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Zeng XL, Zhu LJ, Yang XD. Exploration of the complex origins of primary constipation. World J Clin Cases 2024; 12:5476-5482. [DOI: 10.12998/wjcc.v12.i24.5476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/11/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Constipation is a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty in passing stools. It can significantly affect an individual's quality of life and overall well-being. Understanding the causes of constipation is important for its effective management and treatment. In this paper, we have reviewed the primary causes of constipation or functional constipation. Primary constipation is a bowel disorder associated with colonic or anorectal sensorimotor or neuromuscular dysfunction. As per the literature, it is multifactorial and involves factors such as decreased interstitial cells of Cajal, altered colonic motility, enteric nervous system dysfunction, intestinal flora disturbances, and psychological influences. Clinical symptoms include difficulty in defecation, decreased frequency of defecation, or a feeling of incomplete evacuation. A comprehensive evaluation and management of constipation require an interdisciplinary approach incorporating dietary modifications, lifestyle changes, pharmacotherapy, and psychological interventions. Further research is imperative to explain the intricate mechanisms underlying constipation and develop targeted therapies for improved patient outcomes.
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Affiliation(s)
- Xing-Lin Zeng
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Lian-Jun Zhu
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
| | - Xiang-Dong Yang
- Colorectal and Anal Surgery, Chengdu Anorectal Hospital, Chengdu 610015, Sichuan Province, China
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DCunha AR, Rai SB, Rao SS, D'Souza N. Understanding Childhood Constipation through the Prism of the Caretaker. J Indian Assoc Pediatr Surg 2023; 28:400-406. [PMID: 37842221 PMCID: PMC10569270 DOI: 10.4103/jiaps.jiaps_103_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Childhood constipation is presenting with increasing frequency at pediatric surgical clinics. The caregiver's role in prevention and management is pivotal. This study aimed at determining mothers' knowledge, attitudes, and practices with regard to childhood constipation and the association of these with demographic variables. Materials and Methods This was a survey-based descriptive study conducted at a tertiary care hospital in South India. Randomly selected mothers of children aged 1-10 years consulting for any problem other than constipation were included in the study. Data collection was done by means of a pretested and prevalidated questionnaire. Results There were 169 mothers with a median age of 30 years. Over half were homemakers and of a rural background. Urban mothers scored better than their rural counterparts in the attitude section (P = 0.034). Mothers with greater knowledge had better attitude (P = 0.001) and practice (P = 0.020) scores. Those with higher attitude scores also fared better in the practice section (P = 0.04). Conclusions Knowledge, attitude and practice concerning childhood constipation are connected to each other. South Indian mothers are sufficiently aware of the nuances surrounding childhood constipation, but focused large-scale outreach programs and health education are necessary to bridge the gaps.
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Affiliation(s)
- Aureen Ruby DCunha
- Department of Pediatric Surgery, KS Hegde Medical Academy, Deralakatte, Karnataka, India
| | - Sandeep B. Rai
- Department of Pediatric Surgery, KS Hegde Medical Academy, Deralakatte, Karnataka, India
| | - Swathi Sunil Rao
- Department of Pediatrics, KS Hegde Medical Academy, Deralakatte, Karnataka, India
| | - Neevan D'Souza
- Department of Biostatistics, KS Hegde Medical Academy, Deralakatte, Karnataka, India
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Procházková N, Venlet N, Hansen ML, Lieberoth CB, Dragsted LO, Bahl MI, Licht TR, Kleerebezem M, Lauritzen L, Roager HM. Effects of a wholegrain-rich diet on markers of colonic fermentation and bowel function and their associations with the gut microbiome: a randomised controlled cross-over trial. Front Nutr 2023; 10:1187165. [PMID: 37324737 PMCID: PMC10267323 DOI: 10.3389/fnut.2023.1187165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023] Open
Abstract
Background Diets rich in whole grains are associated with health benefits. Yet, it remains unclear whether the benefits are mediated by changes in gut function and fermentation. Objective We explored the effects of whole-grain vs. refined-grain diets on markers of colonic fermentation and bowel function, as well as their associations with the gut microbiome. Methods Fifty overweight individuals with increased metabolic risk and a high habitual intake of whole grains (~69 g/day) completed a randomised cross-over trial with two 8-week dietary intervention periods comprising a whole-grain diet (≥75 g/day) and a refined-grain diet (<10 g/day), separated by a washout period of ≥6 weeks. A range of markers of colonic fermentation and bowel function were assessed before and after each intervention. Results The whole-grain diet increased the levels of faecal butyrate (p = 0.015) and caproate (p = 0.013) compared to the refined-grain diet. No changes in other faecal SCFA, BCFA or urinary levels of microbial-derived proteolytic markers between the two interventions were observed. Similarly, faecal pH remained unchanged. Faecal pH did however increase (p = 0.030) after the refined-grain diet compared to the baseline. Stool frequency was lower at the end of the refined-grain period compared to the end of the whole-grain diet (p = 0.001). No difference in faecal water content was observed between the intervention periods, however, faecal water content increased following the whole-grain period compared to the baseline (p = 0.007). Dry stool energy density was unaffected by the dietary interventions. Nevertheless, it explained 4.7% of the gut microbiome variation at the end of the refined-grain diet, while faecal pH and colonic transit time explained 4.3 and 5%, respectively. Several butyrate-producers (e.g., Faecalibacterium, Roseburia, Butyriciococcus) were inversely associated with colonic transit time and/or faecal pH, while the mucin-degraders Akkermansia and Ruminococcaceae showed the opposite association. Conclusion Compared with the refined-grain diet, the whole-grain diet increased faecal butyrate and caproate concentrations as well as stool frequency, emphasising that differences between whole and refined grains affect both colonic fermentation and bowel habits.
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Affiliation(s)
- Nicola Procházková
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Naomi Venlet
- Host-Microbe Interactomics, Wageningen University and Research, Wageningen, Netherlands
| | - Mathias L. Hansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Christian B. Lieberoth
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Lars Ove Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Martin I. Bahl
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Tine Rask Licht
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Michiel Kleerebezem
- Host-Microbe Interactomics, Wageningen University and Research, Wageningen, Netherlands
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Henrik M. Roager
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
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Wang H, Gou W, Su C, Du W, Zhang J, Miao Z, Xiao C, Jiang Z, Wang Z, Fu Y, Jia X, Ouyang Y, Jiang H, Huang F, Li L, Zhang B, Zheng JS. Association of gut microbiota with glycaemic traits and incident type 2 diabetes, and modulation by habitual diet: a population-based longitudinal cohort study in Chinese adults. Diabetologia 2022; 65:1145-1156. [PMID: 35357559 PMCID: PMC9174105 DOI: 10.1007/s00125-022-05687-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/24/2022] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS The gut microbiome is mainly shaped by diet, and varies across geographical regions. Little is known about the longitudinal association of gut microbiota with glycaemic control. We aimed to identify gut microbiota prospectively associated with glycaemic traits and type 2 diabetes in a geographically diverse population, and examined the cross-sectional association of dietary or lifestyle factors with the identified gut microbiota. METHODS The China Health and Nutrition Survey is a population-based longitudinal cohort covering 15 provinces/megacities across China. Of the participants in that study, 2772 diabetes-free participants with a gut microbiota profile based on 16S rRNA analysis were included in the present study (age 50.8 ± 12.7 years, mean ± SD). Using a multivariable-adjusted linear mixed-effects model, we examined the prospective association of gut microbiota with glycaemic traits (fasting glucose, fasting insulin, HbA1c and HOMA-IR). We constructed a healthy microbiome index (HMI), and used Poisson regression to examine the relationship between the HMI and incident type 2 diabetes. We evaluated the association of dietary or lifestyle factors with the glycaemic trait-related gut microbiota using a multivariable-adjusted linear regression model. RESULTS After follow-up for 3 years, 123 incident type 2 diabetes cases were identified. We identified 25 gut microbial genera positively or inversely associated with glycaemic traits. The newly created HMI (per SD unit) was inversely associated with incident type 2 diabetes (risk ratio 0.69, 95% CI 0.58, 0.84). Furthermore, we found that several microbial genera that were favourable for the glycaemic trait were consistently associated with healthy dietary habits (higher consumption of vegetable, fruit, fish and nuts). CONCLUSIONS/INTERPRETATION Our results revealed multiple gut microbiota prospectively associated with glycaemic traits and type 2 diabetes in a geographically diverse population, and highlighted the potential of gut microbiota-based diagnosis or therapy for type 2 diabetes. DATA AVAILABILITY The code for data analysis associated with the current study is available at https://github.com/wenutrition/Microbiota-T2D-CHNS.
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Affiliation(s)
- Huijun Wang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Wanglong Gou
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Chang Su
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Wenwen Du
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Jiguo Zhang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Zelei Miao
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Congmei Xiao
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Zengliang Jiang
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Zhihong Wang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Yuanqing Fu
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Xiaofang Jia
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Yifei Ouyang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Hongru Jiang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Feifei Huang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Li Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China
| | - Bing Zhang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China.
- Key Laboratory of Trace Element Nutrition, National Health Commission, Beijing, China.
| | - Ju-Sheng Zheng
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China.
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China.
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, China.
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Association between Dietary Factors and Constipation in Adults Living in Luxembourg and Taking Part in the ORISCAV-LUX 2 Survey. Nutrients 2021; 14:nu14010122. [PMID: 35010999 PMCID: PMC8746799 DOI: 10.3390/nu14010122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022] Open
Abstract
Constipation, a disorder of bowel movements, is among the most frequent gastrointestinal complaints in Western countries. Dietary constituents such as inadequate fiber intake have been related to constipation, but discrepancies exist in the findings regarding dietary factors. This study investigated the association between dietary patterns and bowel movements in adults living in Luxembourg. Data from 1431 participants from ORISCAV-LUX 2 (a cross-sectional survey) who completed a 174-item food frequency questionnaire (FFQ) were analyzed. A questionnaire-based constipation score was assessed by a validated scoring system. Confounders such as physical activity and serum/urine indicators were assessed. Women had higher constipation scores than men (p < 0.001). In food group-based regression models, a negative association was found between higher constipation score and intake of grains (Beta = −0.62, 95%CI: −1.18, −0.05) and lipid-rich foods (Beta = −0.84, 95%CI: −1.55, −0.13), while a positive association was found for sugary products (Beta = 0.54, 95%CI: 0.11, 0.97) (p < 0.05). In a nutrient-based regression model, a positive association was found between constipation score and total energy (Beta = 5.24, 95%CI: 0.37, 10.11) as well as sodium intake (Beta = 2.04, 95%CI: 0.21, 3.87), and a negative one was found for total fats (Beta = −4.17, 95%CI: −7.46, −0.89) and starch (Beta = −2.91, 95%CI: −4.47, −1.36) (p < 0.05). Interestingly, neither fruits and vegetables or dietary fiber were significantly associated with constipation. Thus, grains, lipid-rich foods, total fats and starch were associated with a lower constipation score, while sugary products, sodium, and higher energy intake were correlated with higher constipation.
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