Core Viewpoint - The incidence of chronic constipation is rising in China, with a prevalence rate between 4% and 10%, particularly higher in women and increasing with age [1] Group 1: Patient Demographics and Impact - The number of chronic constipation patients at Tianjin People's Hospital has significantly increased due to changes in diet, lifestyle, and psychological factors [1] - Chronic constipation severely affects the quality of life, leading many patients to self-medicate or rely on long-term prescriptions, which can pose safety risks and delay diagnosis of underlying conditions [1] Group 2: Types of Laxatives - **Bulk-forming Laxatives**: Examples include polycarbophil and wheat cellulose; they are safe for long-term use and suitable for mild constipation, especially in pregnant women and the elderly [2] - **Osmotic Laxatives**: Examples include polyethylene glycol 4000 and lactulose; they soften stool and stimulate bowel movement, suitable for mild to moderate constipation [2] - **Stimulant Laxatives**: Examples include bisacodyl and senna; they act quickly but can lead to dependency and electrolyte imbalances if used long-term [3] - **Lubricant Laxatives**: Examples include glycerin suppositories and liquid paraffin; they provide rapid relief for short-term constipation [3] - **Prokinetic Agents**: Examples include mosapride and itopride; they enhance gut motility and are used in conjunction with other laxatives [3] - **Secretagogues**: Examples include linaclotide; they are prescribed for chronic constipation unresponsive to standard treatments [3] - **Probiotics**: Examples include various strains of Bacillus and Bifidobacterium; they help restore gut flora and improve bowel function, recommended for long-term use [3]

Core Viewpoint - The article highlights a new breakthrough in addressing chronic constipation through gut microbiota regulation, as outlined in the "Clinical Application of Gut Microecology in Chronic Constipation Expert Consensus (2024 Edition)" released by authoritative institutions [1]. Group 1: Gut Microbiota and Chronic Constipation - The consensus indicates that dysbiosis in gut microbiota and chronic constipation are interrelated, creating a vicious cycle [1]. - Patients with constipation show a significant reduction in beneficial bacteria (e.g., Bifidobacterium, Lactobacillus) and an increase in harmful bacteria (e.g., certain Enterobacteriaceae) [1]. - The imbalance in gut microbiota affects the production of short-chain fatty acids that promote intestinal motility and disrupts neurotransmitter (e.g., serotonin) and bile acid metabolism, leading to decreased gut motility [1]. Group 2: Broader Implications of Constipation - The consensus emphasizes the "cross-border impact" of constipation, linking it to various comorbidities through the "gut-brain axis" [1]. - The Wenden District People's Hospital has initiated the application of microbiota transplantation in digestive diseases, liver diseases, and tumor-related diseases, with plans to expand into psychological and endocrine disorders [1].