Constipation is not the scourge we think it is

December 21, 2000

Civilization and the colon: constipation as the "disease of diseases"

Western civilisation has been misled about the dangers of constipation, says medical historian James Whorton from the University of Washington. And doubts have now been raised about the effectiveness of bran cereals to ward off bowel cancer.

In this week's Christmas issue of the BMJ, Professor Whorton reports that for well over two centuries Britons and North Americans have been convinced that constipation is the fundamental "disease of civilization." The "compelling suspicion" that a stagnant bowel filled with putrefying matter can become an infective source for the rest of the body is not supported by the science, he says. There is no evidence that bowel toxins can leach into the circulation.

The Ancient Egyptians first suggested the notion that the body can poison itself as a result of constipation, known as intestinal autointoxication. And every subsequent civilization has enthusiastically embraced the idea, writes Professor Whorton. But constipation has done more to provide clinicians with the obvious solution to undiagnosable ailments and the manufacturers of cereals, laxatives, purgatives, and devices with a rich source of revenue, he says.

Even though intestinal autointoxication is no longer considered medically valid, writes Professor Whorton, Western civilization's preoccupation with its bowels and their movement, or lack of, continues unabated. But, he says, given recent trial evidence showing that high fiber cereals, and bran in particular, do not protect against bowel cancer, it is perhaps time to challenge this "cherished tenet of popular health. culture."

Professor James Whorton, Department of Medical History and Ethics, University of Washington School of Medicine, Seattle, USA


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