R. L., Rizzo, A. L., Frizol, S. M., & Thommazo‐Luporini, L. D. (2020) · Journal of Coloproctology · doi:10.1016/j.jcol.2020.06.004 · Cited by 5
Yao, J., Chen, L., Zhou, S., Yang, Y., Wang, L., Yan, X., Zhang, L., & Li, Y. (2021) · Annals of Palliative Medicine · doi:10.21037/apm-21-811 · Cited by 4
“Conventional treatments include medical therapies such as fiber, osmotic and stimulant laxatives, and selective 5-hydroxytryptamine receptor 4 (5-HT4) agonists to relieve constipation when patients respond poorly to lifestyle modifications (8).”
BackgroundWu, J., Xin, Q., Wang, S., Zhang, X., & Jiang, C. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1531232 · Cited by 4
Chen, S., Lin, J., Huang, M., Lin, S., Wei, Y., Zhang, C., & Huang, Y. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1622619 · Cited by 4
“This condition is experiencing a signi fi cant upward trend (1).”
Liu, L., Li, P., Chen, Y., Yang, G., Cheng, Y., Liu, S., Zhang, X., Wu, Y., Liu, Q., Zhao, P., et al. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1684442 · Cited by 4
“Clinically, STC presents with symptoms such as dry stools, prolonged intervals between bowel movements, and dif fi culty in defecation (Bharucha and Lacy, 2020).”
Wang, C., Zhang, Q., Wei, C., & Jin, Y. (2025) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2025.149010 · Cited by 4
Deciphering the anti-constipation characteristics of palm dates ( Phoenix dactylifera ): a review
Camilleri, E., Blundell, R. A., & Cuschieri, A. (2022) · International Journal of Food Properties · doi:10.1080/10942912.2022.2153865 · Cited by 4
“[1,3] The table describes some of the commonest classification of laxatives and their characteristics that are clinically used to treat patients suffering from constipation.”
BackgroundFactors Associated with Defecation Satisfaction among Japanese Adults with Chronic Constipation
Yamamoto, S., Ohashi, W., Yamaguchi, Y., Igari, H., Koshino, A., Sugiyama, T., Nagao, K., Tamura, Y., Izawa, S., Mano, M., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13113216 · Cited by 4
“This condition could either be a primary disorder or a secondary issue that arises as a consequence of another underlying disease, such as cancer, or due to medication [1].”
BackgroundJiang, C., & Shao, Y. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1403636 · Cited by 4
“The relationship between dietary components and the incidence of constipation has been the subject of particularly high levels of interest, such that dietary management is widely employed as a key facet of any clinical effort aimed at treating constipation (5).”
BackgroundTreatment of constipation with Aloe and its compatibility prescriptions
Shen, X., Gong, L., Li, R., Huang, N., Zhang, H., Chen, S., Liu, Y., & Sun, R. Y. (2024) · Chinese Herbal Medicines · doi:10.1016/j.chmed.2024.07.005 · Cited by 4
“A large number of studies have shown that there are many factors in the pathogenesis of STC, such as changes in intestinal nervous system and metabolism, abnormal mucosal secretion, imbalance of flora and abnormal gastrointestinal hormones, etc. (Bharucha & Lacy, 2020; Bharucha & Wald, 2019).”
Gastric and sacral electrical stimulation for motility disorders—A clinical perspective
Desprez, C., Leroi, A., & Gourcerol, G. (2024) · Neurogastroenterology & Motility · doi:10.1111/nmo.14884 · Cited by 4
“55 However, SNM could become a valuable therapeutic option if long-term responders with refractory severe constipation could be accurately identified.”
Ning, Y., Hu, X., Li, L., Zhuang, Y., & Dai, F. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1610214 · Cited by 7
“Chronic constipation is defined as fewer than three bowel movements per week, typically accompanied by hard or lumpy stools, incomplete evacuation, and bloating, and affects 9% 20% of U.S. adults (4, 5).”
de Camargo, H. P., Machado, V. F., Parra, R. S., Féres, O., da Rocha, J. J. R., & Feitosa, M. R. (2020) · Arquivos de Gastroenterologia · doi:10.1590/s0004-2803.202000000-56 · Cited by 4
“It is estimated that the prevalence of CC in the adult population is 15%(1).”
BackgroundFlow simulations of rectal evacuation: towards a quantitative evaluation from video defaecography
Ahmad, F., Tanguy, S., Dubreuil, A., Magnin, A., Faucheron, J., & de Loubens, C. (2022) · Interface Focus · doi:10.1098/rsfs.2022.0033 · Cited by 4
Evans, C., & Kalman, D. (2024) · Cureus · doi:10.7759/cureus.66698 · Cited by 5
“Constipation is a GI dysfunction that affects an average of 15% of the global population [7,10] and is the most common bowel disorder [1].”
BackgroundYoshihara, T., Kessoku, T., Takatsu, T., Misawa, N., Ashikari, K., Fuyuki, A., Ohkubo, H., Higurashi, T., Iwaki, M., Kurihashi, T., et al. (2024) · Neurogastroenterology & Motility · doi:10.1111/nmo.14938 · Cited by 4
Yang, J., He, X., Yao, J., Zhang, P., Yi, B., Fang, Z., Guo, N., Guan, Y., & Zhang, G. (2024) · Chinese Medicine · doi:10.1186/s13020-024-01015-8 · Cited by 4
“The latter disrupts colonic sensorimotor abilities and brings about abnormalities in neurotransmitters and neuro-chemical signals, thus reducing intestinal peristalsis and promoting constipation [10, 11].”
BackgroundPeng, X., Yang, H., Chen, W., Yu, M., & Wang, D. (2025) · BMC Gastroenterology · doi:10.1186/s12876-024-03543-x · Cited by 4
“This regulation may enhance peristalsis, speeding up the passage of intestinal contents and thereby lowering the likelihood of constipation [24–29].”
Redundancy of the Transverse Colon: Documentation of Length and Prolonged Retention
Matar, A., Abdelnaem, N., Burton, D. B., Cima, R. R., & Camilleri, M. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.01.048 · Cited by 4
Metadata
- Authors
- Bharucha, A. E., & Lacy, B. E.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Bharucha, Adil E.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 158
- Issue
- 5
- Pages
- 1232-1249.e3
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC7573977
- OpenAlex
- W3000300599
- Cited by
- 655
- References
- 170
- Citations by year
- 2026: 108 · 2025: 157 · 2024: 115 · 2023: 99 · 2022: 112 · 2021: 46 · 2020: 17
- FWCI
- 11.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
- Keywords
- chronic constipation, defecation disorders, slow transit constipation, colonic transit, colonic motility, pelvic floor dysfunction, dietary fiber supplementation, laxatives, prokinetic agents, opioid-induced constipation, biofeedback, anorectal manometry, barostat, colectomy, constipation treatment
- MeSH terms
- Secretagogues, Chronic Disease, Colon, Constipation, Defecation, Dietary Fiber, Electromyography, Gastrointestinal Motility, Humans, Intestinal Mucosa, Magnetic Resonance Imaging, Manometry, Rectum, Prevalence, Receptors, Opioid, mu, Pelvic Floor, Dietary Supplements, Defecography, Digital Rectal Examination, Laxatives
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
