Gastroenterologists disputed about the effect of chronic constipation on the development of colorectal cancer

An unbalanced, low-fiber diet and an inactive lifestyle often disrupt the bowels and lead to constipation.Scientists from Moscow and St. Petersburg met at a symposium of a unique format - gastrobattle. The event was held in the framework of the 112th International Spring School of Gastroenterology, Hepatology, RGA, with the support of Valenta Farm.

Famous gastroenterologists each defended their point of view on whether constipation is the cause of intestinal cancer.

Konstantin Alexandrovich Shemerovsky, MD, Professor, Head of the Department of Physiology of Visceral Systems Bykov Institute of Experimental Medicine drew the attention of colleagues to the harmful habit of people to suppress the urge to defecate. It is leads to constipation and threatens the development of colorectal cancer.

As examples, the expert cited a number of studies that prove that constipation increases the risk of developing colon cancer by a factor of 1.5 to 4: “Colon cancer has become younger. In St. Petersburg, colorectal cancer leads among oncological diseases: in 2010, 2,700 new cases were detected, in 2015, 3,654 cases were detected. The most important organ removing toxic and carcinogenic substances suffers because attention is not paid to functional constipation. Indoles, phenols, skatoles, cadaverine (cadaveric poison) should be released every day.Constipation also increases the risk of inflammatory diseases, Crohn's disease, ulcerative colitis, diverticulosis, hemorrhoids”, - said K.A. Shemerovsky.

The expert believes that the daily human ration should include at least 500 grams of fruits and vegetables that will saturate the body with dietary fiber and stimulate intestinal motility. A healthy person should have a bowel movement every morning after breakfast.

The expert recalled the resolution of the expert council, according to which for constipation it is recommended to prescribe drugs with a complex mechanism of action, normalizing intestinal motility, as well as the composition, and functions of its microflora (for example, lactitol): “Exportal® is based on lactitol. This mild, laxative is non-addictive and restores the microbiota through short-chain fatty acids. The drug is indicated for constipation and intestinal dysbiosis”.

Lactitol fermentation produces 10 times more butyric acid, which has an important role in cancer prevention, than fermentation of another widely used oligosaccharide.

His opposer, Yulia Olegovna Shulpekova, Ph.D. a doctor at the Department of Family Medicine of the Faculty of Postgraduate Professional Education (FPPO) of doctors of the Sechenov First Moscow State Medical University doubted the direct connection of constipation with the development of colorectal cancer. However, she did not rule out the likelihood of such a connection with the development of a certain type of constipation: “There is no clear correlation between the risk of colorectal cancer and the frequency and presence of constipation. Such a connection is possible with constipation with slow transit. And the use of dietary fiber and prebiotics is associated with a reduced risk of colorectal cancer, most likely due to the production of butyrate, butyric acid,” - the expert believes.

Irrational diet, lack of plant fiber in food leads to the separation of a dense layer of intestinal mucus, which protects cells from exposure to carcinogens: “As a rule, fibers and prebiotics, which include lactitol, quickly increase the amount of lactic and bifidobacteria and increase the concentration of essential short chain fatty acids, especially butyric acid. All this accelerates the transit of feces in the intestines and safely stimulates bowel”.

Gastro-battle was held online. Scientists do not agree on whether constipation is a triggering factor for colorectal cancer. However, they came to the general conclusion that fiber and lactitol are beneficial and prevent constipation.