Evidence map›Paper›PMID 31945360›Full record

ReviewGastroenterology2020

Mechanisms, Evaluation, and Management of Chronic Constipation.

Adil E Bharucha, Brian E Lacy

4 registry-linked trialsOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 308 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
308citing papers in PubMed, 10 pooled it
44.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05612646 nacompletednot on this map

Taiwan Taichung Veterans General Hospital

TypeinterventionalSponsorTaichung Veterans General HospitalRan2020 to 2022Enrolled128ConditionsConstipationArmsAcupressure, routine nursing and fake acupressure
NCT06850415 nacompletednot on this mapstarted 2025, after this paper: background citation

Validation of New Type Radiopaque Marker in The Evaluation of Colonic Transit Time

TypeinterventionalSponsorMahidol UniversityRan2025 to 2025Enrolled20ConditionsSlow Transit Constipation, Colonic Transit, Chronic Constipation, Colonic Transit CapsuleArmsSiriraj gastrointestinal transit capsule, Sitz-Markers
NCT07277907 phase3recruitingnot on this mapstarted 2025, after this paper: background citation

Efficacy and Safety of Lubiprostone in the Treatment of Slow Transit Constipation: A Multicenter, Randomized Controlled Trial

TypeinterventionalSponsorThird Military Medical UniversityRan2025 to 2027Enrolled346ConditionsSlow Transit Constipation, PharmacotherapyArmsLubiprostone, Polyethylene glycol (PEG )
NCT07719504 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Implementation of Physical Therapy Protocol for Functional Constipation

TypeinterventionalSponsorCairo UniversityRan2026 to 2027Enrolled60ConditionsFunctional Constipation (FC)ArmsStandard medical treatment, Maitland orthopedic manual therapy (MOMT), Russian current stimulation (ERS), Passive peristalsis motion techniques, Osteopathic visceral manipulation (OVM)
3 · Its place in the literature

Who cites it

308 citing papers in PubMed, 10 syntheses or guidelines pooled it, 583 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. [Seoul Consensus on Clinical Practice Guidelines for Functional Constipation].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025
    Guideline
  4. Guideline
  5. Pooled it
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  11. Trial
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  17. Adjunctive efficacy of Bifidobacterium animalis subsp. lactis XLTG11 for functional constipation in children.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024
    Trial
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  20. Article

248 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Adil E BharuchaDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. Electronic address: bharucha.adil@mayo.edu.
Brian E LacyDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Jacksonville College · USMayo Clinic · US

Funding

Pathophysiology of Anorectal DisordersR01DK078924 · NIDDK · MAYO CLINIC ROCHESTER · PI BHARUCHA, ADIL E. · 2008 to 2023
$5.0M
NIDDK NIH HHS R01 DK078924
6 · The paper itself

Abstract

With a worldwide prevalence of 15%, chronic constipation is one of the most frequent gastrointestinal diagnoses made in ambulatory medicine clinics, and is a common source cause for referrals to gastroenterologists and colorectal surgeons in the United States. Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic constipation is either a primary disorder (such as normal transit, slow transit, or defecatory disorders) or a secondary one (due to medications or, in rare cases, anatomic alterations). Colonic sensorimotor disturbances and pelvic floor dysfunction (such as defecatory disorders) are the most widely recognized pathogenic mechanisms. Guided by efficacy and cost, management of constipation should begin with dietary fiber supplementation and stimulant and/or osmotic laxatives, as appropriate, followed, if necessary, by intestinal secretagogues and/or prokinetic agents. Peripherally acting μ-opiate antagonists are another option for opioid-induced constipation. Anorectal tests to evaluate for defecatory disorders should be performed in patients who do not respond to over-the-counter agents. Colonic transit, followed if necessary with assessment of colonic motility with manometry and/or a barostat, can identify colonic dysmotility. Defecatory disorders often respond to biofeedback therapy. For specific patients, slow-transit constipation may necessitate a colectomy. No studies have compared inexpensive laxatives with newer drugs with different mechanisms. We review the mechanisms, evaluation, and management of chronic constipation. We discuss the importance of meticulous analyses of patient history and physical examination, advantages and disadvantages of diagnostic testing, guidance for individualized treatment, and management of medically refractory patients.

Indexed as

Chronic DiseaseColonConstipationDefecationDefecographyDietary FiberDietary SupplementsDigital Rectal ExaminationElectromyographyGastrointestinal MotilityHumansIntestinal MucosaLaxativesMagnetic Resonance ImagingManometryPelvic FloorDietary FiberLaxativesReceptors, Opioid, muSecretagogues

Identifiers

PMID31945360
PMCPMC7573977
OpenAlexW3000300599

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.