Useful information

First time in Japan! The launch of Constipation Guidelines


There are many people who are suffering from constipation.
They “haven’t pooped in the past few days,” “have been recently suffering from constipated tendencies,” etc.

According to the National Life Basic Survey (by Ministry of Health, Labor and Welfare) in Heisei 28th year (2016) 24.5 men and 45.7 women per 1,000 population suffered from constipation.

Even though you think that you are “constipated,” in reality you are too worried about constipation, and sometimes it shouldn’t be called constipation ….
On the other hand, there are rare cases when serious diseases are hidden behind constipation. So constipation can be a serious problem.

When do you say it’s constipation, if feces are not being passed for days

In October 2017, the Japan Gastroenterology Society published the first “chronic constipation clinical practice guidelines” in Japan.

In the guidelines, constipation is defined as: “feces that should normally be discharged from the body cannot be discharged in sufficient quantity and comfortably.”
Some people are convinced that they are “constipated” if “feces must be excreted everyday” and “every morning, if feces aren’t passed, it’s constipation”. However, even if you don’t have bowel movements every day, even if it’s only once every 2 or 3 days, there is no problem as long as you don’t have a stomach ache, discomfort from bowel movement, or bloated stomach.
It isn’t constipation unless there are unpleasant symptoms, even if feces come out only 3 times a week.

There are different types of constipation

Furthermore, in the guideline, constipation is roughly divided into two types – “defecation frequency reduction type” and “defecation difficulty type” (the type caused by the rectum itself).
And there are also two types of constipation that decrease stool frequency. One is “delayed passage in large intestine” in which fecal matter is stagnated because the peristaltic movement of the intestine is weakened, and the other is “normal colon passage type” which reduces the number of times for feces to pass due to shortage of dietary fiber intake and the amount of dietary consumption.
It is often said that “When experiencing constipation you should eat dietary fiber”. Certainly, if it is constipation of the normal colon passage type, eating a meal including dietary fiber certainly leads to resolution of the constipation.
But the peristaltic movement of the intestines weakens, and the stool remains in the intestine. In the case of constipation with delayed colon transit type, there is concern that if you ingest a lot of dietary fiber, it will cause an obstruction.
The coping method differs depending on what type of constipation it is.

Is yogurt really good for constipation?

Yogurt is also said to be “good for constipation”.
Yogurt has abundant “probiotics” that improve the balance of intestinal flora such as bifidus bacteria and lactic acid bacteria and bring beneficial effects.
However, in the guideline, it is said to be “Recommendation 2 (weak recommendation)” because the evidence has not been fully prepared yet.

Some people who are suffering from chronic constipation may take over-the-counter drugs.
There are three types of constipation medicine.

  • “Functional laxatives” that encourage excretion of the stool or softening the stool
  • “Stimulating laxatives” that directly stimulate the intestines to urge defecation
  • Others

Stimulating laxatives are quick-acting and refreshing, so you may want to try them. However, if you use them all the time, the effect diminishes, or you might become mentally dependent.
Even in the guidelines, use was suggested on an “as needed or short term” basis, so please be careful.