Talk:Constipation/Archive 1

Start
I added a paragraph about the possibility that constipation may be caused by an extra bend or loop in the descending colon, a condition which an experienced radiologist will agree is not so uncommon. This paragraph was simply removed. It seems that by editing out anything which is not strictly in accordance with the textbooks Wikipedia is losing what could be a valueable source of discovery for people in general and for those so-called experts who think they already know everything that can be know about a subject.

---

If this needs a cleanup to a higher standard of quality, that higher standard is beyond me. This strikes me as a more practically useful article than almost anything I usually read on Wikipedia. Maybe the usual quota of obscurity would keep people happy. Art LaPella 02:41, July 22, 2005 (UTC)
 * I removed the tag, it looks pretty good to me now. --Kbk 16:10, 6 August 2005 (UTC)

jfdwolff Edit Approaches Vandalism
It seems to me that the massive edit by jfdwolff approaches vandalism. Who is he to be annoyed and essentially replace an entry which has been worked on collaboratively for an extended period of time with something of his own that looks like it belongs in the Merck Manual?

I would like to see balance restored reemphasizing the practical aspects of correcting constipation without resorting to the medical profession. Constipation is common and is caused by the typical low bulk Western diet. Most people are unaware of this and will not be able to extract the most reasonable solution from the current terse medical jargon. The article is now directed to the medical profession instead of the general public, in my opinion, and its practical aspect has been destroyed. At a minimum, the dietary recommedation section needs to be restored.

How can Wikipedia meet the needs of its less technical users if articles are 'upgraded' like this? --Kbk 19:10, 11 August 2005 (UTC)


 * You are free to reinsert the dietary intervention section, but please avoid the ghastly style of the previous version, which addressed the reader in second person and contained lots of unproven nonsense. I take firm offense with your suggestion of "vandalism"; apologies would be appreciated. JFW | T@lk  20:07, 11 August 2005 (UTC)


 * I see no reason to apologize (as yet) as you have not addressed the rest of the issues I have raised. And you have not apologized for aggravating me by deleting the section I've been working on.


 * Why must all medical articles look like the Merck manual, especially those which cover subjects which may interest the average reader? What justifies your essentially tossing the whole article overboard instead of massaging it? Which entries are "unproven nonesense", to be corrected by you without justification?  Wholesale elimination of other people's Wikipedia work (with a dismissive comment, even) is tantamount to vandalism, even if your work is adequate.  When I work on an article, I try to be careful to do it piece by piece, justifying each change with appropriate comments.  I would never replace the article without prior discussion and a decent waiting period.


 * I recognize that you are a medical professional and that you have done a lot of good work for Wikipedia, but that doesn't justify high-handed behavior.


 * I agree with your comments on not addressing the reader directly. Also, your style is definitely an improvement, but IMHO you went too far and eliminated the practical aspects of the article.--Kbk 20:39, 11 August 2005 (UTC)

Your edits to the article have been marginal, and have included second-person instructions like "Don't chew on the bran, it will just begin to act like a piece of chewing gum".

If you wish to reinsert all that dietary advice, you are free to do so. Also, please be mindful of the line at the bottom of every edit page: "If you do not want your writing to be edited mercilessly and redistributed at will, do not submit it." If my merciless editing disturbs you or uncomfortably resembles the Merck Manual then please improve it further. JFW | T@lk  23:19, 11 August 2005 (UTC)


 * I was responsible for the whole section on bran. Thanks for your opinion, but I was simply following the style of the article, and I have already agreed with you on the second-person issue.


 * You have not addressed the other points I raised, so my opinion of you as being high-handed stands. In the future, please don't scrap whole sections or articles without adequate discussion.  That's not "editing". Rather, massage articles into shape in the spirit of Wikipedia.--Kbk 02:21, 12 August 2005 (UTC)

I'm sick of your personal attacks. Just be quiet and edit the article. JFW | T@lk  07:39, 12 August 2005 (UTC)


 * Bingo. I guess we agree to disagree.  I'll revert the section after a bit and then revise it as we've discussed.--Kbk 14:34, 12 August 2005 (UTC)

Phew - Wikipedians, as the Introduction states 'we encourage users to be bold...but don't be reckless!' and 'Civility is a rule here on Wikipedia'. Personally I thought the edit was an improvement, but: David Ruben 20:37, 12 August 2005 (UTC)
 * I agree with Kbk on the risk of us doctors making entries too dry & clinical, but it is sensible to keep entries on a health/medical nature having a layout that has a logical senquence
 * i.e. define a condition, features of the condiion, how to diagnose & assess causes and approproaches to treatment (whether self-help or therapeutic) and then social-historical background.
 * slavish following of a medical page style is too rigid and will not always give the best entries, but completely idiosyncratic layout will not give wikipedia the polished-look we all hope for.
 * JFW's edit gave a much fuller description on constipation and its investigation and treatment, I agree though that self-management was then lacking.
 * Kbk's previous version had many good points on addressing the issue, but I think was a little jumbled across the whole article
 * The previous version mentions taking the time to go to the toilet. This is particularly important in children or those who try over-regulate their lives. I was always taught technically "heed the call". Infants often get constipated and then exacerbate the problem by trying to hold on (because they know it will hurt) and this just allows the bowels to reabsorb more water and make the motions even harder.
 * But I think the previous version was a little "wooley" (a) style was rather too chatty (fine to a certain extent) (b) slighty too wordy and some tightening up of english needed (c) long list of vegetables and discussion on types of flour.
 * The long section on sources dietary fibre perhaps would be better on a separate page:
 * It then could link to constipation as a consequence of insufficient fibre, but also what to reduce back on if experiencing diarrhoea (amazing the number of patients I see with diarrhoea worse each morning after their breakfast of weetabix+milk or prunes !)
 * High fibre also of course thought helpful for cholesterol levels, sensible diet for weight and diabetics. More controversial is the issue of high-fibre and degree of reduction colon cancer.
 * So high fibre, or higher fibre than typical "western diet", really should not be tucked in exclusively under constipation.
 * Can we agree for:
 * Kbk to help ensure English not that of a medical under-graduate textbook, add back a tightly written 'Self management section'
 * JFW & myself ensure within accepted Medical practice (we would worry over some 'nutritionist' POV items) and that article keeps its depth on medical causes and management, using our clinical knowledge.
 * Kbk, do you think the sources of high fibre could be set up on a separate page (can't immediately find any existing WP article) and place some links to diabetes, cholesterol(hypercholesterolemia) etc?
 * I've yet to search WP, but their should be an entry in WP on 'healthy diet' ('healthy diet' gets overused/misused, so I would redirect to 'Sensible approaches to eating') and fibre, saturated fats, high-glycaemic foods, weight/exercise etc. all get mentioned and link appropriate to other articles.


 * Spoke to soon. Healthy diet (helps to search with correct spelling) exists, but seems very stubby. David Ruben 20:41, 12 August 2005 (UTC)

Thanks DR. I'll be nice to Kbk, but unkind to unproven nutritionist waffle. JFW | T@lk  21:49, 14 August 2005 (UTC)


 * Discussion on nutrition cannot be ignored in the subject where so much depends on it being proper. Most folks would welcome inclusion of a section describing the nutritional causes as well as nutritional means to alleviate constipation in more detail. This section needn't be dry as medical facts but ought to be to the point. Gbajramo 19:13, 24 December 2006 (UTC)

Further sources of high fibre should be on Dietary fiber. Changed the link in the article from fibre to dietary fibre. --WS 13:56, 15 August 2005 (UTC)

Bananas or Apples: Cure
I have a question. Fruits and vegetables are suggested as a cure, but specific fruits or vegetables aren't named. I've been told by some people that bananas are a good cure for constipation, while apples are a good cure for diarrhea. I've also been told the opposite is true. Which is correct? Some friends and I were trying to give advice, however; we were all contradicting each other. Now we have a bet. The half that wins has to buy the other half dinner.

BRAT (Bananas,Rice,Applesauce&Toast)is a remedy for diarrhea; bananas don't have much fiber either. Celery, dried apricots or prunes and apples would be more helpful. Enjoy your dinner.art 01:57, 27 January 2007 (UTC)

What foods might help cause it?
To put it bluntly, I enjoy a stool that's on the firmer side but I'm unsure as to how to stimulate it. Dieticians list a plethora of foods known to be mild laxatives, but all I know that supposedly gums up the works is meat and cheese. As I enjoy laxatives like dried fruit in my diet but don't wish to suffer from the resulting inevitable diarrhea (or at best, loose stool) it would be helpful if we could perhaps compile a list of foods that are known to counteract the laxative effect, which presumably in large amounts would induce constipation. —The preceding unsigned comment was added by 75.73.48.43 (talk) 04:41, 12 December 2006 (UTC).

Preventing constipation
Most highly processed and high fat foods are not easily digested and don't have sufficient bulk to move through the digestive system. Such foods include white flour products, dairy, chocolate. In addition, processing and cooking destroys most enzymes in foods slowing down their digestion. Non-processed meats like steak are fine but highly processed canned meats such as ham are not. When eating such foods having an apple or a carrot, or both, shortly after will help move things along which results in normal and regular stool. To conclude, if you need laxatives, natural or others, get more bulk in your diet to move the food along. Walking or running stimulates the digestion further. Result is consistant and healty digestive system which is the foundation of overall health. Gbajramo 19:06, 24 December 2006 (UTC)

Confused
What is this supposed to mean? last sentence of first paragraph: " it can also be the result of regular sexual penetration." It's been tacked on, and really doesn't make sense to me.


 * WP:VAND - pure and simple. JFW | T@lk  17:50, 25 November 2007 (UTC)

Question
What is the name for when you are constipated because you were lying down for an excess number of time (I'm talking days and tens of hours)? It's when the feces doesn't get pushed down because you're in a horizontal position. I'm just looking for the name & maybe a little more in-depth explanation. Thanks in advance!  Zouavman   Le   Zouave   20:12, 14 September 2007 (UTC)


 * I don't think immobility-related constipation has a dedicated term. But we see it in hospital inpatients all the time. JFW | T@lk  17:50, 25 November 2007 (UTC)

Use of Squat Toilets
I added the following to the prevention section: --- According to Bockus Gastroenterology, the use of squat toilets may help to prevent and relieve constipation:

"The ideal posture for defecation is the squatting position, with the thighs flexed upon the abdomen. In this way the capacity of the abdominal cavity is greatly diminished and intra-abdominal pressure increased, thus encouraging expulsion ..."

Then I cited the reference to Bockus, complete with page number. My addition was deleted, citing WP:Weight. This seems unjustified. First of all, the solution to "undue weight" is not zero weight. Secondly, the WEIGHT article deals with minority views that are disputed by the majority. I don't know of anyone who disputes that statement by Bockus. I would appreciate some more opinions about this. --Jonathan108 (talk) 01:58, 8 August 2008 (UTC)

For those not familiar with squatting, this is the posture used by the vast majority of the (non-constipated) world. --Jonathan108 (talk) 17:45, 9 August 2008 (UTC)


 * I definitely learned from a text somewhere that squatting instead sitting reduces hemorrhoids. But man, I'll be darned if I can remember where I read that. Maybe do some research in African medical articles - I know they don't have hemorrhoids in communities where they squat and not sit. Maybe a reference like this will help you in your ideal defecating position article. And if you don't already see the connection, higher intra-abd. pressure = higher incidence of hemorrhoids. Tkjazzer (talk) 15:42, 12 August 2008 (UTC)

Since you posted the same message at Wikipedia talk:WikiProject Medicine, I replied there. --Jonathan108 (talk) 16:45, 12 August 2008 (UTC)

Mention can simply dislodge stuck feces with ones' fingers
Finally, manual dissimpaction can occasionally be done under sedation or a general anesthetic—this avoids pain and loosens the anal sphincter.

Also please mention that due to taboos or whatever, many people never think that indeed with their fingers they can often loosen and dislodge impacted feces themselves. This is even more important for people not located near medical facilities. Also please mention any danger in doing this. Jidanni (talk) 11:22, 12 September 2008 (UTC)

Laxatives
I included a bit of information about the dangers of laxatives. They are very effective, but they carry the risk of dependence, and changes in elimination patterns and inadequate nutrition. People typically over diagnose constipation (you don't have to go every day) and overuse over the counter laxatives, instead of focuses on the root cause of the problem. —Preceding unsigned comment added by UnnaturalSelection (talk • contribs) 02:57, 18 March 2009 (UTC)

Chronic constipation
Cumulative incidence is 1 in 6! JFW | T@lk  17:50, 25 November 2007 (UTC)

Archiving
Am adding an auto archiver. Doc James (talk · contribs · email) 14:43, 15 April 2010 (UTC)

Citation Needing Improvement?
I believe that the following citation could use improvement. It consists of multiple links to the internet which all but the last require a registration. Possibly all the but the last link should be removed? I feel that someone knowledgable with the subject could best decide.

[^ Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A (1998). "Effects of regular exercise in management of chronic idiopathic constipation". Dig. Dis. Sci. 43 (11): 2379–83. doi:10.1023/A:1026609610466. . http://www.kluweronline.com/art.pdf?issn=0163-2116&volume=43&page=2379.]


 * Yes was not the best ref. Replaced it with a better one. Doc James  (talk · contribs · email) 16:55, 24 April 2010 (UTC)
 * Thank you. The citation keeps talking about "cc" but I can not find a definition of what "cc" is.1archie99 (talk) 04:55, 25 April 2010 (UTC)


 * Chronic constipation Doc James  (talk · contribs · email) 05:21, 25 April 2010 (UTC)

A 2009 review
Doc James (talk · contribs · email) 08:03, 5 May 2010 (UTC)

Wikipedia is going a little too far
"Bristol Stool Chart"??? An x-ray of someone's filled colon? Seriously, where is the decency? Seems as though Wikipedia has thrown it out the window. Can't wait until we start seeing photos of actual feces. I bet they have dead bodies on the "Corpse" page. I mean really, do we really need to see actual breasts on the "Breasts" page?

Degradation of society at its finest. Wikipedia you've done it again! —Preceding unsigned comment added by 64.252.23.240 (talk) 00:15, 16 June 2010 (UTC)

External Review Comments
Hello, Constipation article writers and editors. This article currently a priority article for the Wikipedia talk:WikiProject Medicine/Google Project. The goal of this project to is provide a useful list of suggested revisions to help promote the expansion and improvement of this article.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Definition
I’ve added the following references to this section:
 * Walia R, Mahajan L, Steffen R. Recent advances in chronic constipation. Curr Opin Pediatr. (2009);21(5):661-6.
 * McCallum IJ, Ong S, Mercer-Jones M. Chronic constipation in adults. BMJ. (2009);338:b831. doi: 10.1136/bmj.b831.
 * Emmanuel AV, Tack J, Quigley EM, Talley NJ. Pharmacological management of constipation. Neurogastroenterol Motil. (2009);21 Suppl 2:41-54.

In addition to children, constipation is also common in older persons. A section could be added to discuss this. Useful references are:
 * Kyle G. The older person: management of constipation. Br J Community Nurs. (2010);15(2):58-64.
 * Gallagher P, O'Mahony D. Constipation in old age. Best Pract Res Clin Gastroenterol. (2009);23(6):875-87.
 * Bouras EP, Tangalos EG. Chronic constipation in the elderly. Gastroenterol Clin North Am. (2009);38(3):463-80.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Causes
I’ve added citations where needed throughout this section. I also added additional metabolic and myogenic causes. I removed the unsupported statements regarding diet. Studies do not support cow’s milk as a cause of constipation.
 * Walia R, Mahajan L, Steffen R. Recent advances in chronic constipation. Curr Opin Pediatr. (2009);21(5):661-6.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Prevention
References were added to this section

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Treatment
This section needs to be expanded and reorganized. ‘Children’ is not a treatment, and the information in this section belongs with the information on laxatives. Treatments to include are:
 * adoption of the recommendation semi-squatting position (McCallum IJ, Ong S, Mercer-Jones M. Chronic constipation in adults. BMJ. (2009);338:b831. doi: 10.1136/bmj.b831. )
 * biofeedback (Bassotti G, Chistolini F, Sietchiping-Nzepa F, de Roberto G, Morelli A, Chiarioni G. Biofeedback for pelvic floor dysfunction in constipation. BMJ (2004);328:393-6)

The section on laxatives can be expanded. There are four main types of laxatives: bulking agents, stool softeners, stimulant laxatives, and osmotically active compounds.
 * Emmanuel AV, Tack J, Quigley EM, Talley NJ. Pharmacological management of constipation. Neurogastroenterol Motil. (2009);21 Suppl 2:41-54.

An easily accessible overview of these types of medicines with brand name examples can be found here:
 * National Digestive Diseases Information Clearinghouse. (2007) NIH Publication No. 07–2754. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/#treatment, Accessed 7-18-10.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Prognosis
This section should be expanded and requires citations. Complications that can arise from constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction.
 * National Digestive Diseases Information Clearinghouse. (2007) NIH Publication No. 07–2754. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/#treatment, Accessed 7-18-10.
 * Bharucha A. Constipation. Best Practice and Research Clinical Gastroenterology. 2007;21:709.
 * Walia R, Mahajan L, Steffen R. Recent advances in chronic constipation. Curr Opin Pediatr. (2009);21(5):661-6.
 * McCallum IJ, Ong S, Mercer-Jones M. Chronic constipation in adults. BMJ. (2009);338:b831. doi: 10.1136/bmj.b831.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

sentence and itations added-additional expansion still advised. BSW-RMH (talk) 02:24, 12 August 2010 (UTC)

Epidemiology
The information is outdated (1989). Additional information that would be more useful:


 * 12% of the population worldwide reports having constipation. (Wald A, Kamm MA, Muller-Lissner SA, Scarpignato C, Marx W, Schuijt C. The BI Omnibus Study: An international survey of community prevalence of constipation and laxative use in adults. Digestive Disorders Week. 20-25 May 2006. Abstract T1255. http://www.dulcolaxo.es/es/Main/Notas_de_Prensa/Poster_Epi_data_FINAL_06.05.08.pdf, Accessed 7-18-10)
 * Chronic constipation accounts for 3% of all visits annually to pediatric outpatient clinics (Walia R, Mahajan L, Steffen R. Recent advances in chronic constipation. Curr Opin Pediatr. (2009);21(5):661-6. )
 * Constipation-related healthcare costs total $6.9 billion in the US annually (Locke GR, Pemberton JH, Phillips SF. AGA technical review on constipation. Gastroenterol 2000; 119:1766–1778.)
 * More than 4 million Americans have frequent constipation, accounting for 2.5 million physician visits a year. (National Digestive Diseases Information Clearinghouse. (2007) NIH Publication No. 07–2754. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/#treatment, Accessed 7-18-10.)
 * Around $725 million is spent on laxative products each year in America. (National Digestive Diseases Information Clearinghouse. (2007) NIH Publication No. 07–2754. http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/#treatment, Accessed 7-18-10.)

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

added BSW-RMH (talk) 02:37, 12 August 2010 (UTC)

In animals
This section was unreferenced. I removed it. It could be added back with verifiable citations.

BSW-RMH (talk) 03:11, 19 July 2010 (UTC)

Article needs a makeover
The article focus now is on constipation due to colonic slow transit and neglects constipation due to obstructed defecation. Treatment of these two broad classes of constipation is very different, because the underlying causes are very different. The abstract to explains this well. 66.167.43.31 (talk) 22:33, 15 August 2010 (UTC)


 * "Constipation is a subjective symptom of various pathological conditions. Incidence of constipation fluctuates from 2 to 30% in the general population. Approximately 50% of constipated patients referred to tertiary care centers have obstructed defecation constipation. Constipation of obstructed defecation may be due to mechanical causes or functional disorders of the anorectal region. Mechanical causes are related to morphological abnormalities of the anorectum (megarectum, rectal prolapse, rectocele, enterocele, neoplasms, stenosis). Functional disorders are associated with neurological disorders and dysfunction of the pelvic floor muscles or anorectal muscles (anismus, descending perineum syndrome, Hirschsprung's disease). However, this type of constipation should be differentiated by colonic slow transit constipation which, if coexists, should be managed to a second time. Assessment of patients with severe constipation includes a good history, physical examination and specialized investigations (colonic transit time, anorectal manometry, rectal balloon expulsion test, defecography, electromyography), which contribute to the diagnosis and the differential diagnosis of the cause of the obstructed defecation. Thereby, constipated patients can be given appropriate treatment for their problem, which may be conservative (bulk agents, high-fiber diet or laxatives), biofeedback training or surgery."


 * Agree that is why it is still a start class. Doc James (talk · contribs · email) 04:05, 16 August 2010 (UTC)

Psychological?
This section should really be renamed to "Voluntary Witholding". The reasons for doing this are not always a psychological problem as this section seems to imply. Simply being in a situation where it is impractical to deficate such as being away from home outside or in a vehicle with no public facilities nearby.81.152.71.65 (talk) 17:27, 28 December 2010 (UTC)

Chronic constipation review
Doc James (talk · contribs · email) 02:01, 2 August 2011 (UTC)

Edit request from 204.237.5.118, 16 September 2011
In the start of the article is lists dyssynergia and dyschezia as synonyms for constipation. This is incorrect. Dyssynergia is a cause of constipation, while dyschezia is difficulty defecating, which is a different thing than constipation. Dyschezia is typically caused by dyssynergia. Dyschezia refers to a patient who has the urge to defecate, but is unable to do so often because dyssynergia between anal spinchter, abdominal muscles, and puborectalis.

204.237.5.118 (talk) 01:02, 16 September 2011 (UTC)
 * Please give reference/s to reliable sources, and ask again - thanks; see WP:V.  Chzz  ► 01:10, 17 September 2011 (UTC)

Dehydration as a cause of constipation
The section on causes lists insufficient fluid intake as a cause of constipation, but would more accurately say "dehydration". After all, constipation is a symptom of diabetes mellitus, as dehydration is a symptom of this illness, but this is not caused by insufficient fluid intake. ACEOREVIVED (talk) 21:23, 19 January 2012 (UTC)

OK I have changed the article now! ACEOREVIVED (talk) 00:18, 8 February 2012 (UTC)


 * I remember reading a paper at one point that actually investigated the "drink more water" advice, and found that there was no statistically significant improvement in symptoms, and concluded there was no evidence that increased water intake improved constipation. If i come across it again, I will add it.Tepi (talk) 22:27, 20 August 2012 (UTC)

Also, Dyssynergic defecation is not synonymous with Constipation
Dyssynergic defecation is a type of functional constipation, and functional rectal outlet obstruction, but it is not interchangeable with the more general term of Constipation. Dyssynergic defecation is actually one of the many synonyms of anismus, indeed the Rome criteria state that it is a preferred term than anismus. I'll remove this statement in the article then.Tepi (talk) 22:27, 20 August 2012 (UTC)

Obstructed defecation
I feel we should link to this page on the constipation article. According to | this guy, the difference between constipation and obstructed defecation is:

CONSTIPATION Infrequent defaecation, less than once every 3 days and / or passing very hard stools or both

Associated conditions Simple constipation, slow transit constipation	Associated conditions Internal rectal intussusception, rectocoele, anismus

OBSTRUCTED DEFAECATION

Difficulty in evacuation or emptying the rectum. This may occur even with frequent visits to the toilet and even with passing soft motions

Internal rectal intussusception, rectocoele, anismus

23_2&#123;(SBST:SU:m.&#125;&#125; (talk) 22:17, 18 October 2012 (UTC)

Other causes than low liquid intake
It says in the section on diet that constipation can be caused by low liquid intake. This is correct, but there could be other causes of dehydration that could lead to constipation, such as diabetes mellitus. I think that the article ought to be altered accordingly. ACEOREVIVED (talk) 19:42, 22 November 2012 (UTC)

Why is there no mentioning of transanal irrigation? Nature has published international consensus on this. See http://www.nature.com/sc/journal/v51/n10/pdf/sc201386a.pdf — Preceding unsigned comment added by 193.0.60.108 (talk) 12:04, 16 July 2014 (UTC)

Menstruation?
According to sources I came across menstruation is a cause. Another user here does not seem to agree. Let me dig out those references so we can discuss them.--Nadirali نادرالی (talk) 23:21, 17 December 2014 (UTC)
 * You have provided three sources for "Females can also suffer from constipation during their period in which hormones affect the digestive system resulting in typical constipation symptoms."
 * This is not reliable
 * This is not reliable
 * This one does not appear to support the content in question and is also not a good source as it is a primary source
 * Please read WP:MEDRS
 * Doc James (talk · contribs · email) 23:23, 17 December 2014 (UTC)

Psychological
The section regarding the psychological causes of constipation seems to me inadequate. Firstly, both sources in the section reference pediatric studies, rather than adult studies, which is only vaguely stated. Secondly, while "factors such as fear of pain, fear of public restrooms, or laziness" are listed, other common withholding factors for children are a fear of toilets in general, fear of the loss of physical control required to defecate, and rebellion against parental toilet training efforts.

These factors are credited in the American Academy of Pediatrics' "Guide to Toilet Training", which, although referenced by many secondary sources (such as and ), does not seem to be available in digital form. 184.234.36.134 (talk) 21:13, 5 January 2015 (UTC)

different colored stool
green stool... you sit on it or it is caused by alien abductions... most common between ages 21 and 21 and a half. red stool: it is caused by too much pizza or diabetic nerve pain caused by giraffes in new zealand. purple stool: doesn't exist yellow stool: caused by too much heat in antartica black stool: caused by too many phone calls by insolent 5 year olds — Preceding unsigned comment added by 2601:41:4000:DABB:1EC:1ABF:A058:148 (talk) 23:52, 26 September 2015 (UTC)

Plants
Under-consumption of plant foods is also attributed to the prevalence of constipation in preschoolers.


 * This was added but the source fails WP:MEDRS. JFW &#124; T@lk  22:46, 30 December 2015 (UTC)

Use of the word "straining"?
I just noticed that there was no Wikipedia page on "straining" yet - and this term is actually used a few times on this page without explaining it. I guess most of us know intuitively what it means, but could it be defined with a sentence? I've set up a redirect page for straining as I think its most common use is with respect to defecation, but maybe a disambiguation page would be better - also linking to "straining a muscle" perhaps? EvMsmile (talk) 12:49, 21 February 2016 (UTC)
 * I feel like a more appropriate redirect for "straining" would be strain, a disambiguation page with many related articles. If someone didn't know what strain was, they could look at one of these articles, or even look the word up on Wiktionary. pwnzor.ak  (talk) 16:00, 21 February 2016 (UTC)
 * I thought about that as well, but when I look at the page about strain, nowhere does it refer to the issue with defecation and what straining means in the context of defecation? Same applies to the Wiktionary page about strain? Would the solution be to edit both of those pages somehow? What exactly is the definition of straining in the context of defecation/constipation? It is somehow pushing your rectal muscles? I am not sure how it would be best explained. EvMsmile (talk) 00:21, 22 February 2016 (UTC)
 * I've now added a definition in the article: "straining in this context is a strong effort to push out stool often by holding one's breath and by pushing the respective muscles in the abdominal area hard" and also added this information to the disambiguation page of strain. Is it OK like this? Who can improve on it further? Would like to add a hatnote but don't know how to - the hatnote should say "straining redirects to here; for other uses of strain, see strain disambiguation page". EvMsmile (talk) 02:57, 15 March 2016 (UTC)

Editing Workplan
We are fourth-year students at the UCSF School of Medicine who are editing this article as part of a Wiki Education Foundation-supported course assignment. Our edits, as outlined by section are as follows: Perseuspatel will work on editing for the following sections Definition: --ensure that definition is up to date and in line with medical literature. --consider including criteria into this definition

Special populations --Create a sub-heading for special populations (children and post-partum women) --add more information to each of these, including most common causes of constipation --provide information as to how constipation is defined for pediatric populations --contrast with infant dyschezia

Causes: --I will add more information into these sections and consider adding other common etiologies to this list --rads4lyfe will add adult causes of constipation (both acute and chronic), and possibly a special section for the elderly population. Will also include hyperlinks to relevant sections. --perseus patel will add pediatric causes of constipation.

For all the above sections, I will work on increasing general readability.

As a group, we will re-do the introduction section: Intro: --Include more up to date statistics --Create a better breakdown of constipation etiologies to provide readers with a more understandable structure on how to think about causes of constipation (rads4lyfe with help with this by breaking down the causes into adult and pediatric constipation) --Our group with meet to do this together, after completing the rest of the page. — Preceding unsigned comment added by Perseuspatel (talk • contribs) 00:08, 4 March 2017 (UTC)

I plan to perform a thorough literature review of this topic, thoroughly analyze my assigned sections within this wikipedia page, and make the appropriate edits with the goal of improving the medical relevance of the page.

-Lead Section: Collaborate with classmate to efficiently summarize constipation.

-Diagnosis: Review present information, update accordingly, and arrange in an easy to understand manner by splitting up into: history,physical,labs,imaging etc.

-Criteria: Review for medical accuracy, consider merging with diagnosis section

-Prognosis: Review for medical accuracy, consider renaming section or adding subsection of complications, warning symptoms associated with constipation.

-Prevention: Probably the most relevant section for readers; rads4lyfe will expand this section and list ways to prevent constipation/how good these measures are/links to the pages explaining how they work.

-Treatment: Review for medical relevance and explicitly talk about when each treatment is appropriate and when the "next step" should be taken. Will also include links to relevant pages.

Epidemiology: Find the most uptodate review article, compare the prevalence in the US compared to other countries — Preceding unsigned comment added by Ryan1514 (talk • contribs) 16:03, 3 March 2017 (UTC)


 * Can you all read WP:MEDMOS
 * Also please do not use links to the inside net at UCSF.
 * WP:MEDHOW discusses how to reference. Best Doc James  (talk · contribs · email) 18:16, 10 March 2017 (UTC)

Ref
What ref supports

"They are still recovering from the delivery process especially if they have had a perineal tear or underwent a episiotomy. Risk factors that increase the risk of constipation in this population include:* Damage to the levator ani muscles (pelvic floor muscles) during childbirth Hemorrhoids are common in pregnancy and also may get exacerbated when constipated. Anything that can cause pain with bowel movements (examples- hemorrhoids, perineal tear, episiotomy) can lead to constipation because patients may withhold from having a bowel movement to avoid pain. "
 * Forceps-assisted delivery
 * Lengthy second stage of labor
 * Delivering a large child
 * Hemorrhoids

Doc James (talk · contribs · email) 22:43, 16 March 2017 (UTC)

Peer Review for Perseus' Contribution to the Constipation Article, by JB
Overall, I feel like you made some valuable contributions to the article. You provided a clear definition that will give people a better understanding about how to think about constipation when they read through the rest of the article. The sections on children and postpartum women give important information about these populations that are uniquely susceptible to constipation. It was easy to follow from a layperson's perspective and avoided a lot of complicated medical terms. Individual comments for each of the sections that you addressed are provided below:

Definition – I like how you clearly stated that constipation is a symptom and not a disease. Great overview of common symptoms. Because this is the first reference of the Rome Criteria, it might be good to at least define it and then say you can find the individual symptoms in the diagnostic approach or children section below.

Congenital Causes – it might be useful to add a hyperlink to congenital disorders to provide a general overview of what this term means. You can similarly add hyperlinks for HD, achalasia, and imperforate anus so that people can click on them to read more. Otherwise, great section - it was easy to follow and touched on all the major congenital causes of constipation.

Children – I like how you started with some epidemiology to show how common constipation is in the pediatric population. Very insightful discussion about how children are especially vulnerable to constipation due to certain lifestyle changes. I'm sure it will be reassuring to many parents reading this article to see that the majority of constipation is not related to a medical disease and they can just treat the symptoms. I also like that you defined the normal amount of bowel movements/day for each age group. The Rome III criteria was an excellent addition to this section - it provides a clear list of symptoms that readers can reference to see if their symptoms align with.

Postpartum Women - I like how you defined the postpartum stage because many people probably won't know what that is. I found myself wondering why some of the risk factors you mentioned cause women to have an increased risk of constipation - potentially something to add in the future. Great explanation of why hemorrhoids can lead to constipation. It might be useful to add a hyperlink to the pelvic floor muscles, to provide a definition of what they are. Overall, this is a great addition to the article because this is obviously a vulnerable population that commonly gets constipated.

Readability and References – your sections were very easy to follow and used simple terms and short sentences. I like how you added references for each of the sentences/statistics you provided. This is important so that people can see that there is actual scientific evidence for the information you provided and I hope it will inspire further wikipedia editors to do the same.

Great job! The wikipedia community thanks you for your contributions!

Jbonano15 (talk) 18:42, 20 March 2017 (UTC)

Peer Review for Ryan - AW
-Lead Section: Collaborate with classmate to efficiently summarize constipation. -- Good overview, consider adding sentence about dietary/behavioral causes of constipation

-Diagnosis: Review present information, update accordingly, and arrange in an easy to understand manner by splitting up into: history,physical,labs,imaging etc. -- Well researched & thorough. My only suggestion would be to simplify some of the language such as "elucidate", "admixture" etc. Also, "red flag symptoms" might not have a clear meaning for lay people.

-Criteria: Review for medical accuracy, consider merging with diagnosis section -- clear and concise

-Prognosis: Review for medical accuracy, consider renaming section or adding subsection of complications, warning symptoms associated with constipation. -- clear and concise

-Prevention: Probably the most relevant section for readers; rads4lyfe will expand this section and list ways to prevent constipation/how good these measures are/links to the pages explaining how they work.

-Treatment: Review for medical relevance and explicitly talk about hen each treatment is appropriate and when the "next step" should be taken. Will also include links to relevant pages -- Good overview. Consider adding links to definitions of osmotic vs. stimulant laxatives or naming one of each type.

Nice work!

Angelwhit06 (talk) 00:17, 21 March 2017 (UTC)

Peer Review For Causes Section
Overall, it looks really good. I like the way it is broken down into broad categories A few points:

-In the first paragraph, consider further breaking down the causes of constipation by behavioral factors vs medical problems (I think this might be practically useful for a lot of readers)

-In diet section, might give some examples of common foods which are high in fiber content

-In the psychological section, you could add that voluntarily withholding can lead to addition problems (fissures)

-In the congenital section, I might start the discussion of HD off with how it should be suspected in infants who have not passed their first stool (since this type of constipation is a bit different than an infant who had previously been stooling normally and then develops constipation) — Preceding unsigned comment added by Q59k511 (talk • contribs) 08:38, 22 March 2017 (UTC)

Frequency of BMs
The ref says "Some people may have three bowel movements a day. Other people may only have three bowel movements a week."

As this is a common definition have restored. Doc James (talk · contribs · email) 12:09, 23 March 2017 (UTC)

Constipation treatment guide - Canadian Society for Gastrointestinal Endoscopy
This External Link is not of the Canadian Society for Gastrointestinal Endoscopy, but is a seemingly private commercial site. — Preceding unsigned comment added by 174.6.101.144 (talk • contribs) 02:47, 26 August 2014 (UTC)

Surgical intervention Readability
The surgical intervention section needs work to increase readability Mgiulietti (talk) 17:09, 8 May 2017 (UTC)

Removed redundant information
added information in March 2017 about the Rome process criteria for diagnosing children. The information is good but the user added the same list twice; obviously it should only be in once. I just removed one list.  Blue Rasberry  (talk)  14:44, 6 July 2017 (UTC)

History of constipation
I just added a history section per WP:MEDMOS. In it I posted two books which address the history of constipation. I have not read either of these books, and only found excerpts online.



I did a pubmed search and was unable to find anything about history there. This is a start!  Blue Rasberry  (talk)  15:52, 6 July 2017 (UTC)

Content not supported by the source
This content is not supported by the source:


 * In the elderly, common causes include: insufficient dietary fiber intake, inadequate fluid intake, decreased physical activity, side effects of medications, hypothyroidism, and obstruction by colorectal cancer.

The ref says: "Discussion and conclusion. A search of the recent literature revealed that there is a paucity of evidenced-based publications that address the etiologic factors of chronic constipation. Much of what has been popularized in the past, and even to the present, may be based primarily on myths handed down from one generation to the next [3, 8]. In the absence of well-designed studies, there does not appear to be sufficient evidence-based information to implicate insufficient dietary fiber intake, inadequate fluid intake, reduced physical activity, side effects of drugs, hypothyroidism, sex hormones, or cancer obstruction as a major etiologic factor in the development of chronic constipation."

Best regards. --BallenaBlanca   (Talk)  22:40, 10 July 2017 (UTC)


 * It says "Geriatric patient educational material and a general practice review suggest insufficient dietary fiber intake, inadequate fluid intake, decrease physical activity, side effects of drugs, hypothyroidism, sex hormones and colorectal cancer obstruction may play a role in the pathogenesis of constipation"


 * And than says poorly supported by evidence. Adjusted to text to reflect this. Doc James  (talk · contribs · email) 23:08, 10 July 2017 (UTC)


 * Agree. --BallenaBlanca [[Image:BallenaBlanca.jpg|25px]] [[Image:Mars symbol (bold blue).svg|12px]] (Talk)  00:27, 11 July 2017 (UTC)

Content fork to constipation in children
This article had enough information about constipation in children that I thought it had WP:UNDUE weight. I cut this content out and put it all into constipation in children along with some new content. See what I cut. I put the new article into WP:MEDMOS format so now any of the sections there could be developed without being space restricted here.  Blue Rasberry  (talk)  19:52, 11 July 2017 (UTC)
 * Sounds good. Doc James  (talk · contribs · email) 00:27, 12 July 2017 (UTC)

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