(Foreword: The following information is provided as is, and should not be construed as an endorsement of any kind of the items mentioned. Furthermore, all readers should ask for the advice of a doctor when making choices concerning health. The writer is not a doctor and is providing the article from research obtained from third party sources.)

Numerous statistical figures have quoted that the impact of constipation to be as low as 2% to as high as 30%. A large recent 2006 survey conducted by the famous pharmaceutical company Boehringer Ingelheim pinpoints the number to be at 12% worldwide. Even at 2% though, most people would agree that constipation seems to be a problem afflicting a broad segment of the population.

One explanation for why the statistics are so inconsistent is that constipation has historically been a poorly-defined condition. The poor definitions are due the fact that constipation varies quite a bit between patients. Frequency of bowel movements, time spent straining at the toilet and hardness of feces are but three examples of patient-reported symptoms that vary wildly from person-to-person. Some attempt has been made by both U.S. national agencies and private groups (such as the Rome Foundation) in unifying our definition of constipation. Nevertheless, diagnosis is made difficult by such variations.

Diagnosis of disease is followed by the monumental goal of pinning down the primary cause in each patient. Diagnosis is easy if there are many other tell-tale signs, such as those found in patients with irritable bowel syndrome. In another subgroup, patients may suffer from nerve and muscle damage that are the culprits of constipation. But for a very large group, physicians will be unable to find a cause. In this large group, the condition is simply called “idiopathic constipation”.

Often first line therapy for people diagnosed with chronic idiopathic constipation is introduction of high fiber into diet. Recent studies show that fiber and fluids are effective in only a small fraction of patients. Because of the ease and accessibility of high fiber treatment, it is quite popular with physicians and patients. Response is expected within two weeks, at which time both parties may decide whether the diagnosis and therapy were successful.

Other types of natural treatments include both lubricant laxatives and herbal supplements such as senna. Herbal and natural supplements are not always safe. The FDA has banned some natural supplements, namely aloe vera and cascara recently, for failure on the part of manufacturers to provide sufficient safety data. However, some other over-the-counter treatments remain available.

There are also a number of prescription-only constipation medications available. Some of these act as laxatives, whereas others are special compounds that modulate the functional properties of the gastrointestinal tract. In recent times, exciting therapies such as biofeedback have also risen to prominence. Expect treatments for constipation to advanced greatly in the next few years.

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Functional constipation is defined as that without known causes. There are only a few FDA approved therapies for such a condition, in addition to the standard intense fiber intake.

A third class of less regulated substances known as herbal or natural remedies are also accessible. However, before using them, it’s wise to understand the dangers in even natural or herbal treatments, and whether or not there is any basis in truth for their efficacy.

Before reading the following, please keep in mind what you read is not medical advice but was written solely for educational and medical purposes. In fact, it’s impossible that this article be useful for diagnosis of anyone’s particular condition. Furthermore, products are mentioned in this article not for endorsement, but for educational value.

The class of constipation known as chronic idiopathic constipation is somewhat mysterious because it is only defined in terms of its symptoms, but the causes are, by definition, unknown. If the cause can be found, then it would lose the idiopathic label and become one of several classes of diseases, e.g. rectal prolapse, dyssynergia.

To begin, we must consider that physiological characteristics vary from person to person, such as height, weight, metabolism and more. Among these varying characteristics is the idea of bowel regularity. For the entire life of some, having a bowel movement is mandatory once per day. For others, ever since their childhood they have found that it’s not unusual to go for several days without having a bowel movement. Despite such differences, doctors have come to a broad consensus known as the Rome Criteria, which is a set of conditions that a patient must satisfy to be diagnosed with chronic constipation.

In order to treat chronic constipation, the physician will usually offer the patient three choices. The first choice is to submit to an intense fiber diet for two weeks. The patient will take up to 30 grams of insoluble fiber with the help of supplements and plenty of water. After two weeks, if the diet is deemed successful, then it is considered a correct diagnosis as well as a correct treatment. The second choice is to take one of several, new FDA approved medications for treating chronic constipation. These medicines have passed gold-standard, clinical trials and are deemed most likely to help. The third choice is for the patient to try some non-FDA approved, “natural” medications.

Natural treatments may sound safe, however they should be treated with utmost caution like FDA-approved medicines. For one, correct dosage has never been tested in a scientific way. For another, there are no standards of purity to which a manufacturer must adhere as the natural treatment is not claimed to be a real medicine.

These warnings aside, a patient may still turn to some remedies based on very common ingredients. Some examples include castor oil and prune juice, both of which will be discussed. Can these natural laxatives be classified in any way? One group is known as stimulant laxatives, and cause the intestine to contract more forcefully as well as retain water to assist in expelling lumenal contents. Medical versions of these are the anthraquinones, but also the natural herb senna which contains anthraquinones that have the same sort of effect on the colon.

The other type of natural laxatives include prune juice, mineral and castor oil. Each of these seem to have an effect of increasing water retention. The oils likely coat the digested food mass to prevent fluid loss. Whereas the sorbitol of prune juice cannot be digested and therefore acts like a bulk, fiber material that absorbs water. Water seems to have the effect of helping the contents move swiftly through the gastrointestinal lumen. Indeed prunes are one of the main ingredients in the homemade laxative known as Beverly-Travis.

Just because such products are available for consumption without the need for a prescription doesn’t mean they are safe. If a patient is intent on trying them, it should be done with the help of a physician who understands the patient. If such natural treatments end up working for any patient, then he and his doctor should be congratulated.

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The initial prescription by a physician for treating constipation often contains no medication at all. Instead, a physician will ask a patient to try supplement his or her diet with the addition of extra fiber. The extra fiber may come from natural sources, or from supplements that are derived from natural sources.

A lot of people have heard of supplements such as metamucil that are fortified with loads of fiber. Metamucil is a product made by Procter and Gamble, marketed to people who suffer from constipation. But a little research will show that there are high fiber foods from entirely natural sources. Prunes, or dried plums, are one such example. The most interesting fact is that prunes contain another agent that is beneficial for treating constipation.

Plums have been a part of mankind’s food source for many millennia. Archaeologist evidence shows large number of pits in waste sites that go back to ancient times. Then as now, the process for manufacturing prunes has probably changed relatively little. The plum fruit is harvested from the plant and then arranged in a cool oven structure. The plums are dehydrated at 180 degrees Fahrenheit for a little under 20 hours. The resulting prunes are collected for further processing.

The chemical makeup of prunes is complex, which is one reason for its multipronged effectiveness as a constipation agent. And although we have sufficiently advanced technology to discern these chemicals, we have yet to fully understand the mechanism whereby each chemical aids in laxative activity.

The things we do understand regarding its anti-constipation properties are two folds. First, we know that the high fiber content of prunes means that eating it helps bulk up foods in the way traditional fiber supplements aid digestion. Two, we also know that prunes contain a lot of sorbitol which is a sugar-like substance that retains water and makes stool softer and therefore faster-moving in the gut.

On top of ingredients with laxative properties, prunes are a high energy source. The high energy is derived from its mix of both simple and complex sugars such as glucose and fructose. People who eat prunes get a quick energy boost as well as a sustained one from digestion of complex sugars.

Anecdotal evidence suggests that there are a number of other useful natural chemicals that support human health. One example are the phenolic compounds that seem to amplify the laxative properties of sorbitol and fiber. Another example is the helpful mineral potassium which aids in muscle contraction. Ample potassium ensures proper muscle energy and function.

Although there’s no need to prepare the prunes in a special way before eating, a commercial food preparer in the United Kingdom stumbled upon a home recipe for treating constipation that involves blending prunes with other fruits and vegetables. The recipe, known by the name Beverley-Travis, has become famous and even studied for its efficacy in improving digestive health.

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In 2002, the Federal Drug Administration banned the further marketing of cascara and aloe-based natural laxatives for treating constipation. This action left senna as the sole herb-based treatment. Senna is derived from a plant that is found around the world, but with origins in the region now commonly known as the Middle East and East Africa. In temperate regions, one can find variations of the senna plant. Its shape is essentially a short to medium height shrub.

The name senna has an interesting background, stemming from the Semitic languages such as Arabic and Hebrew, which is suggested by the geographical origins of the plant. The active agent is a compound that is known as an anthraquinone. In broader terms, anthraquinones are found in other substances that have purgative or laxative effects which stimulate the gastrointestinal tract.

As one might guess, the application of the senna herb as a constipation treatment goes back hundreds or even thousands of years. Senna was used in its raw, unprocessed form, without the benefit of modern methods in purification of the active compounds. Today it can be found in semi-processed form like tea leaves, or in more processed forms like capsules.

Even though it’s specified as an herbal supplement, consumers would be wise to know the background of manufacturing companies that sell this product. A company with poor quality control can produce a bad batch of senna. But supposing the company has the highest standards, a consumer should continue to be wary as there may be side effects of this natural laxative that is largely unregulated by stringent pharmaceutical laws. Herbal supplements can cause unintended and dangerous effects.

Continuing on the theme of safety, a consumer is advised to be aware that there are specific warnings that accompany senna. Some studies have raised the point that people who suffer from heart disease or high blood pressure can be adversely affected by senna. These observations suggest that any patient with constipation should ask for the help and guidance of a personal physician prior to starting any kind of treatment.

The original method of consumption was in herb form. In modern times, there are many ways of taking senna. A tea form is available from many producers. Application is as simple as dropping a tea bag in hot water and having some tea. More sophisticated forms also exist. The tea formulation may have been the exact way senna was used in pre-modern times.

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