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12.10.04 -- Constipation and Laxative Use Found to Increase Colon Cancer Risk

By Greg Arnold, DC, CSCS, September 30, 2004, abstracted from “Constipation, laxative use and risk of colorectal cancer: The Miyagi Cohort Study” in the September 2004 issue of the European Journal of Cancer

Constipation is one of the most common gastrointestinal complaints in the United States, resulting in about 2 million doctor visits annually. According to the 1996 National Health Interview Survey, about 3 million people in the United States suffer from constipation, particularly women and adults aged 65 and over.1

Constipation’s role as a risk factor for colon cancer has received inconsistent reviews in the literature. While a review found a significantly increased risk between constipation and colon cancer,2 the only prospective cohort study ever conducted did not support an association between constipation and colon cancer.3

Regardless of the risk, patients turn to laxatives to help treat their constipation, with laxative sales exceeding $500 million each year.4 Now a new study5 suggests that constipation coupled with laxative use is a risk for colon cancer.

Researchers studied questionnaires completed by nearly 42,000 Japanese men and women 40-64 years old. The questionnaire asked about education, personal and family history of cancer and other diseases, health habits, including frequency of bowel movements, laxative use, smoking, alcohol consumption, diet and physical activity.

The researcher found a “modest, marginally significant, association” between constipation and colon cancer. They also found an increased risk between laxative use and colon cancer, agreeing with previous studies.6 While constipation is thought to contribute to colon cancer due to the increased the time ammonium acetate in waste has to be absorbed by the body,7 laxatives are thought to contribute to cancer risk because of their ingredients.8

When looking at ways to remedy this situation, we can look to fiber intake among Americans. The National Center for Health Statistics9 states that Americans eat an average of 5 to 14 grams of fiber each, far short of the 20 to 35 grams recommended by the American Dietetic Association.

Supplementation can be very effective in helping Americans increase their daily fiber intake. One such supplement is psyllium husk fiber, with one tablespoon providing 7 grams of fiber. Recent research has found psyllium to exhibit anti-cancer properties, with 3.5 grams of psyllium per day helping to prevent colon cancer.10

Reference:
1 National Library of Medicine’s National Digestive Diseases Information Clearinghouse (NDDIC) website http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/index.htm

2 Sonnenberg, A. and A.D. Muller, Constipation and cathartics as risk factors of colorectal cancer: a meta-analysis. Pharmacology, 1993. 47 Suppl 1: p. 224-33

3 Dukas, L., et al., Prospective study of bowel movement, laxative use, and risk of colorectal cancer among women. Am J Epidemiol, 2000. 151(10): p. 958-64

4 Murray, M. Natural Alternatives to OTC and Prescription Drugs, Morrow, NY, 1994, p. 196

5 Watanabe, T., et al., Constipation, laxative use and risk of colorectal cancer: The Miyagi Cohort Study. Eur J Cancer, 2004. 40(14): p. 2109-15

6 Wu, A.H., et al., Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer, 1987. 55(6): p. 687-94

7 Zarkovic, M., et al., Tumor promotion by fecapentaene-12 in a rat colon carcinogenesis model. Carcinogenesis, 1993. 14(7): p. 1261-4

8 Borrelli, F., et al., Effect of bisacodyl and cascara on growth of aberrant crypt foci and malignant tumors in the rat colon. Life Sci, 2001. 69(16): p. 1871-7

9 National Center for Health Statistics. Dietary Intake of Macronutrients, Micronutrients, and Other Dietary Constituents: United States, 1988-94. Vital and Health Statistics, Series 11, number 245. July 2002

10 Bonithon-Kopp, C., et al., Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group. Lancet, 2000. 356(9238): p. 1300-6

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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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