PATIENT PRESENTATION MARKER

Constipation symptoms

What this marker measures

The degree to which Rome IV criteria are met/not for functional constipation. This does not constitute a diagnosis.

Health categories/Interpretations informed by this marker

Gut function
● Slower colonic transit: patients with constipation symptoms may have slower colonic transit.^1–4
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Clinical features
‍● Lower GI symptoms: constipation symptoms are a commonly-reported lower GI symptom cluster that can affect quality of life.
^‍

Interpreting the result

PRESENT

Questionnaire responses indicate at least two of the above features, each for 6 months or more, with loose stools rarely or never.

PARTIALLY PRESENT

Questionnaire responses indicate at least one of: fewer than 3 bowel motions per week, or hard stools, straining, blockage, manual help or incomplete emptying more than 25% of the time.

NOT PRESENT

Questionnaire responses do not indicate constipation symptoms.

Patient management insights

DIETARY STRATEGIES

Add ground flaxseed: ground flaxseed may improve overall constipation symptoms in functional constipation.^5–7
GRADE C

Add kiwifruit: 2 green or 3 gold kiwifruit per day may improve overall constipation symptoms in functional constipation and IBS-C.^8–10
GRADE C

SUPPLEMENTATION

Take ginger: ginger may improve overall constipation symptoms in individuals with relapsing-remitting multiple sclerosis, functional dyspepsia and IBS.^11,12
GRADE C
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Take L. reuteri DSM 17938: Lactobacillus reuteri DSM 17938 may improve constipation in individuals with normal colonic transit time and lack of defaecatory dysfunction.¹³
GRADE C

Tips for patients discussion

"Your questionnaire responses show that you're experiencing some symptoms of constipation. These are common and can affect how you feel day to day. There are some simple options we can try, including foods such as kiwifruit or ground flaxseed, and we'll start with the one that best suits your situation."

Source references for all clinical associations, interpretation definitions, and patient management insights on this card.

1. Rao, S. S. C. et al. Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation. Clin Gastroenterol Hepatol 7, 537–544 (2009).
2. Saad, R. J. et al. Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls. Am J Gastroenterol 105, 403–411 (2010).
3. Bohlin, J. et al. Longer colonic transit time is associated with laxative and drug use, lifestyle factors, and symptoms of constipation. Acta Radiol Open 7, 2058460118807232 (2018).
4. Raahave, D. et al. Correlation of bowel symptoms with colonic transit, length, and faecal load in functional faecal retention. Dan Med Bull 56, 83–88 (2009).
5. Soltanian, N. & Janghorbani, M. A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type 2 diabetes. Nutr Metab (Lond) 15, 36 (2018).
6. Sun, J. et al. Effects of flaxseed supplementation on functional constipation and quality of life in a Chinese population: a randomized trial. Asia Pac J Clin Nutr 29, 61–67 (2020).
7. Ma, J. et al. Influence of flax seeds on the gut microbiota of elderly patients with constipation. J Multidiscip Healthc 15, 2407–2418 (2022).
8. Gearry, R. et al. Consumption of 2 green kiwifruits daily improves constipation and abdominal comfort—results of an international multicenter randomized controlled trial. Am J Gastroenterol 118, 1058–1068 (2023).
9. Eady, S. L. et al. The effects on immune function and digestive health of consuming the skin and flesh of Zespri® SunGold kiwifruit (Actinidia chinensis var. chinensis ‘Zesy002’) in healthy and IBS-constipated individuals. Nutrients 12, 1453 (2020).
10. Eady, S. L. et al. The effect of ‘Zesy002’ kiwifruit (Actinidia chinensis var. chinensis) on gut health function: a randomised cross-over clinical trial. J Nutr Sci 8, e18 (2019).
11. Foshati, S. et al. The effects of ginger supplementation on common gastrointestinal symptoms in patients with relapsing-remitting multiple sclerosis: a double-blind randomized placebo-controlled trial. BMC Complement Med Ther 23 (2023). doi:10.1186/s12906-023-04227-x
12. Baek, H.-I. et al. Efficacy and safety of steamed ginger extract for gastric health: a randomized, double-blind, placebo-controlled multi-center clinical trial. Food Funct 16, 7316–7329 (2025).
13. Riezzo, G. et al. Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation. Benef Microbes (2018). doi:10.3920/BM2017.0049