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Other culprits include intestinal parasites or bacterial overgrowth

2020;32:e13858. wileyonlinelibrary.com/journal/nmo | 1 of 11 2020 John Wiley & Sons Ltd 1 | INTRODUCTION Constipation is a functional defecation disorder affecting up to 20% of the general population.1 It is characterized by infrequent bowel movements and difficulty in passing stools.2 Constipation affects patient life quality and can cause many disruptions such as significant psychological distress, abdominal distension, vomiting, gut obstruction, and perforation.3 Therefore, patients suffering from constipation are at higher risk to colonic cancer, hemor- rhoids, and other gastrointestinal illnesses.3 Constipation can be the result of insufficient fiber and fluid intake or side effec ts of medication.4 The intestinal mucosal barrier is covered by hydrate gel secreted by epithelial goblet cells which protect against me- chanical damage and chemical irritants in the lumen.5 The intact epithelial cell layer controls absorption of nutriments and allows passive transport of ions and water by the apical junctional com- plex

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