CAM recommendations to treat chronic constipation
Dr. Brooks Cash from the National Naval Medical Center in Bethesda, Maryland has published a detailed review on Medscape.
There are some surprising conclusions regarding common treatments, including fluids, dietary fiber, physical activity, education, enema, and biofeedback.
Fluids
- Adequate fluid intake might promote general health, but decreased fluid intake does not appear to be a major cause of chronic constipation.
- No studies show that increased fluid intake improves bowel function.
Fiber
- Most Americans consume 5-10 grams daily (20-35 grams are recommended).
- The American Gastroenterological Association recommends a gradual increase in fiber intake in either dietary or standardized supplement form as a first-line approach to treat chronic constipation.
- People without an underlying motility disorder improve or become symptom free.
- There is no strong or consistent evidence for the effectiveness of treating constipation with dietary fiber in institution-dwelling older adults.
Physical activity
- In elderly people living at home, in hospitals, or nursing homes, exercise is not effective stand-alone therapy for chronic constipation.
- Exercise may help improve bowel function as part of a broad rehabilitation program.
Education
- There is some evidence that having a bowel movement may be a conditioned response for which some individuals can be trained.
Enema
- Claims of benefit remain unproven.
Biofeedback Therapy
- Effective for people with abnormal contraction or failure to relax the pelvic floor muscles during attempts to defecate.
- Requires good interaction between the therapist and the patient.
11/15/07 20:29 JR
