Chronic constipation: a survey of the patient perspective
Open accessAbstract
Summary: Background Constipation is a common, often chronic, gastrointestinal motility disorder characterized by such symptoms as straining, hard stool, and infrequent defecation. Published literature is limited regarding symptom prevalence, healthcare‐seeking behaviour, and patient satisfaction with traditional therapies for chronic constipation. Aim To assess the prevalence of chronic constipation among a random sample of Americans, to identify the frequency, severity and bothersomeness of their symptoms, and to assess satisfaction levels with traditional treatments. Methods All members (N = 37 004) of the Knowledge Networks Panel, representative of the US population, participated in a web‐based survey. Eligibility was established using a six‐question screener. Results Of the 24 090 panellists consenting to participate, 557 met eligibility requirements and took the 45‐question survey. The most prevalent symptom was straining (79%). Hard stool and straining were the top two severe symptoms, and bloating, straining and hard stool were the top three bothersome symptoms. Symptoms affected quality of life of more than half (52%) the respondents. Among those who worked or went to school, 12% experienced reduced productivity and a mean of 2.4 days of absence in the month before the survey. Most respondents had used (96%) or were using (72%) constipation relief therapy; however, nearly half (47%) were not completely satisfied, mainly because of efficacy (82%) and safety (16%) concerns. Conclusions Chronic constipation is common. Individual symptoms are often severe and bothersome, and many patients are dissatisfied with traditional treatment options, primarily because of lack of efficacy.
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More than half of patients with chronic constipation are not satisfied with their current treatment.
“However, more than half are not satisfied with their current treatment [6, 7]”
From British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults (2025) · cites this paper as [7]
The Treatment satisfaction section reports that 47% of respondents were not completely satisfied with their current constipation treatment—less than half, not more than half. The abstract repeats the 47% figure. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredNearly all patients try lifestyle management options for symptom relief, including dietary modifications that primarily focus on increasing dietary fibre intake.
“Nearly all patients try lifestyle management options for symptom relief, including dietary modifications that primarily focus on increasing dietary fibre intake [6, 7].”
From British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults (2025) · cites this paper as [7]
The Introduction identifies increased dietary fibre as a lifestyle approach, and ‘Treatments to reduce constipation symptoms’ reports that 96% of respondents had tried some treatment. But the 96% includes over-the-counter and prescription products; the paper does not say nearly all patients tried lifestyle management or that dietary changes primarily focused on increasing fibre. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThis lack of comprehensive guidelines interferes with the advice given by healthcare professionals, ultimately negatively impacting patients' symptom management and overall satisfaction.
“This interferes with the advice given by healthcare professionals, ultimately negatively impacting patients' symptom management and overall satisfaction [6, 7].”
From British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults (2025) · cites this paper as [7]
The Treatment satisfaction section (page unavailable) reports that 47% of respondents were not completely satisfied with treatment, chiefly because it was ineffective. The paper does not link a lack of comprehensive guidelines to healthcare professionals’ advice or show that such advice caused poorer symptom management or satisfaction. (LLM, conf=0.78)
Experimental — accuracy not yet measuredBowel movements alone are not a reliable indicator for constipation severity.
“Bowel movements alone are not a reliable indicator for constipation severity, as they might be the successive outcome from laxatives without describing the sensation during defecation or the repeated passage of hard stools and straining.1,3”
From Eight-Week Supplementation With <i>Bifidobacterium lactis</i> HN019 and Functional Constipation: A Randomized Clinical Trial (2024) · cites this paper as [3]
More than half of patients with chronic constipation are not satisfied with their current treatment.
“However, more than half are not satisfied with their current treatment [ 6 , 7 ], highlighting an urgent need to improve management strategies for chronic constipation.”
From British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults (2025) · cites this paper as [7]
Current therapeutic guidelines for chronic constipation have considerable limitations that may help explain high treatment dissatisfaction rates.
“However, there are considerable limitations with these guidelines, which may help explain the high treatment dissatisfaction rates [ 6 , 7 ].”
From British Dietetic Association Guidelines for the Dietary Management of Chronic Constipation in Adults (2025) · cites this paper as [7]
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“Overall, these medications have limited efficacy, are expensive, and may result in adverse side effects, especially over the long term [35].”
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- Authors
- JOHANSON, J. F., & KRALSTEIN, J.
- Affiliations
- University of Illinois Chicago, Rockford campus (US)
- Corresponding author
- JOHANSON, J. F.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2007-01-08
- Volume
- 25
- Issue
- 5
- Pages
- 599-608
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W1921373566
- Cited by
- 617
- References
- 19
- Citations by year
- 2026: 11 · 2025: 34 · 2024: 38 · 2023: 42 · 2022: 48 · 2021: 38 · 2020: 47 · 2019: 36 · 2018: 32 · 2017: 32 · 2016: 47 · 2015: 35 · 2014: 46 · 2013: 21 · 2012: 24
- FWCI
- 15.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Novartis Pharmaceuticals Corporation
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
- Keywords
- chronic constipation, prevalence, symptom severity, straining, hard stools, bloating, quality of life, labor productivity, health-seeking behavior, treatment satisfaction, gastrointestinal motility disorders
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Constipation, Data Collection, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, United States
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