GASTROENTEROLOGY ARTICLE OF THE WEEK
March 17, 2005
Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol 2005;100:232-242
1. Lifestyle modifications that usually lead to improvement in constipation include
a. a “fiber-deficient” fiber
b. not drinking sufficient amounts of water
c. insufficient physical activity in young patients with severe constipation
d. increased physical activity in the elderly with mild constipation
True or False
2. In children, constipation is more common in boys
3. Colonic transit is prolonged during pregnancy, possibly due to higher levels of circulating progesterone.
4. Increasing fluid intake is an effective method for improving constipation
5. A dolichocolon is a long (>200cm) colon which is usually associated with constipation and responds to partial colectomy.
6. The majority of patients presenting with constipation do not achieve significant subjective improvement from fiber therapy.
7. Chronic constipation may be associated with an increased risk in colon cancer
8. Mean colonic transit time changes with the different phases of the menstrual cycle
9. Melanosis coli represent cell debris from colon epithelial cell apoptosis that was taken up by macrophages, and stained by anthraquinones.
10. In general, patients presenting with constipation report a lower fiber intake than those who do not have constipation
11. Tolerance to laxative use rarely develops, except in the most advanced cases with colonic inertia
12. Chronic use of laxatives does not result in colonic damage or increase the risk for colon cancer