{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:59:03Z","timestamp":1785517143326,"version":"3.56.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"International University of Health and Welfare"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic constipation is common, and the appropriate use of stimulant laxatives remains challenging. Although dependence due to habitual stimulant-laxative use is frequently observed, the long-term effects of regular use on dependence and tolerance have not been fully elucidated. This study aimed to characterize the clinical features and substance use-related symptoms associated with stimulant-laxative use in patients with chronic constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter prospective observational study was conducted at three centers and enrolled patients with chronic constipation, including those meeting the Rome IV criteria. Patients were categorized based on stimulant-laxative use into None (\n                      <jats:italic>N<\/jats:italic>\n                      ), Short-term\/Rescue (SR), and Regular (\n                      <jats:italic>R<\/jats:italic>\n                      ), defined as the use of stimulant laxatives\u2009\u2265\u20093 per week for\u2009&gt;\u20091\u00a0year. Substance use\u2013related symptoms were assessed using the CAGE-AID questionnaire (\u2265\u20092 point), and self-reported ICD-11 and DSM-5-TR substance use disorder criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 280 patients were included (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009197, SR\u2009=\u200951,\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u200932). Baseline characteristics did not differ significantly among groups. CAGE-AID positivity was 5.1%, 58.8%, and 90.6% in the\n                      <jats:italic>N<\/jats:italic>\n                      , SR, and\n                      <jats:italic>R<\/jats:italic>\n                      groups, respectively. ICD-11 criteria were markedly higher in the\n                      <jats:italic>R<\/jats:italic>\n                      group (65.6%) compared with the\n                      <jats:italic>N<\/jats:italic>\n                      (0%) and SR (11.8%) groups. DSM-5-TR criteria showed a similar pattern (0%, 15.7%, and 65.6%, respectively). The\n                      <jats:italic>R<\/jats:italic>\n                      group consistently demonstrated higher positive screening rates across all tools.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long-term stimulant-laxative use is associated with increased substance use-related symptoms and features suggestive of habituation in patients with chronic constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study was registered in the University Hospital Medical Information Network (UMIN000051617) on July 15, 2023.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00535-026-02455-9","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:55:53Z","timestamp":1780070153000},"page":"1123-1134","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dependence-related screening positivity among regular stimulant-laxative users with chronic constipation: a multicenter prospective observational study"],"prefix":"10.1007","volume":"61","clinical-trial-number":[{"clinical-trial-number":"umin000051617","registry":"10.18810\/umin-japan"}],"author":[{"given":"Yo","family":"Ishihara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eikichi","family":"Ihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Esaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Tomita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh Huy","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayumi","family":"Ohira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Horiuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Toriumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Nishizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Ohkubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Imajo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Oyamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Kurihashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Nakazato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5587-1386","authenticated-orcid":false,"given":"Takaomi","family":"Kessoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2455_CR1","first-page":"1","volume":"3","author":"M Camilleri","year":"2017","unstructured":"Camilleri M, Ford AC, Mawe GM, Dinning PG, Rao SS, Chey WD, et al. Chronic constipation. Nat Rev Dis Prim. 2017;3:1\u201319.","journal-title":"Nat Rev Dis Prim"},{"key":"2455_CR2","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13311","volume":"30","author":"D Krueger","year":"2018","unstructured":"Krueger D, Demir IE, Ceyhan GO, Zeller F, Schemann M. bis-(p-hydroxyphenyl)-pyridyl-2-methane (BHPM), the active metabolite of the laxatives bisacodyl and sodium picosulfate, enhances contractility and secretion in human intestine in vitro. Neurogastroenterol Motil. 2018;30:e13311.","journal-title":"Neurogastroenterol Motil"},{"key":"2455_CR3","doi-asserted-by":"publisher","first-page":"S143","DOI":"10.1002\/(SICI)1099-1573(1998)12:1+<S143::AID-PTR277>3.0.CO;2-G","volume":"12","author":"N Mascolo","year":"1998","unstructured":"Mascolo N, Capasso R, Capasso F. Senna: a safe and effective drug. Phytother Res. 1998;12:S143\u20135.","journal-title":"Phytother Res"},{"key":"2455_CR4","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1053\/j.gastro.2023.03.214","volume":"164","author":"L Chang","year":"2023","unstructured":"Chang L, Chey WD, Imdad A, Almario CV, Bharucha AE, Diem S, et al. American Gastroenterological Association-American College of Gastroenterology clinical practice guideline: pharmacological management of chronic idiopathic constipation. Gastroenterology. 2023;164:1086\u2013106.","journal-title":"Gastroenterology"},{"key":"2455_CR5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1080\/00365521.2018.1563806","volume":"54","author":"M Noergaard","year":"2019","unstructured":"Noergaard M, Traerup Andersen J, Jimenez-Solem E, Bring CM. Long-term treatment with stimulant laxatives: clinical evidence for effectiveness and safety? Scand J Gastroenterol. 2019;54:27\u201334.","journal-title":"Scand J Gastroenterol"},{"key":"2455_CR6","doi-asserted-by":"publisher","first-page":"175628482412496","DOI":"10.1177\/17562848241249664","volume":"17","author":"P Whorwell","year":"2024","unstructured":"Whorwell P, Lange R, Scarpignato C. Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge. Therap Adv Gastroenterol. 2024;17:17562848241249664.","journal-title":"Therap Adv Gastroenterol"},{"key":"2455_CR7","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.jpedsurg.2018.01.002","volume":"53","author":"A Vilanova-Sanchez","year":"2018","unstructured":"Vilanova-Sanchez A, Gasior AC, Toocheck N, Weaver L, Wood RJ, Reck CA, et al. Are senna-based laxatives safe when used as long-term treatment for constipation in children? J Pediatr Surg. 2018;53:722\u20137.","journal-title":"J Pediatr Surg"},{"key":"2455_CR8","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1002\/eat.22745","volume":"50","author":"R Elran-Barak","year":"2017","unstructured":"Elran-Barak R, Goldschmidt AB, Crow SJ, Peterson CB, Hill L, Crosby RD, et al. Is laxative misuse associated with binge eating? Examination of laxative misuse among individuals seeking treatment for eating disorders. Int J Eat Disord. 2017;50:1114\u20138.","journal-title":"Int J Eat Disord"},{"key":"2455_CR9","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1002\/eat.20365","volume":"40","author":"KJ Steffen","year":"2007","unstructured":"Steffen KJ, Mitchell JE, Roerig JL, Lancaster KL. The eating disorders medicine cabinet revisited: a clinician\u2019s guide to ipecac and laxatives. Int J Eat Disord. 2007;40:360\u20138.","journal-title":"Int J Eat Disord"},{"key":"2455_CR10","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","volume":"150","author":"F Mearin","year":"2016","unstructured":"Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology. 2016;150:1393-1407.e5.","journal-title":"Gastroenterology"},{"key":"2455_CR11","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1053\/j.gastro.2016.02.009","volume":"150","author":"SS Rao","year":"2016","unstructured":"Rao SS, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A, et al. Functional anorectal disorders. Gastroenterology. 2016;150:1430-1442.e4.","journal-title":"Gastroenterology"},{"key":"2455_CR12","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1097\/00004836-199806000-00014","volume":"26","author":"JS Joo","year":"1998","unstructured":"Joo JS, Ehrenpreis ED, Gonzalez L, Kaye M, Breno S, Wexner SD, et al. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited. J Clin Gastroenterol. 1998;26:283\u20136.","journal-title":"J Clin Gastroenterol"},{"key":"2455_CR13","first-page":"135","volume":"94","author":"RL Brown","year":"1995","unstructured":"Brown RL, Rounds LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wis Med J. 1995;94:135\u201340.","journal-title":"Wis Med J"},{"key":"2455_CR14","volume-title":"Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. Geneva, Switzerland: World Health Organization; 2024."},{"key":"2455_CR15","unstructured":"American Psychiatric Association (eds). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Arlington, VA; 2022."},{"key":"2455_CR16","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1046\/j.1525-1497.1997.00076.x","volume":"12","author":"MA Whooley","year":"1997","unstructured":"Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression: two questions are as good as many. J Gen Intern Med. 1997;12:439\u201345.","journal-title":"J Gen Intern Med"},{"key":"2455_CR17","first-page":"247","volume":"31","author":"A Otsuka","year":"1998","unstructured":"Otsuka A, Seto M, Kanno J, Uesato I. Development of the Scale for Suicide Ideation and study of factors related to suicidal ideation. Jpn J Couns Sci (Jpn). 1998;31:247\u201358.","journal-title":"Jpn J Couns Sci (Jpn)"},{"key":"2455_CR18","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1037\/0022-006X.47.2.343","volume":"47","author":"AT Beck","year":"1979","unstructured":"Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47:343\u201352.","journal-title":"J Consult Clin Psychol"},{"key":"2455_CR19","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/S0895-4356(98)00096-1","volume":"51","author":"S Fukuhara","year":"1998","unstructured":"Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol. 1998;51:1045\u201353.","journal-title":"J Clin Epidemiol"},{"key":"2455_CR20","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1080\/00365520510012208","volume":"40","author":"P Marquis","year":"2005","unstructured":"Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O. Development and validation of the patient assessment of constipation quality of life questionnaire. Scand J Gastroenterol. 2005;40:540\u201351.","journal-title":"Scand J Gastroenterol"},{"key":"2455_CR21","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s00535-013-0825-y","volume":"49","author":"H Nomura","year":"2014","unstructured":"Nomura H, Agatsuma T, Mimura T. Validity and reliability of the Japanese version of the patient assessment of constipation quality of life questionnaire. J Gastroenterol. 2014;49:667\u201373.","journal-title":"J Gastroenterol"},{"key":"2455_CR22","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1080\/003655299750025327","volume":"34","author":"L Frank","year":"1999","unstructured":"Frank L, Kleinman L, Farup C, Taylor L, Miner P Jr. Psychometric validation of a constipation symptom assessment questionnaire. Scand J Gastroenterol. 1999;34:870\u20137.","journal-title":"Scand J Gastroenterol"},{"key":"2455_CR23","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1007\/BF02056950","volume":"39","author":"F Agachan","year":"1996","unstructured":"Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996;39:681\u20135.","journal-title":"Dis Colon Rectum"},{"key":"2455_CR24","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1159\/000539788","volume":"105","author":"K Nakada","year":"2024","unstructured":"Nakada K, Nagahara A, Isshi K, Oshima T, Futagami S, Tanaka Y, et al. Development and validation of a simple and multifaceted instrument, chronic constipation: therapeutic efficacy and satisfaction test, for the clinical evaluation of patients with chronic constipation. Digestion. 2024;105:359\u201372.","journal-title":"Digestion"},{"key":"2455_CR25","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1136\/gut.10.10.842","volume":"10","author":"JM Hinton","year":"1969","unstructured":"Hinton JM, Lennard-Jones JE, Young AC. A new method for studying gut transit times using radioopaque markers. Gut. 1969;10:842\u20137.","journal-title":"Gut"},{"key":"2455_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare6020055","author":"S Tanaka","year":"2018","unstructured":"Tanaka S, Yabunaka K, Matsumoto M, Tamai N, Noguchi H, Yoshida M, et al. Fecal distribution changes using colorectal ultrasonography in older people with physical and cognitive impairment living in long-term care facilities: a longitudinal observational study. Healthcare (Basel). 2018. https:\/\/doi.org\/10.3390\/healthcare6020055.","journal-title":"Healthcare (Basel)"},{"key":"2455_CR27","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1146\/annurev.med.47.1.127","volume":"47","author":"EH Baker","year":"1996","unstructured":"Baker EH, Sandle GI. Complications of laxative abuse. Annu Rev Med. 1996;47:127\u201334.","journal-title":"Annu Rev Med"},{"key":"2455_CR28","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s40337-021-00502-9","volume":"9","author":"D Gibson","year":"2021","unstructured":"Gibson D, Benabe J, Watters A, Oakes J, Mehler PS. Personality characteristics and medical impact of stimulant-laxative abuse in eating disorder patients: a pilot study. J Eat Disord. 2021;9:146.","journal-title":"J Eat Disord"},{"key":"2455_CR29","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s13730-014-0120-7","volume":"3","author":"Y Shirasawa","year":"2014","unstructured":"Shirasawa Y, Fukuda M, Kimura G. Diuretics-assisted treatment of chronic laxative abuse. CEN Case Rep. 2014;3:209\u201314.","journal-title":"CEN Case Rep"},{"key":"2455_CR30","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.2165\/11898640-000000000-00000","volume":"70","author":"JL Roerig","year":"2010","unstructured":"Roerig JL, Steffen KJ, Mitchell JE, Zunker C. Laxative abuse: epidemiology, diagnosis and management: epidemiology, diagnosis and management. Drugs. 2010;70:1487\u2013503.","journal-title":"Drugs"},{"key":"2455_CR31","first-page":"62","volume":"106","author":"E Ihara","year":"2025","unstructured":"Ihara E, Manabe N, Ohkubo H, Ogasawara N, Ogino H, Kakimoto K, et al. Evidence-based clinical guidelines for chronic constipation 2023. Digestion. 2025;106:62\u201389.","journal-title":"Digestion"},{"key":"2455_CR32","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.70162","author":"Z Zhao","year":"2025","unstructured":"Zhao Z, Bai B, Wang S, Zhou Y, Yu P, Zhao Q, et al. Association of depression, anxiety, and somatic symptom with refractory constipation. Neurogastroenterol Motil. 2025. https:\/\/doi.org\/10.1111\/nmo.70162.","journal-title":"Neurogastroenterol Motil"},{"key":"2455_CR33","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1097\/01.psy.0000221359.35034.e7","volume":"68","author":"F Tozzi","year":"2006","unstructured":"Tozzi F, Thornton LM, Mitchell J, Fichter MM, Klump KL, Lilenfeld LR, et al. Features associated with laxative abuse in individuals with eating disorders. Psychosom Med. 2006;68:470\u20137.","journal-title":"Psychosom Med"},{"key":"2455_CR34","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.jpsychires.2024.12.043","volume":"182","author":"BA MacNeil","year":"2025","unstructured":"MacNeil BA, Gorman T, Maier J. Examining the associations between laxative use, substance use, depressive symptoms, and obsessions and compulsions in adults with an eating disorder. J Psychiatr Res. 2025;182:142\u20138.","journal-title":"J Psychiatr Res"},{"key":"2455_CR35","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1002\/eat.20267","volume":"39","author":"R Bryant-Waugh","year":"2006","unstructured":"Bryant-Waugh R, Turner H, East P, Gamble C, Mehta R. Misuse of laxatives among adult outpatients with eating disorders: prevalence and profiles. Int J Eat Disord. 2006;39:404\u20139.","journal-title":"Int J Eat Disord"},{"key":"2455_CR36","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/1054-139X(94)90266-6","volume":"15","author":"LF Marquart","year":"1994","unstructured":"Marquart LF, Sobal J. Weight loss beliefs, practices and support systems for high school wrestlers. J Adolesc Health. 1994;15:410\u20135.","journal-title":"J Adolesc Health"},{"key":"2455_CR37","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1373\/clinchem.2006.077883","volume":"53","author":"JH Shelton","year":"2007","unstructured":"Shelton JH, Santa Ana CA, Thompson DR, Emmett M, Fordtran JS. Factitious diarrhea induced by stimulant laxatives: accuracy of diagnosis by a clinical reference laboratory using thin layer chromatography. Clin Chem. 2007;53:85\u201390.","journal-title":"Clin Chem"},{"key":"2455_CR38","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1111\/jcpt.13204","volume":"45","author":"S Khan","year":"2020","unstructured":"Khan S, Khan SU. Adverse drug event of hypokalaemia-induced cardiotoxicity secondary to the use of laxatives: a systematic review of case reports. J Clin Pharm Ther. 2020;45:927\u201336.","journal-title":"J Clin Pharm Ther"},{"key":"2455_CR39","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1093\/fampra\/cmac108","volume":"40","author":"I Cifci","year":"2023","unstructured":"Cifci I, Gokdemir O, Aygun O, Guldal D. Evaluation of functional constipation frequency and related factors. Fam Pract. 2023;40:268\u201372.","journal-title":"Fam Pract"},{"key":"2455_CR40","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005685","volume":"95","author":"X Li","year":"2016","unstructured":"Li X, Feng R, Wu H, Zhang L, Zhao L, Dai N, et al. Psychological characteristics and GoNogo research of patients with functional constipation. Medicine (Baltim). 2016;95:e5685.","journal-title":"Medicine (Baltim)"},{"key":"2455_CR41","doi-asserted-by":"publisher","first-page":"6863037","DOI":"10.1155\/2024\/6863037","volume":"2024","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Gan X, Zhou C, Ye Z, He P, Liu M, et al. Relationship of regular laxative use, genetic susceptibility of depression, and risk of incident depression in the general population. Depress Anxiety. 2024;2024:6863037.","journal-title":"Depress Anxiety"},{"key":"2455_CR42","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s13104-021-05549-0","volume":"14","author":"Y Hosoda","year":"2021","unstructured":"Hosoda Y, Ohtani T, Hanazawa H, Tanaka M, Kimura H, Ohsako N, et al. Establishment of a Japanese version of the sick, control, one stone, fat, and food (SCOFF) questionnaire for screening eating disorders in university students. BMC Res Notes. 2021;14:142.","journal-title":"BMC Res Notes"}],"container-title":["Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02455-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00535-026-02455-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02455-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:04:01Z","timestamp":1785513841000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00535-026-02455-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["2455"],"URL":"https:\/\/doi.org\/10.1007\/s00535-026-02455-9","relation":{},"ISSN":["0944-1174","1435-5922"],"issn-type":[{"value":"0944-1174","type":"print"},{"value":"1435-5922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"22 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A. Nakajima receives grants and research support from Gilead, Mylan EPD, EA Pharma, Kowa, Taisho, and Biofermin, and is a consulting adviser for Gilead, Boehringer Ingelheim, BMS, Kowa, Astellas, EA Pharma, and Mylan EPD. E. Ihara receives lecture honoraria from Takeda Pharmaceutical Co., Ltd., EA Pharma Co., Ltd., Viatris Inc., and Mochida Pharmaceutical Co., Ltd. Y. Ishihara receives a research grant from Shionogi & Co., Ltd.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the International University of Health and Welfare Narita Hospital (June 27, 2023; Approval No. 23-Nr-009). Additional approvals were obtained from the Ethics Committee of Kanagawa Dental University Yokohama Clinic (Approval No. 957; September 9, 2023) and Iwasaki Internal Medicine Clinic (Approval No. 23-1; August 1, 2023).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from all participants prior to enrollment.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}