Chronic Constipation Is Unhealthy, After All

Doctors for years have told worried patients that constipation is unpleasant, may cause hemorrhoids and increases the risk of deep vein thrombosis, but isn’t inherently unhealthy. However, Mayo Clinic researchers reported at a recent meeting of the American College of Gastroenterology that it may be linked to a 20% rise in the 10-year risk of mortality. They believe constipation may be a ‘marker’ for a yet-to-be-determined disease process, rather than a direct cause of mortality.

The researchers studied 4000 Minnesotan residents, 15% of whom reported chronic constipation. They were followed for ten years, from 1990 to 2000. After this time, 73% of the constipated were alive, compared with 85% of the non-constipated. This was after adjusting for differences in age, gender, smoking, and marital status.

A clue as to the possible causes of increased mortality came when the results were adjusted for 19 other diseases that the participants might have – cardiovascular diseases, cancers, diabetes, liver and kidney disease; when this was done, the measured 20% increase in mortality was reduced to 16%, and was no longer statistically significant (i.e. it could have occurred by chance alone).

It should be noted that this study was supported by Novartis, the manufacturer of Zelnorm® (tegaserod), which is approved for the treatment of long-term constipation. However, it might be better for constipation sufferers to try non-drug means of relief before turning to an expensive drug.

Comments

[Robert Griffith]

Please note that the FDA has asked Novartis to withdraw Zelnorm(R) (tegaserod) because of a very slight risk of increased cardiac effects.