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Functional constipation (FC) is a common clinical condition without any specific physiological causes with economic cost and adverse effects on patients' quality of life. The present study aimed to evaluate the causes of nonobstructive constipation in traditional Persian medicine and its prevalence in patients with functional constipation by content analysis of patients' interviews and clinical exams. In this study, almost two thirds of the patients with functional constipation had mild to severe cold distemperament of the gastrointestinal system, and in almost half of them the signs and symptoms were compatible with dry distemperament of the gastrointestinal. This observational study reports high prevalence of gastrointestinal system distemperaments in patients with functional constipation. According to the results, we can consider the proposed management of distemperaments in traditional Persian medicine for functional constipation treatment and pathophysiology explanation. This project is a novel study that provides the opportunity for investigating the epidemiological aspects of these distemperaments and their relationship with functional constipation., (© The Author(s) 2015.)

Objective: To evaluate the efficacy of Malva sylvestris L. flowers extract for treatment of FC., Method: Adults with FC were allocated to receive the M. sylvestris L. flowers aqueous extract syrup (MSL, 1 g extract/day) or placebo for four weeks. Frequency of constipation symptoms and stool forms were assessed every week. Self-reported improvement was assessed after treatment., Results: Compared with placebo, more increase was observed in defecation frequency (F = 18.8, P < 0.001) and more decrease was observed in frequency of all constipation symptoms by MSL (F = 16.5 to 25.3, all P values <0.001). Also, the MSL group experienced more reduction in frequency of hard stool forms (45.4% vs. 9.1%, P < 0.001) and reported more improvement in all symptoms (all P values <0.01) than placebo., Conclusion: The M. sylvestris L. flowers aqueous extract is efficacious and safe for the treatment of FC in adult patients. Investigating the mechanisms of action is warranted. IRCT2014031617032N1., (Copyright © 2015 Elsevier Ltd. All rights reserved.)