title: Constipation in adults.
abstract: BACKGROUND
  Although there are defined criteria for the diagnosis of constipation, in practice, diagnostic criteria are less rigid, and in part depend on the perception of normal bowel habit. Constipation is highly prevalent, with approximately 12 million general practitioner prescriptions for laxatives in England in 2001.
  
  
  METHODS
  We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions, and of other interventions, in adults with idiopathic chronic constipation? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  
  
  RESULTS
  We found 42 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
  
  
  CONCLUSIONS
  In this systematic review we present information relating to the effectiveness and safety of the following interventions: arachis oil, biofeedback, bisacodyl, cascara, docusate, exercise, glycerine suppositories, glycerol, high-fibre diet, increasing fluids, ispaghula husk, lactitol, lactulose, macrogols (polyethylene glycols), magnesium salts, methylcellulose, paraffin, phosphate enemas, seed oils, senna, sodium citrate enemas, sterculia.
authors.affiliation: Christchurch Hospital and School of Medicine, Christchurch, New Zealand.
authors.forename: Frank
authors.initials: F
authors.lastname: Frizelle
authors.forename: Murray
authors.initials: M
authors.lastname: Barclay
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D001726:Bisacodyl / Q000494:pharmacology; D003248:Constipation; D003672:Defecation / Q000187:drug effects; D006801:Humans; D011092:Polyethylene Glycols / Q000494:pharmacology
chemical_list: D001726:Bisacodyl; D011092:Polyethylene Glycols