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Constipation National Digestive Diseases Information Clearinghouse

What is constipation?Constipation is a condition in which a personhas ewer than three bowel movements a

week or has bowel movements with stoolsthat are hard, dry, and small, making thempainul or dicult to pass. People may eelbloated or have pain in their abdomen—thearea between the chest and hips. Somepeople think they are constipated i they donot have a bowel movement every day. Bowelmovements may occur three times a day orthree times a week, depending on the person.

Most people get constipated at some pointin their lives. Constipation can be acute,

which means sudden and lasting a short time,

or chronic, which means lasting a long time,even years. Most constipation is acute andnot dangerous. Understanding the causes,prevention, and treatment o constipation canhelp many people take steps to nd relie.

What is the gastrointestinal(GI) tract?The GI tract is a series o hollow organs

joined in a long, twisting tube rom themouth to the anus. The body digests oodusing the movement o muscles in theGI tract, along with the release o hormonesand enzymes. Organs that make up theGI tract are the mouth, esophagus, stomach,small intestine, large intestine—whichincludes the appendix, cecum, colon, andrectum—and anus. The intestines aresometimes called the bowel. The last parto the GI tract—called the lower GI tract—consists o the large intestine and anus.

The large intestine absorbs water and anyremaining nutrients rom partially digestedood passed rom the small intestine. Thelarge intestine then changes waste rom

liquid to a solid matter called stool. Stoolpasses rom the colon to the rectum. Therectum is located between the last part o the colon—called the sigmoid colon—andthe anus. The rectum stores stool priorto a bowel movement. During a bowelmovement, stool moves rom the rectum tothe anus, the opening through which stoolleaves the body.

Colon

Rectum Anus

The lower GI tract



How common is constipationand who is affected?Constipation is one o the most common GIproblems in the United States, aecting anestimated 42 million people, or 15 percent o the population. People o any age, race, orgender can get constipated. Those reportingconstipation most oten are women, adultsages 65 and older, non-Caucasians, andpeople in lower socioeconomic classes.1

Constipation is also a common problem

during pregnancy, ollowing childbirthor surgery, or ater taking medications torelieve pain rom things such as a brokenbone, tooth extraction, or back pain. In2004, 6.3 million outpatient visits were due toconstipation and 5.3 million prescriptions orconstipation medications were written.2

What causes constipation?Constipation is caused by stool spending toomuch time in the colon. The colon absorbs

too much water rom the stool, makingit hard and dry. Hard, dry stool is moredicult or the muscles o the rectum topush out o the body.

Common actors or disorders that lead toconstipation are

• diets low in ber

• lack o physical activity

• medications

• lie changes or daily routine changes

• ignoring the urge to have a bowel movement

1Higgins PD, Johanson JF. Epidemiology o constipation in North America: a systematic review. American Journal of Gastroenterology. 2004;99:750–759.

2Everhart JE, ed. The Burden of Digestive Diseases inthe United States. Bethesda, MD: National Instituteo Diabetes and Digestive and Kidney Diseases, U.S.Dept. o Health and Human Services; 2008. NIHPublication 09–6433.

• neurological and metabolic disorders

• GI tract problems

• unctional GI disorders

Diets Low in FiberThe most common cause o constipation is adiet with too little ber. Fiber is a substancein oods that comes rom plants. Fiber helpsstool stay sot so it moves smoothly throughthe colon. Liquids such as water and juicehelp ber to be more eective.

Older adults commonly do not get enoughber in their diets. They may lose interest ineating because ood does not taste the sameas it once did, they do not eel hungry asoten, they do not want to cook, or they haveproblems with chewing or swallowing. Theseactors may lead an older adult to chooseoods that are quick to make or buy, such asast oods or prepared oods, which are otenlow in ber.

Lack of Physical Activity A lack o physical activity can lead toconstipation, although scientists do not know

why. For example, constipation oten occursater an accident or during an illness when aperson must stay in bed and cannot exercise.Lack o physical activity is thought to be oneo the reasons constipation is common inolder adults.

MedicationsMedications that can cause constipation

include

• pain medications, especially narcotics

• antacids that contain aluminum and calcium

• calcium channel blockers, which areused to treat high blood pressure andheart disease

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• medications that treat Parkinson’sdisease—a disorder that aects nervecells in a part o the brain that controlsmuscle movement—because thesemedications also aect the nerves in thecolon wall

• antispasmodics—medications that prevent sudden muscle contractions

• some antidepressants

• iron supplements

• diuretics—medications that help thekidneys remove fuid rom the blood

• anticonvulsants—medications thatdecrease abnormal electrical activity inthe brain to prevent seizures

Constipation can also be caused by overuseo over-the-counter laxatives. A laxative ismedication that loosens stool and increasesbowel movements. Although people mayeel relie when they use laxatives, theyusually must increase the dose over time

because the body grows reliant on laxativesto have a bowel movement. Overuse o laxatives can decrease the colon’s naturalability to contract and make constipation

worse. Continued overuse o laxatives candamage nerves, muscles, and tissues in thelarge intestine.

Life Changes or Daily RoutineChangesDuring pregnancy, women may beconstipated because o hormonal changes orbecause the uterus compresses the intestine.

Aging can aect bowel regularity, becauseo a gradual loss o nerves stimulating themuscles in the colon, which results in lessintestinal activity. People can also becomeconstipated while traveling, because theirnormal diet and daily routine are disrupted.

Ignoring the Urge to Have aBowel MovementPeople who ignore the urge to have a bowelmovement may eventually stop eelingthe need to have one, which can lead toconstipation. Some people delay having abowel movement because they do not wantto use toilets outside their home, particularlypublic restrooms, or they eel they are toobusy.

Neurological and MetabolicDisordersCertain neurological and metabolic disorderscan cause ood to pass through the digestivesystem too slowly, leading to constipation.Neurological disorders, such as spinal cordinjury and parkinsonism, aect the brain andspine. Parkinsonism is any condition thatleads to the types o movement changes seenin Parkinson’s disease. Metabolic disorders,such as diabetes and hypothyroidism, disruptthe process the body uses to get energy rom

ood. Hypothyroidism is a disorder thatcauses the body to produce too little thyroidhormone, which can cause many o thebody’s unctions to slow down.

GI Tract ProblemsSome problems in the GI tract can compressor narrow the colon and rectum, causingconstipation. These problems include

• adhesions—bands o tissue that canconnect the loops o the intestines to

each other, which may block ood orstool rom moving through the GI tract

• diverticulosis—a condition that occurs when small pouches, or sacs, orm andpush outward through weak spots inthe colon wall; the pouches are calleddiverticula

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• colon polyps—growths on the surace o the colon that can be raised or fat

• tumors—abnormal masses o tissue thatresult when cells divide more than theyshould or do not die when they should

• celiac disease—an immune reactionto gluten, a protein ound in wheat,rye, and barley, that causes damageto the lining o the small intestine andprevents absorption o nutrients

Read more about the Celiac Disease Awareness Campaign at www.celiac.nih.gov.

Functional GI DisordersFunctional GI disorders are problemscaused by changes in how the GI tract works.People with a unctional GI disorder haverequent symptoms; however, the GI tractdoes not become damaged. Functionalconstipation oten results rom problems

with muscle activity in the colon or anus thatdelay stool movement.

Functional constipation is diagnosed inpeople who have had symptoms or at least6 months and meet the ollowing criteria orthe last 3 months beore diagnosis:3

3Longstreth GF, Thompson WG, Chey WD, et al.Functional bowel disorders. In: Drossman DA, ed. Rome III: The Functional Gastrointestinal Disorders.3rd ed. Lawrence, KS: Allen Press, Inc.; 2006:515–523.

• Two or more o the ollowing symptoms:

– straining to have a bowel movementat least 25 percent o the time

– having lumpy or hard stools at least25 percent o the time

– eeling as though stool is still in the

rectum ater a bowel movement atleast 25 percent o the time

– eeling as though something isblocking stool rom passing at least25 percent o the time

– using their ngers to help with stoolpassage at least 25 percent o thetime

– having ewer than three bowelmovements per week

• Rarely passing loose stools without theuse o laxatives

• Not having irritable bowel syndrome

(IBS)

IBS is a unctional GI disorder withsymptoms that include abdominal pain ordiscomort, oten reported as cramping,along with diarrhea, constipation, or both.Read more in Irritable Bowel Syndrome at

www.digestive.niddk.nih.gov .

How is the cause of constipation diagnosed?

To diagnose the cause o constipation, thehealth care provider will take a medicalhistory, perorm a physical exam, and orderspecic tests. The tests ordered depend onhow long the person has been constipated;how severe the constipation is; the person’sage; and whether the person has had bloodin stools, recent changes in bowel habits, or

weight loss. Most people with constipationdo not need extensive testing and can betreated with changes in diet and exercise.

4 Constipation

http://www.celiac.nih.gov/

http://www.digestive.niddk.nih.gov/

http://www.celiac.nih.gov/




Medical History The health care provider may ask questionsabout the person’s constipation, includinghow long symptoms have been present,requency o bowel movements, consistencyo stools, and presence o blood in the stool.The health care provider may ask questionsabout the person’s eating habits, medication,and level o physical activity. A record o this inormation can be prepared beore the

visit to help the health care provider make adiagnosis.

Physical Exam A physical exam should include a rectal exam with a gloved, lubricated nger to evaluatethe tone o the muscle that closes o theanus—called the anal sphincter—and todetect tenderness, obstruction, or blood.The health care provider may perorm atest or blood in the stool by placing a smallsample o the person’s stool on a paper cardand adding a drop or two o testing solution.

A color change is a sign o blood in the stool.

Diagnostic Tests Additional testing is usually reservedor older adults and people with severesymptoms, sudden changes in the numberand consistency o bowel movements, orblood in the stool. Additional tests that maybe used to evaluate constipation include

• blood test

• lower GI series

• fexible sigmoidoscopy or colonoscopy

• colorectal transit studies

• anorectal unction tests

• deecography

Blood test. A blood test involves drawingblood at a health care provider’s oce ora commercial acility and sending it to alab or analysis. The blood test can showi there may be an underlying disease orcondition causing constipation. For examplelow levels o thyroid hormone may indicatehypothyroidism.

Lower GI series. A lower GI series is an x-ray exam that is used to look at the largeintestine. The test is perormed at a hospitalor an outpatient center by a radiologist—adoctor who specializes in medical imaging.The health care provider may give the person

written bowel prep instructions to ollow athome. The person may be asked to ollowa clear liquid diet or 1 to 3 days beore theprocedure. A laxative or an enema may beused beore the test. An enema involvesfushing water or laxative into the anus usinga special squirt bottle. The medicationscause diarrhea, so the person should stayclose to a bathroom during the bowel prep.

For the test, the person will lie on a table while the radiologist inserts a fexible tubeinto the person’s anus. The large intestineis lled with barium, a chalky liquid, makingsigns o problems that may be causingconstipation show up more clearly on x rays.

For several days, traces o barium in thelarge intestine cause stools to be white orlight colored. Enemas and repeated bowelmovements may cause anal soreness. A health care provider will provide specic

instructions about eating and drinking aterthe test.

5 Constipation



Flexible sigmoidoscopy or colonoscopy. Thetests are similar, but a colonoscopy is usedto view the rectum and entire colon, whilea fexible sigmoidoscopy is used to view justthe rectum and lower colon. These testsare perormed at a hospital or an outpatientcenter by a gastroenterologist—a doctor whospecializes in digestive diseases. For bothtests, a health care provider will give writtenbowel prep instructions to ollow at home.The person may be asked to ollow a clearliquid diet or 1 to 3 days beore either test.

The night beore both tests, the person mayneed to take a laxative. One or more enemasmay also be required the night beore andabout 2 hours beore both tests.

In most cases, light anesthesia, and possiblypain medication, is used during a fexiblesigmoidoscopy or colonoscopy. For eithertest, the person will lie on a table while thegastroenterologist inserts a fexible tube intothe anus. A small camera on the tube sendsa video image o the intestinal lining to a

computer screen. The test can show signs o problems in the lower GI tract.

The gastroenterologist may also perorma biopsy, a procedure that involves takinga small piece o intestinal lining tissue orexamination with a microscope. The person

will not eel the biopsy. A pathologist—adoctor who specializes in diagnosingdiseases—examines the tissue in a lab.

Cramping or bloating may occur duringthe rst hour ater the test. Driving is

not permitted or 24 hours ater a fexiblesigmoidoscopy or colonoscopy to allowthe sedative time to wear o. Beore theappointment, a person should make plans ora ride home. Full recovery is expected by thenext day.

Colorectal transit studies. These tests showhow well ood moves through the colon.

• Radiopaque markers. With thistechnique, the person swallows capsulescontaining small markers that are

visible on an x ray. The markers movethrough the GI tract just as ood and

waste do and are passed naturally withstool. During the course o this test,the person eats a high-ber diet to helpstool move through the GI tract. Threeto 7 days ater the person swallowsthe capsules, abdominal x rays, takenseveral times, monitor the movemento the markers through the colon. An

x-ray technician takes the x rays in ahospital radiology department or healthcare provider’s oce, and a radiologistinterprets the x rays.

• Scintigraphy. This type o nuclearmedicine study relies on the detectiono small amounts o radiation atera person eats a meal containing

radioactive chemicals. The dose o theradioactive chemicals is small; thereore,scintigraphy is not likely to cause damageto cells. Special external cameras andcomputers are used to create images o the radioactive chemicals as they movethrough the intestine. To prepare orthe test, the person may need to stoptaking some medications and should noteat any ood ater midnight the nightbeore the test. Scintigraphy is done asan outpatient procedure by a speciallytrained technician, and a radiologistinterprets the results.

Anorectal unction tests. These testsdiagnose constipation caused by anorectaldysunction, which reers to problems withthe anus and rectum. To prepare or these

6 Constipation



tests, the person should use an enema andnot eat anything 2 hours prior to the test. Anesthesia is not needed or these tests.

• Anal manometry uses pressure sensorsand a balloon that can be infated inthe rectum to check the sensitivityand unction o the rectum. Analmanometry also checks the tightnesso the anal sphincter muscles aroundthe anus. For this test, a thin tube

with a balloon on its tip and pressuresensors below the balloon is insertedinto the anus until the balloon is in therectum and pressure sensors are insidethe anus. The tube is slowly pulledback through the sphincter muscle tomeasure muscle tone and contractions.The test takes about 30 minutes.

• Balloon expulsion tests consist o lling a balloon with varying amountso water ater it has been inserted intothe rectum. The person is given astopwatch and instructed to go to the

restroom and measure the amount o time it takes to expel the balloon. I theperson cannot expel a balloon lled withless than 150 milliliters o water or ittakes longer than 1 minute to expel theballoon, the person may have a decreasein unction or evacuation o stool.

Deecography. This x ray o the anorectalarea shows how well the person can holdand evacuate stool. The test also identiesstructural changes in the rectum and anus,

such as rectocele and rectal prolapse.Rectocele is a condition in which the rectumprotrudes through the vagina, and rectalprolapse is a condition in which the rectumdrops down through the anus. To prepareor the test, the person uses two enemasand does not eat anything 2 hours prior tothe test. During the test, the health careprovider lls the rectum with a sot pastethat shows up on x rays and is the sameconsistency as stool. The person sits on a

7 Constipation

toilet inside an x-ray machine. The personis rst asked to pull in and squeeze thesphincter muscles to prevent leakage. Thenthe person is asked to strain to have a bowelmovement. The radiologist studies the x raysor anorectal problems that occurred as thepaste was expelled.

How is constipation treated?Treatment or constipation depends onthe cause, severity, and duration o the

constipation and may include one or more othe ollowing:

• changes in eating, diet, and nutrition

• exercise and liestyle changes

• medication

• surgery

• bioeedback

First-line treatments or constipation includechanges in eating, diet, and nutrition;

exercise and liestyle changes; and laxatives.People who do not respond to these rst-linetreatments should talk with their health careprovider about other treatments.

Eating, Diet, and NutritionThe Academy o Nutrition and Dieteticsrecommends consuming 20 to 35 grams o ber a day or adults. Americans consumeonly 15 grams a day on average.4 Peopleoten eat too many rened and processedoods rom which the natural ber has been

removed. A health care provider can helpplan a diet with the appropriate amount o ber. A list o high-ber oods is shown onpage 8. People prone to constipation shouldlimit oods that have little or no ber, such asice cream, cheese, meat, and processed oods.

4Slavin JL. Position o the American Dietetic Association: health implications o dietary ber. Journal of the American Dietetic Association.2008;108:1716–1731.



Examples of Foods That Have Fiber Beans, cereals, and breads Fiber

1/2 cup o beans (navy, pinto, 6.2–9.6 grams

kidney, etc.), cooked

1/2 cup o shredded wheat, 2.7–3.8 grams

ready-to-eat cereal

1/3 cup o 100% bran, 9.1 grams

ready-to-eat cereal

1 small oat bran mun 3.0 grams

1 whole-wheat English mun 4.4 grams

Fruits

1 small apple, with skin 3.6 grams

1 medium pear, with skin 5.5 grams

1/2 cup o raspberries 4.0 grams

1/2 cup o stewed prunes 3.8 grams

Vegetables

1/2 cup o winter squash, cooked 2.9 grams

1 medium sweet potato, baked in skin 3.8 grams

1/2 cup o green peas, cooked 3.5–4.4 grams

1 small potato, baked, with skin 3.0 grams

1/2 cup o mixed vegetables, cooked 4.0 grams

1/2 cup o broccoli, cooked 2.6–2.8 grams

1/2 cup o greens (spinach, collards, 2.5–3.5 grams

turnip greens), cooked

Source: U.S. Department o Agriculture and U.S. Department o Health and Human Services, Dietary Guidelines for Americans, 2010.

Drinking water and other liquids, such asruit and vegetable juices and clear soups,may make ber in the diet more eective innormalizing bowel unction and maintainingregularity. A health care provider can giveadvice about how much a person shoulddrink each day based on the person’s healthand activity level and where the person lives.

Exercise and Lifestyle ChangesEngaging in daily exercise can help people

with constipation. Another strategy isto try to have a bowel movement at thesame time each day. The best time is 15 to45 minutes ater breakast because eatinghelps stimulate the colon. People withconstipation should reserve enough time tohave a bowel movement and be sure not toignore the urge to have a bowel movement.

8 Constipation



MedicationWhen a medication is causing constipation,the health care provider may suggest theperson stop taking the medication or switchto a dierent medication.

Laxative medications and enemas may berecommended or people who have madediet and liestyle changes and are stillconstipated. Laxatives taken by mouthare available in liquid, tablet, powder, andgranule orms.

• Bulk-orming agents. Brand namesinclude Metamucil, FiberCon, Citrucel,Konsyl, and Serutan. Bulk-ormingagents absorb fuid in the intestines,making stools bulkier, which helpstrigger the bowel to contract and pushstool out. These supplements shouldbe taken with water or they can causeobstruction. Bulk-orming agentsare generally considered the saestlaxative, but they can interere with the

absorption o some medications. Manypeople also report no relie ater takingbulk-orming agents and suer rombloating and abdominal pain.

• Osmotic agents. Brand names includeMilk o Magnesia, Fleet Phospho-Soda, Cephulac, Sorbitol, and Miralax.Osmotic agents help stool retainfuid, increasing the number o bowelmovements and sotening the stool.These laxatives are usually used bypeople who are bedridden or cannottake bulk-orming agents. Olderadults and people with heart or kidneyailure should be careul when takingosmotic agents because they can causedehydration or a mineral imbalance.

• Stool soteners. Brand names includeColace, Docusate, and Surak. Stoolsoteners help mix fuid into stools

to soten them. Stool soteners maybe suggested or people who shouldavoid straining in order to pass abowel movement; they are otenrecommended ater childbirth orsurgery.

• Lubricants. Brand names includeFleet and Zymenol. Lubricants workby coating the surace o stool, whichhelps the stool hold in fuid and passmore easily. Lubricants are simple,inexpensive laxatives that may berecommended or people with anorectalblockage.

Other types o laxatives include

• Stimulants. Brand names includeCorrectol, Dulcolax, Purge, andSenokot. Stimulant laxatives causethe intestines to contract, which movesstool. Stimulants should be reservedor constipation that is severe or hasnot responded to other treatments.

People should not use stimulantlaxatives containing phenolphthalein,as phenolphthalein may increase thelikelihood o cancer. Most laxativessold in the United States do not containphenolphthalein.

• Chloride channel activators.

Lubiprostone (Amitiza) is a chloridechannel activator available with aprescription. This type o laxativeincreases fuid in the GI tract.Lubiprostone has been shown to be sae

when used or 6 to 12 months.

People who depend on laxatives to havea bowel movement need to talk with theirhealth care provider about how to slowlystop using them. For most people, stoppinglaxatives restores the colon’s natural abilityto contract.

9 Constipation



Surgery Surgery may be needed to correct ananorectal blockage caused by rectal prolapse.Surgical removal o the colon may be anoption or people whose colon muscles donot work properly, causing severe symptomsthat do not respond to treatment. However,the benets o this surgery should be

weighed against possible complications, which include abdominal pain and diarrhea.

BiofeedbackPeople with chronic constipation causedby problems with the anorectal musclescan use bioeedback to retrain the muscles.Bioeedback uses special sensors to measurebodily unctions. The measurements aredisplayed on a video screen as line graphsand sounds indicate when the person isusing the correct muscles. The health careprovider uses the inormation to help theperson modiy or change abnormal unction.The person practices at home. The person

may need to continue practicing or 3 monthsto get the most benet rom the training.

What are the complicationsof constipation?Sometimes constipation can lead tocomplications, such as hemorrhoids, analssures, rectal prolapse, and ecal impaction.

Hemorrhoids are swollen and infamed veins around the anus or in the lowerrectum that can be caused by strainingto have a bowel movement. People withhemorrhoids may have rectal bleeding thatappears bright red on the surace o stool,on toilet paper, or in the toilet ater a bowel

movement. Treatment or hemorrhoids mayinclude making dietary changes to preventconstipation, taking warm tub baths, andapplying special cream to the aected areaor using suppositories beore bedtime.Hemorrhoids that do not respond to at-hometreatments can be treated by a health careprovider. Read more in Hemorrhoids at

www.digestive.niddk.nih.gov .

Anal fssures are small tears in the anusthat may cause itching, pain, or bleeding.Treatment or anal ssures may includemaking dietary changes to preventconstipation, applying cream to numbthe area or relax the muscles, using stoolsoteners, or taking warm tub baths. Analssures that do not respond to at-hometreatment can be treated with minor surgery.

Rectal prolapse can be caused by strainingduring bowel movements. The conditionmay lead to mucus leaking rom the anus.Eliminating the cause o the prolapse,such as straining or coughing, is usually theonly treatment needed. Severe or chronicprolapse requires surgery to strengthen andtighten the anal sphincter muscle or to repairthe prolapsed lining.

Fecal impaction occurs when hard stoolpacks the intestine and rectum so tightlythat the normal pushing action o the colonis not enough to expel the stool. Thiscondition occurs most oten in children andolder adults. An impaction can be sotened

with mineral oil taken by mouth or through

an enema. Ater sotening the impaction,the health care provider may break upand remove part o the hardened stool byinserting one or two ngers into the anus.

10 Constipation





Points to Remember• Constipation is a condition in which

a person has ewer than three bowelmovements a week or has bowelmovements with stools that arehard, dry, and small, making thempainul or dicult to pass.

• Most people get constipated at some point in their lives. Most constipation is acute and not

dangerous.

• Common causes o constipation are

– diets low in ber

– lack o physical activity

– medications

– lie changes or daily routinechanges

– ignoring the urge to have abowel movement

– neurological and metabolic

disorders– gastrointestinal (GI) tract

problems

– unctional GI disorders

• To diagnose the cause o constipation, the health careprovider will take a medical history,perorm a physical exam, and orderspecic tests.

• Treatment or constipation depends

on the cause, severity, and durationo the constipation and may includeone or more o the ollowing:

– changes in eating, diet, andnutrition

– exercise and liestyle changes

– medication

– surgery

– bioeedback

Hope through ResearchThe National Institute o Diabetes andDigestive and Kidney Diseases (NIDDK)and other components o the NationalInstitutes o Health (NIH) conduct andsupport basic and clinical research into manydigestive disorders, including constipation.

Clinical trials are research studies involvingpeople. Clinical trials look at sae andeective new ways to prevent, detect, ortreat disease. Researchers also use clinical

trials to look at other aspects o care, suchas improving the quality o lie or people

with chronic illnesses. To learn more aboutclinical trials, why they matter, and how toparticipate, visit the NIH Clinical ResearchTrials and You website at www.nih.gov/health /

clinicaltrials. For inormation about currentstudies, visit www.ClinicalTrials.gov .

For More Information American Gastroenterological Association

4930 Del Ray AvenueBethesda, MD 20814Phone: 301–654–2055Fax: 301–654–5920Email: [email protected] Internet: www.gastro.org

American Neurogastroenterology and

Motility Society

45685 Harmony LaneBelleville, MI 48111Phone: 734–699–1130

Fax: 734–699–1136Email: [email protected] Internet: www.motilitysociety.org

International Foundation or Functional

Gastrointestinal Disorders

700 West Virginia Street, Suite 201Milwaukee, WI 53204Phone: 1–888–964–2001 or 414–964–1799Fax: 414–964–7176Email: [email protected] Internet: www.igd.org

11 Constipation

http://www.nih.gov/health/clinicaltrials




http://www.clinicaltrials.gov/

mailto:[email protected]

http://www.gastro.org/


http://www.motilitysociety.org/


http://www.iffgd.org/


http://www.clinicaltrials.gov/


http://www.gastro.org/


http://www.motilitysociety.org/


http://www.iffgd.org/



AcknowledgmentsPublications produced by the Clearinghouseare careully reviewed by both NIDDK scientists and outside experts. Thispublication was reviewed by MichaelCamilleri, M.D., Mayo Clinic.

You may also fnd additional inormation about thistopic by visiting MedlinePlus at www.medlineplus.gov .

This publication may contain inormation aboutmedications and, when taken as prescribed,

the conditions they treat. When prepared, thispublication included the most current inormationavailable. For updates or or questions aboutany medications, contact the U.S. Food and Drug

Administration toll-ree at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov . Consult yourhealth care provider or more inormation.

The U.S. Government does not endorse or avor anyspecifc commercial product or company. Trade,proprietary, or company names appearing in thisdocument are used only because they are considerednecessary in the context o the inormation provided.

I a product is not mentioned, the omission does notmean or imply that the product is unsatisactory.

National Digestive DiseasesInformation Clearinghouse

2 Inormation WayBethesda, MD 20892–3570Phone: 1–800–891–5389TTY: 1–866–569–1162Fax: 703–738–4929Email: [email protected]: www.digestive.niddk.nih.gov

The National Digestive Diseases InormationClearinghouse (NDDIC) is a service o theNational Institute o Diabetes and Digestiveand Kidney Diseases (NIDDK). TheNIDDK is part o the National Institutes o Health o the U.S. Department o Healthand Human Services. Established in 1980,the Clearinghouse provides inormationabout digestive diseases to people withdigestive disorders and to their amilies,health care proessionals, and the public.The NDDIC answers inquiries, develops anddistributes publications, and works closely

with proessional and patient organizationsand Government agencies to coordinateresources about digestive diseases.

This publication is not copyrighted. The Clearinghouseencourages users o this publication to duplicate anddistribute as many copies as desired.

This publication is available at www.digestive.niddk.nih.gov.

NIH Publication No. 13–2754

September 2013

The NIDDK prints on rec cled paper ith bio based ink

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