Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Mild dehydration: a risk factor of constipation?

Abstract

Constipation defined as changes in the frequency, volume, weight, consistency and ease of passage of the stool occurs in any age group. The most important factors known to promote constipation are reduced physical activity and inadequate dietary intake of fibres, carbohydrates and fluids. Fluid losses induced by diarrhoea and febrile illness alter water balance and promote constipation. When children increase their water consumption above their usual intake, no change in stool frequency and consistency was observed. The improvement of constipation by increasing water intake, therefore, may be effective in children only when voluntary fluid consumption is lower-than-normal for the child's age and activity level. In the elderly, low fluid intake, which may be indicative of hypohydration, was a cause of constipation and a significant relationship between liquid deprivation from 2500 to 500 ml per day and constipation was reported. Dehydration is also observed when saline laxatives are used for the treatment of constipation if fluid replacement is not maintained and may affect the efficacy of the treatment. While sulphate in drinking water does not appear to have a significant laxative effect, fluid intake and magnesium sulphate-rich mineral waters were shown to improve constipation in healthy infants. In conclusion, fluid loss and fluid restriction and thus de-or hypohydration increase constipation. It is thus important to maintain euhydration as a prevention of constipation.

Your institute does not have access to this article

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1

References

  • Abrahamsson H, Antov S & Bosaeus I (1988): Gastrointestinal and colonic segmental transit time evaluated by single abdominal X-ray in healthy subjects and constipated patients. Scand. J. Gastroenterol. 23, 72–80.

    Google Scholar 

  • Alvarezlara MA, Martinmalo A, Espinosa M, Rodriguezbenot A & Aljama P (2001): Blood pressure and body water distribution in chronic renal failure patients. Nephrol. Dial. Transpl. 16(Suppl 1), 94–97.

    Google Scholar 

  • American College of Gastroenterology's Committee (1985): Laxative use in constipation. Am. J. Gastroenterol 8, 303–309.

  • Anonymous (1999): Study shows fluid, calcium intake have no effect on childhood constipation. J. Am. Diet. Assoc 9, 190.

  • Bank S & Marks IN (1977): The aetiology, diagnosis and treatment of constipation and diarrhoea in geriatric patients. S. A. Med. J. 51, 409–414.

    CAS  Google Scholar 

  • Borovnicar DJ, Stroud DB, Bines JE, Haslam RHM & Strauss BJG (2000): Comparison of total body chlorine, potassium, and water measurements in children with cystic fibrosis. Am. J. Clin. Nutr. 71, 36–43.

    CAS  PubMed  Google Scholar 

  • Branski D, Sharon P & Abrahamov A (1986): Prostaglandins in disorders of the intestinal tract: a review. J. Pediatr. Gastroenterol. Nutr. 5, 853–860.

    CAS  PubMed  Google Scholar 

  • Brodribb AJM & Groves C (1978): Effect of bran particle size on stool weight. Gut 19, 60–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Burkitt DP, Walker ARP & Painter NS (1972): Effect of dietary fiber on stools and transit-time and its role in the causation of disease. Lancet II, 1408–1411.

    Google Scholar 

  • Calloway NA (1964): A clinical investigation of fecal pH in geriatric constipation: corrective therapy. J. Am. Geriatr. Soc. 12, 368–371.

    CAS  PubMed  Google Scholar 

  • Cann PA, Read NW, Brown C, Hobson N & Holdsworth CD (1983): The irritable bowel syndrome (IBS) relationship of disorders in the transit of a single solid meal to symptom patterns. Gut 24, 405–411.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Chien L, Robertson H & Gerrard J (1968): Infantile gastroenteritis due to water with high sulfate content. Can. Med. Assoc. J. 99, 102–104.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Chung BD, Parekh U & Sellin JH (1999): Effect of increased fluid intake on stool output in normal healthy volunteers. J. Clin. Gastroenterol. 28, 29–32.

    CAS  PubMed  Google Scholar 

  • Clark CG & Godfrey J (1981): Constipation—a simple approach to treatment. J. R. Coll. Gen. Pract. 31, 38–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Clayden GS (1992): Management of chronic constipation. Arch. Dis. Child. 67, 340–344.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Constant F, Morali A, Arnaud MJ, Delabroise AM, Thirion F, Matisse N, Wagner M, Dohn JP, Vuillemin JL & Gay G (1999): Traitement de la constipation primaire du nourrisson: etude comparative et randomisée de deux eaux minérales (60 cas). Arch. Pédiatr. 6(Suppl 2), P100, 553s.

    Google Scholar 

  • Corazziari E, Cucchiara S, Staiano A, Romaniello G, Tamburrini O, Torsoli A & Auricchio S (1985): Gastrointestinal transit time, frequency of defecation, and anorectal manometry in healthy and constipated children. J. Pediatr. 106, 379–382.

    CAS  PubMed  Google Scholar 

  • Dardaine V, Desveaux A & Constans (1994): La constipation chez le sujet âgé. Rev. Méd. Tours 28, 343–346.

    Google Scholar 

  • Davies GJ, Crowder M, Reid B & Dickerson JWT (1986): Bowel function measurements of individuals with different eating patterns. Gut 27, 164–169.

    CAS  PubMed  PubMed Central  Google Scholar 

  • De Lorenzo A, Andreoli A, Fusco A, Magnani A, D'Orazio N & Bertoli A (2000): Effect of subclinical hypothyroidism on body fluid compartments. Horm. Metab. Res. 32, 359–363.

    CAS  PubMed  Google Scholar 

  • Donowitz M (1979): Current concepts of laxative action: mechanisms by which laxatives increase stool water. Clin. Gastroenterol. 1, 77–84.

    CAS  Google Scholar 

  • Dresen K-A & Krattzer GL (1959): Fecal impaction in modern practice. JAMA 170, 644–647.

    CAS  Google Scholar 

  • Ehrenpreis T (1971): Hirschsprung's disease. Digest. Dis. 16, 1032–1052.

    CAS  Google Scholar 

  • Esteban E, Rubin C, McGeehin M, Flanders D, Baker MJ & Sinks TH (1997): Evaluation of human health effects associated with elevated levels of sulfate in drinking water: a cohort investigation in South Dakota. Int. J. Occup. Med. Environ. Health 3, 171–176.

    CAS  Google Scholar 

  • Federal Register Notice, US EPA (1999): Health effects from exposure to high levels of sulfate. In: Drinking Water Study and Sulfate Workshop. 21 January, EPA 815-R-99-001, pp. 1–25 and 11 February, vol 64, pp 7028–7030.

  • Felt B, Wise CG, Olson A, Kochhar P, Marcus S & Coran A (1999): Guideline for the management of pediatric idiopathic constipation and soiling. Arch. Pediatr. Adolesc. Med. 153, 380–385.

    CAS  PubMed  Google Scholar 

  • Fingl E (1983): Laxatives and cathartics. In: The Pharmacological Basis of Therapeutics. 6 th Edition, eds. A Gilman, LS Goodman & A Gilman, pp 1002–1012. New York: Macmillan Publishing.

    Google Scholar 

  • Fitzgerald JF (1987): Constipation in children. Pediatr. Rev. 8, 299–302.

    CAS  PubMed  Google Scholar 

  • Frithz G, Wictorin B & Ronquist G (1991): Calcium induced constipation in a prepubescent boy. Acta Paediatr. Scand. 80, 964–965.

    CAS  PubMed  Google Scholar 

  • Gomez GG, Sandler RS & Seal E (1995): High levels of inorganic sulfate cause diarrhea in neonatal piglets. J. Nutr. 125, 2322–2325.

    Google Scholar 

  • Gore RM, Mintzer RA & Calenoff L (1981): Gastrointestinal complications of spinal cord injury. Spine 6, 538–544.

    CAS  PubMed  Google Scholar 

  • Grossi F & Scalabrino A (1996): Thermal therapy of functional dyskinesias of the alimentary tract. Clin. Ther. 148, 105–115.

    Google Scholar 

  • Heizer WD, Sandler RS, Seal E, Murray SC, Busby MG, Schliebe BG & Pusek SN (1997): Intestinal effects of sulfate of drinking water on normal human subjects Digest. Dis. Sci. 42, 1055–1061.

    CAS  Google Scholar 

  • Hirschsprung H (1887): Stuhlträgheit Neugeborener in Folge von Dilatation und Hypertrophie des Colon. Jahrb. Kinderh. 27, 1–7.

    Google Scholar 

  • Hyams DE (1974): Gastrointestinal problems in the old. I. BMJ 1, 107–110.

    CAS  PubMed  Google Scholar 

  • Ishikawa S (2000): Urinary excretion of aquaporin-2 in pathological states of water metabolism. Ann. Med. 32, 90–93.

    CAS  PubMed  Google Scholar 

  • Issenmann RM, Hewson S, Pirhonen D, Taylor W & Tirosh A (1987): Are chronic digestive complaints the result of abnormal dietary patterns? Diet and digestive complaints in children at 22 and 40 months of age. Am. J. Dis. Child. 141, 679–682.

    Google Scholar 

  • Kamm MA & Speakman CTM (1993): Constipation, fecal impaction and laxatives. In: Gastroenterology: Clinical Science and Practice. ed. Bouchier IA, Allan RN, Hodgson HJ & Keighley MR, pp 790–813. Philadelphia, PA: Saunders.

    Google Scholar 

  • Kelsay JL, Behall KM & Prather ES (1978): Effect of fiber from fruits and vegetables on metabolic responses of human subjects. I. Bowel transit time, number of defecations, fecal weight, urinary excretions of energy and nitrogen and apparent digestibilities of energy, nitrogen, and fat. Am. J. Clin. Nutr. 31, 1149–1153.

    CAS  PubMed  Google Scholar 

  • Kinnunen O & Salokannel J (1989): Comparison of the effects of magnesium hydroxide and a bulk laxative on lipids, carbohydrates, vitamins A and E, and minerals in geriatric hospital patients in the treatment of constipation. J. Int. Med. Res. 17, 442–454.

    CAS  PubMed  Google Scholar 

  • Klauser AG, Beck A, Schindlbeck NE & Müller-Lissner SA (1990): Low fluid intake lowers stool output in healthy male volunteers. Z. Gastroenterol. 28, 606–609.

    CAS  PubMed  Google Scholar 

  • Klein H (1982): Constipation and fecal impaction. Med. Clin. North Am. 66, 1135–1141.

    CAS  PubMed  Google Scholar 

  • Kreek M-J, Hahn EF, Schaefer RA & Fishman J (1983): Naloxone, a specific opioid antagonist, reverse chronic idiopathic constipation. Lancet I, 261–262.

    Google Scholar 

  • Krevsky B, Maurer AH, Niewiarowski T & Cohen S (1992): Effect of verapamil on human intestinal transit. Digest. Dis. Sci. 37, 919–924.

    CAS  PubMed  Google Scholar 

  • Lampe JW, Fredstrom SB, Slavin JL & Potter JD (1993): Sex difference in colonic function: a randomised trial. Gut 34, 531–536.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Lembcke B & Fuchs C (1984): Magnesium load induced by ingestion of magnesium-containing antacids. Contr. Nephrol. 38, 185–194.

    CAS  Google Scholar 

  • Leung AKC, Chan PYH & Cho HYH (1996): Constipation in children. Am. Fam. Physician 54, 611–618.

    CAS  PubMed  Google Scholar 

  • Lewis LG & Rudolph CD (1997): Practical approach to defecation disorders in children. Pediatr. Ann. 26, 260–268.

    CAS  PubMed  Google Scholar 

  • Lindeman RD, Romero LJ, Liang HC, Baumgartner RN, Koehler KM & Garry PJ (2000): Do elderly persons need to be encouraged to drink more fluid? J. Gerontol. Med. Sci. 55A, M361–M365.

    Google Scholar 

  • Loening-Baucke VA (1984): Sensitivity of the sigmoid colon and rectum in children treated for chronic constipation. J. Pediatr. Gastroenterol. Nutr. 3, 454–459.

    CAS  PubMed  Google Scholar 

  • Loening-Baucke V (1993a): Constipation in early childhood: patient characteristics, treatment, and longterm follow up. Gut 34, 1400–1404.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Loening-Baucke V (1993b): Chronic constipation in children. Gastroenterology 105, 1557–1584.

    CAS  PubMed  Google Scholar 

  • Loening-Baucke V & Younoszai MK (1984): Effect of treatment on rectal and sigmoid motility in chronically constipated children. Pediatrics 73, 199–205.

    CAS  PubMed  Google Scholar 

  • McClung HJ, Boyne L & Heitlinger L (1995): Constipation and dietary fiber intake in children. Pediatrics 96, 999–1001.

    CAS  PubMed  Google Scholar 

  • McRorie J, Pepple S & Rudolph C (1998): Effects of fiber laxatives and calcium docusate on regional water content and viscosity of digesta in the large intestine of the pig. Digest. Dis. Sci. 43, 738–745.

    CAS  PubMed  Google Scholar 

  • Meunier P, Marechal JM & Jaubert de Beaujeu M (1979a): Rectoanal pressures and rectal sensitivity studies in chronic childhood constipation. Gastroenterology 77, 330–336.

    CAS  PubMed  Google Scholar 

  • Meunier P, Rochas A & Lambert R (1979b): Motor activity of the sigmoid colon in chronic constipation: comparative study with normal subjects. Gut 20, 1095–1101.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Murtag J (1990): Constipation. Aust. Fam. Physician 19, 1693–1697.

    Google Scholar 

  • Nyhan WL (1952): Stool frequency of normal infants in the first week of life. Pediatrics 10, 414–425.

    CAS  PubMed  Google Scholar 

  • Nyska A, Waner T, Galiano A & Fich A (1994): Constipation and megacolon in rats related to treatment with oxodipine, a calcium antagonist. Toxicol. Pathol. 22, 589–594.

    CAS  PubMed  Google Scholar 

  • Olney L (1976): Constipation in childhood. Am. Fam. Physician 13, 85–89.

    CAS  PubMed  Google Scholar 

  • Portenoy RK (1987): Constipation in the cancer patient: causes and management. Med. Clin. North Am. 71, 303–311.

    CAS  PubMed  Google Scholar 

  • Read NW, Abouzekry L, Read MG, Howell RP, Ottewell D & Donnelly TC (1985): Anorectal function in elderly patients with fecal impaction. Gastroenterology 89, 959–966.

    CAS  PubMed  Google Scholar 

  • Read NW & Timms JM (1986): Defecation and the pathophysiogy of constipation. Clin. Gastroenterol. 15, 937–965.

    CAS  PubMed  Google Scholar 

  • Read NW & Timms JM (1987): Pathophysiology of constipation. Acta Gastroenterol. Belg. 50, 393–404.

    CAS  PubMed  Google Scholar 

  • Rendtorff RC & Kashgarian M (1967): Stool patterns of healthy adult males. Dis. Colon Rectum 10, 222–228.

    CAS  PubMed  Google Scholar 

  • Robson KM, Kiely DK & Lembo T (2000): Development of constipation in nursing home residents. Dis. Colon Rectum 43, 940–943.

    CAS  PubMed  Google Scholar 

  • Smith GA, Perry JF & Yonehiro EG (1955): Mechanical intestinal obstruction. A study of 1252 cases. Surg. Gynecol. Obstetr. 100, 651–660.

    CAS  Google Scholar 

  • Squires RH & Doerck M (1993): Constipation. In: Pediatric Therapy. eds. Eichenwald HF, Stroder J & Ginsburg CM, pp 127–131. St Louis, MO: Mosby Year Book.

    Google Scholar 

  • Tasman-Jones C (1973): Constipation: pathogenesis and management. Drugs 5, 220–226.

    CAS  PubMed  Google Scholar 

  • Tedesco FJ (1985): Laxative use in constipation. Am. J. Gastroenterol. 80, 303–309.

    CAS  PubMed  Google Scholar 

  • Thompson WG (1980): Laxatives: clinical pharmacology and rational use. Drugs 19, 49–58.

    CAS  PubMed  Google Scholar 

  • Towers AL, Burgio KL, Locher JL, Merkel IS, Safaeian M & Wald A (1994): Constipation in the elderly: influence of dietary, psychological and physiological factors. J. Am. Geriatr. Soc. 42, 701–706.

    CAS  PubMed  Google Scholar 

  • Tremaine WJ (1990): Chronic constipation: causes and management. Hosp. Pract. 25, 89–100.

    CAS  Google Scholar 

  • Varma JS, Bradnock J, Smith RG & Smith AN (1988): Constipation in the elderly. A physiologic study. Dis. Colon Rectum 31, 111–115.

    CAS  PubMed  Google Scholar 

  • Veenhuizen MF (1993): Association between water sulfate and diarrhea in swine on Ohio farms. J. Am. Vet. Med. Assoc. 202, 1255–1260.

    CAS  PubMed  Google Scholar 

  • Veenhuizen MF, Shurson GC & Kohler EM (1992): Effect of concentration and source of sulfate on nursery pig performance and health. J. Am. Vet. Med. Assoc. 201, 1203–1208.

    CAS  PubMed  Google Scholar 

  • Waggener HU (1966): Fecal incontinence in normal children secondary to chronic fecal impaction. Med. Time 94, 503–504.

    CAS  Google Scholar 

  • Weaver LT (1988): Bowel habit from birth to old age. J. Pediatr. Gastroenterol. Nutr. 7, 637–640.

    CAS  PubMed  Google Scholar 

  • Weber J, Denis Ph, Mihout B, Muller JM, Blanquart F, Galmiche JP, Simon P & Pasquis P (1985): Effect of brain-stem lesion on colonic and anorectal motility study on three patients. Digest. Dis. Sci. 30, 419–425.

    CAS  PubMed  Google Scholar 

  • Welch JP, Schweizer RT & Bartus SA (1980): Management of antacid impactions in hemodialysis and renal transplant patients. Am. J. Surg. 139, 561–568.

    CAS  PubMed  Google Scholar 

  • Wrenn K (1989): Fecal impaction. N. Eng. J. Med. 321, 658–662.

    CAS  Google Scholar 

  • Wright BA & Staats DO (1986): The geriatric implications of fecal impaction. Nurs. Pract. 11, 53–66.

    CAS  Google Scholar 

  • Young RJ, Beerman LE & Vanderhoof (1998): Increasing oral fluid in chronic constipation in children. Gastroenterol. Nurs. 21, 156–161.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

Guarantor: MJ Arnaud.

Corresponding author

Correspondence to M J Arnaud.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Arnaud, M. Mild dehydration: a risk factor of constipation?. Eur J Clin Nutr 57, S88–S95 (2003). https://doi.org/10.1038/sj.ejcn.1601907

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1601907

Keywords

  • constipation
  • water intake
  • dehydration
  • hypohydration
  • treatment

Further reading

Search

Quick links