Constipation, 13 million Italians suffer from it, laxative abuse increases

Over 13 million Italians are affected by constipation , a problem as widespread as it is misunderstood. In the vast majority of cases, the disorder is treated with laxatives and herbs , even though in 80% of cases they do not represent an effective and lasting solution. Despite this, according to data from AIFA (Italian Medicines Agency) , the overall expenditure on laxatives in 2023 reached 130 million euros, up 4.5% compared to the previous year . To these must be added approximately 2.4 billion euros of expenditure on plant-based laxatives. Adolfo Renzi, head of the Functional Diseases of the Esophagus and Colon-Rectal Unit at Buon Consiglio Fatebenefratelli Hospital in Naples, highlighted the abuse, understood as widespread and inappropriate use, of drugs and herbs for laxative purposes during the second “Hot Topics in Functional Digestive Surgery Meeting” conference, promoted by Buon Consiglio Fatebenefratelli Hospital in Naples and the Italian Unitary Society of Colon-Proctology (SIUCP), which just concluded in Naples.

“Many people think that constipation is a single pathology, but in reality it is a symptom with multiple causes – explains the expert – Mainly, there are two types: constipation due to slow intestinal transit and that due to difficulty defecating. The latter, in particular, is linked to anatomical obstacles such as rectal prolapse, rectocele, rectal intussusception, cystocele and pelvic floor dysfunction. For this type of constipation, which represents 80% of total cases, it is essential to contact colon-proctologists. These specialists can diagnose through tests such as defecography or defeco-MRI, and identify specific problems”.

Symptoms reported by patients with constipation are generally excessive and prolonged straining during defecation; a sense of anal obstruction or blockage; a sensation of incomplete evacuation and the use of manual maneuvers or aids such as enemas and suppositories. “ Those who suffer most from it are middle-aged women , perhaps with one or more pregnancies, who report incomplete intestinal emptying. Constipation can significantly reduce people's quality of life, making travel and vacations stressful and problematic in particular. The tendency, however, is to resort to palliatives, such as laxatives, which in 3 out of 4 cases are useless or can even prove harmful even if 'natural'”.

Before resorting to laxatives, experts increasingly emphasize the fundamental importance of a diet rich in fiber (fruit, vegetables, whole grains, legumes), adequate hydration (at least 1.5-2 liters of water a day) and regular physical activity as the first line of defense against constipation . But when the problem persists, it is advisable to consult a specialist and go deeper.

1 - Meals at regular times , which help intestinal well-being

2 - Diet with fiber : it is recommended to consume at least 20-35 grams of fiber per day.

3 - Regular exercise : physical activity facilitates intestinal activity.

4 - Adequate hydration : drinking water helps maintain good stool transit which is softer

5 - Avoid taking laxatives without talking to your doctor.