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This review aims to explore the relationship between constipation and abdominal pain and assess the evidence surrounding whether laxation improves abdominal pain and whether such a response to laxation differs between IBS\u2010C and functional constipation. In patients with functional constipation, increasing frequency of bowel motions by laxatives regardless of mechanism of action is associated with reductions in the severity of abdominal pain, supporting the role of constipation as a contributor to abdominal discomfort. In patients with IBS\u2010C, evidence from systematic reviews indicates that abdominal pain is driven by factors additional to constipation alone and that visceral analgesic modulation is also needed to optimize pain. Changing definitions of IBS\u2010C and heterogeneity in clinical trial design including endpoints have raised uncertainty about the comparative ability of older laxatives without known neuromodulatory effects to improve chronic abdominal pain compared with new secretagogues and prokinetics for the management of IBS\u2010C. While it is known that abdominal pain is associated with constipation and laxation contributes to relief of that pain, it remains unproven whether proposed visceral analgesic properties of new laxatives provide greater pain relief than laxation alone. However, it is likely that the response to laxation in IBS\u2010C is only part of the puzzle.<\/jats:p>","DOI":"10.1111\/jgh.14970","type":"journal-article","created":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T05:40:05Z","timestamp":1578116405000},"page":"1294-1301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Chronic constipation and abdominal pain: Independent or closely interrelated symptoms?"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-7327","authenticated-orcid":false,"given":"May Y W","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Alfred Health and Monash University  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology The Royal Melbourne Hospital and Melbourne University  Melbourne Victoria 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